The Commonwealth Fund Connection

The Commonwealth Fund Connection is a roundup of recent Fund publications, charts, multimedia, and other timely content. 

  • July 24, 2009 Issue
Individual Insurance Market Failing American Families
The individual health insurance market is not a viable option for the majority of uninsured adults, according to this new Commonwealth Fund analysis. Seventy-three percent of people who tried to buy insurance on their own in the last three years did not purchase a policy, primarily because premiums were too high. An associated video looks at how people contending with the individual insurance market would benefit from the creation of a national health insurance exchange, through which a choice of affordable insurance plans with standard benefits and nondiscriminatory practices would be available.
How Health Care Reform Can Lower the Costs of Insurance Administration
The United States leads all industrialized countries in the share of national health care expenditures devoted to insurance administration. This issue brief examines the sources of insurance administrative costs in this country and describes how a private–public approach to health care reform could substantially lower such costs.
Chronic Burdens: The Persistently High Out-of-Pocket Health Care Expenses Faced by Many Americans with Chronic Conditions
This Commonwealth Fund issue brief, prepared by Peter Cunningham, Ph.D., of the Center for Studying Health System Change, shows that nearly 40 percent of nonelderly adults with three or more chronic conditions had out-of-pocket expenses and premiums exceeding 5 percent of income for two consecutive years, compared with 20 percent of people who had a single chronic condition and 14 percent who had no chronic conditions.
Alternative Paths to a High Performance U.S. Health System: Impact of Three Approaches on Health Care Spending
National health reform efforts are seeking to expand insurance coverage, improve quality of care, and "bend the health care cost curve." This Policy Points brief highlights data from a recent Commonwealth Fund report that analyzed alternative approaches to defining the role of a public plan and presented estimates of the potential impacts on health spending compared with projected trends.
Politics and Policy in State Health Reform
In this report cofunded by The Commonwealth Fund and published on the Robert Wood Johnson Foundation's State Coverage Initiatives Web site, Walter Zelman, Ph.D., chair of the Department of Health Science at California State University, Los Angeles, and a veteran of President Clinton’s health reform effort, offers a cautionary tale for policymakers and others seeking once again to achieve comprehensive health care reform.
Helping Health Care Providers Put Policy into Practice
Given the tightly packed schedules of health care providers, there can be a lag time of as long as a decade in acting on national recommendations for best practices. The latest episode of New Directions in Health Care: The Commonwealth Fund Podcast focuses on public–private improvement partnerships, a concept developed with Commonwealth Fund support by the Vermont Child Health Improvement Program, to provide regional training, site visits, and more to speed the process of change.
New Performance Data Now Available on
We have updated with the latest performance data on the process-of-care and hospital patient experience measures that are publicly reported by the Centers for Medicare and Medicaid Services. Users of the site can conduct side-by-side comparisons of 4,500 hospitals nationwide, track performance over time against numerous benchmarks, and download tools to improve health care quality. The latest update shows evidence of improvement on one important indicator of patients' experiences, from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. In March 2008, the initial reporting period, about 2,500 hospitals reported that patients gave them a nine or 10 (on a scale of one to 10, with 10 being the highest) in response to the question: "How do patients rate the hospital overall?" In the most recent update, more than 3,700 hospitals earned a patient rating of nine or 10 overall.
Regina Benjamin Picked for Surgeon General
President Obama announced last week that he has chosen Regina Benjamin, M.D., of Alabama's Bayou La Batre Rural Health Clinic, to serve as surgeon general. With Commonwealth Fund support, John Wasson, M.D., of Dartmouth Medical School and Dr. Benjamin developed the online survey tool,—launched in 2004—which allows people to assess their health and receive information tailored to their particular needs.

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