Publications: Vulnerable Populations

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High-Performance Health Care for Vulnerable Populations: A Policy Framework for Promoting Accountable Care in Medicaid

November 16, 2012 - This report explores how state Medicaid agencies might align with and build on the Medicare Shared Savings Program, which rewards groups of providers that meet cost and quality benchmarks by working together to coordinate patients' care in accountable care organizations.

Fund Report

The Influence of Hospice Use on Nursing Home and Hospital Use in Assisted Living Among Dual-Eligible Enrollees

November 13, 2012 - In this study, Commonwealth Fund–supported researchers examined over 12 months the outcomes of assisted living residents who are dually eligible for Medicare and Medicaid, seeking to determine the association of hospice use with nursing home and hospital admission.

In Brief

Including Safety-Net Providers in Integrated Delivery Systems: Issues and Options for Policymakers

August 14, 2012 - This issue brief explores key design considerations for including safety-net providers in integrated delivery systems, which provide or arrange a coordinated continuum of health care services to a defined population, and hold themselves accountable for the outcomes and health status of their patients.

Issue Brief

Addressing Women's Health Needs and Improving Birth Outcomes: Results from a Peer-to-Peer State Medicaid Learning Project

August 8, 2012 - This brief examines seven Medicaid agencies that have worked to develop the programs, policies, and infrastructures needed to identify and reduce women's health risks either prior to or between pregnancies in an effort to lower high rates of maternal mortality, infant mortality, and preterm births.

Issue Brief

The Post-Katrina Conversion of Clinics in New Orleans to Medical Homes Shows Change Is Possible, But Hard to Sustain

August 6, 2012 - Given the right incentives, safety-net primary care clinics can make the transition to become patient-centered medical homes. The results of the New Orleans program, however, underscore that primary care transformation is a long process, and one difficult to achieve and sustain.

In the Literature

Strained Local and State Government Finances Among Current Realities That Threaten Public Hospitals' Profitability

August 6, 2012 - This Commonwealth Fund study of 150 safety-net hospitals finds that, to overcome declining government subsidies, safety-net hospitals governed by elected politicians must focus on cost control, quality improvement, and services that attract insured patients.

In the Literature

Association Between Patient-Centered Medical Home Rating and Operating Cost at Federally Funded Health Centers

June 26, 2012 - This Commonwealth Fund-supported study of federally funded health centers calls for evidence-based payment for medical homes.

In the Literature

Achieving Better Quality of Care for Low-Income Populations: The Roles of Health Insurance and the Medical Home in Reducing Health Inequities

May 16, 2012 - A new analysis of the Commonwealth Fund 2010 Biennial Health Insurance Survey demonstrates that when low-income adults have both health insurance and a medical home, they are less likely to report cost-related access problems, more likely to be up-to-date with preventive screenings, and report greater satisfaction with the quality of their care.

Issue Brief

Recommended Core Measures for Evaluating the Patient-Centered Medical Home: Cost, Utilization, and Clinical Quality

May 16, 2012 - This Commonwealth Fund data brief describes how more than 70 researchers came together as part of the Patient-Centered Medical Home Evaluators’ Collaborative to identify a set of standardized measures to assess patient-centered medical homes.

Data Brief

Integrating Immigrants into the U.S. Health System

May 11, 2012 - The authors of this Commonwealth Fund-supported study argue that physicians must develop competencies to provide culturally sensitive care to a more diverse patient population.

In Brief

Pay-for-Performance Programs to Reduce Racial/Ethnic Disparities: What Might Different Designs Achieve?

April 9, 2012 - With Commonwealth Fund support, researchers used Hospital Quality Alliance data on more than 4 million patients at 4,500 hospitals to analyze the effects of different pay-for-performance designs on disparities in care between minority and white patients.

In Brief

Toward a High Performance Health Care System for Vulnerable Populations: Funding for Safety-Net Hospitals

March 8, 2012 - This new report prepared for The Commonwealth Fund Commission on a High Performance Health System offers a series of recommendations to help shore up safety-net hospitals and ensure they can continue to provide high-quality care to low-income, vulnerable patients once the health reform law is fully implemented.

Fund Report

Guiding Transformation: How Medical Practices Can Become Patient-Centered Medical Homes

February 27, 2012 - The patient-centered medical home has been proposed as a model for transforming primary care and improving efficiency and effectiveness in the health care system. This report outlines and describes the changes that most medical practices would need to make to become patient-centered medical homes.

Fund Report

New Opportunities for Integrating and Improving Health Care for Women, Children, and Their Families

February 8, 2012 - This issue brief highlights the efforts of Colorado, Florida, Ohio, and Vermont to integrate health care services for low-income women and children, especially through state Title V maternal and child health programs.

Issue Brief

The Income Divide in Health Care: How the Affordable Care Act Will Help Restore Fairness to the U.S. Health System

February 7, 2012 - Adults in low- and moderate-income families are more likely to be uninsured, to lack a regular source of health care, and to struggle to get the health care they need compared to those in higher-income families, according to this new Commonwealth Fund survey.

Issue Brief