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Commission Corner

The Commonwealth Fund Commission on a High Performance Health System has had a busy summer, beginning with the publication of the second edition of its National Scorecard, Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2008. The 2008 Scorecard rates U.S. health system performance on 37 core indicators for a score of 65 out of 100, a slight decline from the 2006 score of 67. The report demonstrates that access to health care declined significantly during this period and that health system efficiency remains low. However, selected quality metrics have shown improvement. Overall, the 2008 Scorecard indicates that, despite pockets of progress, the U.S. health system continues to operate far below the performance of leading nations, delivery systems, states, and regions.

The Commission hosted a briefing on Capitol Hill for congressional and administration staff to discuss the National Scorecard's implications and how to achieve higher value for the resources spent on health care.

The Commission held its summer meeting in Providence, Rhode Island, in July. The main purpose was to think through potential recommendations for the next president and Congress in order to move the country toward higher performance in health care. Taking advantage of local expertise, the Commission had the opportunity to hear from Rhode Island Lieutenant Governor Elizabeth Roberts about how the state has worked toward high performance in a collaborative setting. Rhode Island Health Insurance Commissioner Chris Koller relayed how the state uses creative regulation to improve value in the insurance market, and Jon Kingsdale, executive director of the Commonwealth Health Connector, shared lessons learned from Massachusetts' Connector.

In August, the Commission published Organizing the U.S. Health Care Delivery System for High Performance, which examines the detrimental effects of fragmentation in the current system and offers policy recommendations to establish greater coordination across providers and care settings. Accompanying the report is a Commission data brief based on a survey of U.S. adults, Public Views on U.S. Health System Organization: A Call for New Directions. The data brief reports that eight of 10 respondents believe the U.S. health system needs fundamental change or complete rebuilding. Adults want their health care to be more patient-centered and integrated and support a greater role for health information systems and teamwork in improving care.

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