The Commonwealth Fund Connection

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

  • September 14, 2009 Issue
Out of Options: Why So Many Workers in Small Businesses Lack Affordable Health Insurance, and How Health Care Reform Can Help
Small-business owners and employees are among those who stand to benefit the most from provisions in some of the current health reform proposals under consideration by Congress, according to this Commonwealth Fund study. Provisions to extend health care coverage to everyone and repair the small group insurance market would alleviate high premium costs, high broker fees, underwriting, and a lack of transparency about benefit packages that owners of small businesses currently face.
New Testimony: Time to Reverse the Trend in the Uninsured
Last week, the Census Bureau released data showing that the number of uninsured Americans rose by 0.6 million, from 45.7 million in 2007 to 46.3 million in 2008. This increase, the result of a continuing decline in the number of individuals with employer-sponsored coverage, would have been much worse without the parallel growth in government-provided insurance, said Commonwealth Fund president Karen Davis in her invited testimony last Thursday before the U.S. House of Representative's Joint Economic Committee and a statement issued by the Fund. Public programs, Davis said, covered 4.4 million more people in 2008 than in 2007, including an additional 3 million covered by Medicaid.
How Will Comprehensive Reform Improve Health Care for Americans? A Resource for Journalists from The Commonwealth Fund
Commonwealth Fund supplement to the September/October 2009 issue of the Columbia Journalism Review provides journalists and others with an evidence-based context for understanding how both lack of coverage and spiraling health care costs directly affect American families and businesses, and how comprehensive health reform can address these problems.
Reforming Long-Term Care in the United States: Findings from a National Survey of Specialists
Long-term care specialists—including consumer advocates, providers, public officials, and policy experts—who participated in a Commonwealth Fund-supported national survey generally agreed on the need for long-term care reform. Key groups supported the establishment of government-sponsored financing strategies, a shift toward home- and community-based care, offering payment incentives to improve quality, and more effective regulation of nursing homes, home health care agencies, and assisted-living facilities.
New Long-Term Care Tools
Three Commonwealth Fund-supported tools pertaining to long-term care are now available through summaries in the Innovations section of 

The Family Council Manual and Toolkit: A Guide for Creating and Sustaining Effective Nursing Home Family Councils is a new practical handbook for family members interested in setting up a new family council as well as a comprehensive resource for more experienced leaders facing new issues or wanting to reinvigorate an existing council. The manual and toolkit were developed by FRIA, a nonprofit consumer advocacy group.

With support from the Centers for Medicare and Medicaid Services and partial funding from The Commonwealth Fund, the Rhode Island Department of Health conducted a project called the Individualized Care Pilot (ICP), which used the mandated federal regulatory survey process to motivate and enable the state's nursing homes to fully realize the potential for resident-centered care inherent in the Nursing Home Reform Law. The Individualized Care Pilot Toolbox, which outlines the project design and offers surveyor training materials, is now online.

Based on the experiences of more than 400 nursing homes, the online Staff Stability Toolkit is designed to serve as an evidence-based resource for nursing homes that are working to reduce staff turnover. The toolkit, developed by Quality Partners' of Rhode Island with Commonwealth Fund support, identifies some of the perverse incentives, such as giving hiring bonuses rather than retention bonuses, and poor management practices, such as ineffective hiring and scheduling, that contribute to high staff turnover in nursing homes. It also offers guidance on ways to sustain employee stability.
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New Research Finds Congressional Budget Office Has Underestimated Savings and Overestimated Costs from Health Policy Changes
In an August 26th New York Times op-ed, Jon Gabel wrote that over the last 30 years, the Congressional Budget Office (CBO), which assesses the costs of health reform and other legislation as it moves through Congress and is widely respected for its competence and integrity, has underestimated the amount of savings and overestimated the costs that major changes in the health care system would bring. Drawing on Commonwealth Fund–supported research, Gabel, a senior fellow at the National Opinion Research Center of the University of Chicago, analyzed CBO's forecasts of three major changes in the Medicare program relative to their ultimate outcomes.
Coverage for All, Paid for Responsibly
Commonwealth Fund president Karen Davis contributed her reaction to President' Obama's health reform speech to the New York Times health care debate blog, "Prescriptions," on September 9. In the blog post, she observed that "President Obama reminded Congress and the public of the goals of health reform, which have often gotten lost in the din of the debate."
Join a Webinar on CHIP Implementation Choices

A number of experts believe that the Children's Health Insurance Program (CHIP) Reauthorization Act of 2009 has the potential to transform health care for the children it serves. In a recent Commonwealth Fund report, researchers led by Lisa Simpson of the Child Policy Research Center at Cincinnati Children’s Hospital Medical Center offer their recommendations for improving CHIP outreach and enrollment, as well as the quality of care enrollees receive. Also see a Web feature that highlights provisions and recommendations.

You can hear Lisa Simpson and other speakers outline the key features of the law and provide implementation guidance in a webinar on Tuesday, September 15, at 2 p.m., E.D.T. The webinar is cosponsored by the National Academy of State Health Policy (NASHP), the Association of Maternal and Child Health Programs, and the National Initiative for Children's Healthcare Quality (NASHP). The event will feature coauthors Lisa Simpson, professor and director of the Child Policy Research Center at Cincinnati Children's Hospital Medical Center, and Jocelyn Guyer, co-executive director of the Georgetown Center for Children and Families, and Catherine Hess, senior program director at NASHP.

Watch a Webinar on Health Reform
A recent "Talking Health" webinar, presented by the Association of Health Care Journalists (AHCJ), Columbia Journalism Review (CJR), The Commonwealth Fund, and the CUNY Graduate School of Journalism, revealed what top journalists think of the coverage of health reform. During the event, held September 9, moderator Mike Hoyt, editor of CJR, directed audience questions to panelists Kay Lazar of the Boston Globe, Karen Tumulty of Time, Robert Laszewski of Health Care Policy and Marketplace Review, and Trudy Lieberman, director of the Health and Medicine Reporting Program at CUNY Graduate School of Journalism, and AHCJ board president. A recording of this event and the presentations are now available.

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