The Commonwealth Fund Connection

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

Safe, Reliable Health Care Systems: Will Health Reform Legislation Help Get Us There?

Throughout the lengthy debate over health insurance expansions and new regulations in the recently passed health care reform legislation, relatively little attention has been paid to the parts of the law that seek to strengthen the delivery system. As discussed in a Commonwealth Fund blog post, several of these less-noted provisions could help build safer, more reliable health care systems—by promoting transparency and performance reporting, encouraging organized care, reforming the malpractice system, and supporting research on evidence-based care.

According to the authors, Vice President Anne-Marie J. Audet and Executive Vice President for Programs Stephen C. Schoenbaum, the "health reform law uses both carrots and sticks to help build a system of reliable care for every patient, every time." It does so by:

  • demanding greater transparency on provider performance;
  • fostering greater collaboration and teamwork among providers;
  • encouraging reform of our current system of medical malpractice; and
  • creating a private, nonprofit Patient-Centered Outcomes Research Institute to conduct comparative clinical effectiveness research.

New Study: Streamlining Administration in Health Care Would Save Billions
Excessive administrative complexity costs physicians nearly 12 percent of their net revenue derived from patient care, according to a new study, published by Health Affairs. Streamlining the administrative processes associated with the billing and payment of medical providers, researchers estimate, could save $7 billion annually and save four hours per week of physicians' time and five hours of support staffs' time. The study was supported by The Commonwealth Fund and the Robert Wood Johnson Foundation.
Evidence-Based Pediatric Care: What Are We Missing?
Over the past two decades, pediatric practice has shifted focus from disease and infection to health promotion and risk reduction. Yet the tools to measure the effectiveness of pediatric care have not kept pace with this shift, according to the authors of this issue brief. This means that attempts to promote evidence-based care under the new health reform legislation may inadvertently neglect important aspects of pediatric care, including behavioral and developmental screening. The researchers propose a broad framework for evaluating pediatric practice that should be of value to clinicians as well as policymakers.
Medicare End-of-Life Benefit for Nursing Home Residents
In this Commonwealth Fund–supported study, the authors call for a new Medicare benefit to support end-of-life care for those spending their final days in a nursing home. Arguing that the current hospice benefit is a poor fit with the nursing home setting, the authors recommend a benefit that would enable nursing home residents to receive individualized palliative and psychosocial services in addition to rehabilitative services.
Federal Funding to Reduce Readmissions
As described in a recent Health Affairs blog post, the new health reform law provides $500 million to support partnerships between hospitals and community-based organizations that aim to provide evidence-based care for Medicare beneficiaries at high risk of readmission. The provision grew out of the Care Transitions Intervention, which has been successfully implemented in 14 states and led to significantly reduced readmissions. Proven strategies to improve care transitions are described in a new resource developed by The Commonwealth Fund, the John A. Hartford Foundation, and the Health Research and Educational Trust: The Health Care Leader Action Guide to Reduce Avoidable Readmissions.
Health Care Reform: What's in the Law, and What Happens Next?

Commonwealth Fund experts have been fielding questions about the new health care reform legislation and what it will mean in the months and years ahead. View a presentation on the law's main provisions; a Commonwealth Fund–developed supplement for the Columbia Journalism Review, What Will Happen Under Health Reform—And What's Next?; a webcast, "What's in There?: An Ask-the-Experts Overview of the Health Reform Law"; and other resources on the Commonwealth Fund's Web site.

To help navigate through the legislation, we have also created the following timelines:

Bright Futures Training and Implementation Materials
Among its many provisions to improve health insurance coverage, the 2010 health reform legislation mandates coverage of preventive services for infants, young children, and adolescents, including evidence-based preventive care and screenings as outlined in comprehensive "Bright Futures" guidelines developed for the Health Resources and Services Administration by the American Academy of Pediatrics. New Bright Futures training and implementation materials for pediatric practices are available for free download. The materials are informed by the results of a pilot project supported by The Commonwealth Fund, in which 15 practices across the nation tested strategies to improve care.
2011–12 Harkness Fellowships Open to Applicants

The 2011–12 Harkness Fellowships are open to applicants from Australia, Germany, the Netherlands, New Zealand, Norway, Switzerland, and the United Kingdom. The deadline for receipt of applications is September 13, 2010.

The Commonwealth Fund's Harkness Fellowships in Health Care Policy and Practice provide a unique opportunity for mid-career professionals—academic researchers, government policymakers, clinicians, managers, and journalists—to spend up to 12 months in the United States conducting a policy-oriented research study, working with leading U.S. health policy experts and gaining in-depth knowledge of not only the U.S. health care system, but also the health care systems in the fellows' home countries. For details and the application form, please visit http://www.commonwealthfund.org/Fellowships/Harkness-Fellowships.aspx.

2011–12 Australian-American Health Policy Fellowship Open to Applicants

On behalf of the Australian Government Department of Health and Ageing, The Commonwealth Fund is pleased to announce the 2011–12 Australian-American Health Policy Fellowship. The deadline for receipt of applications is August 15, 2010.

The Australian-American Health Policy Fellowship offers a unique opportunity for outstanding, mid-career U.S. professionals—academics, government officials, clinical leaders, decision-makers in managed care and other private health care organizations, and journalists—to spend up to 10 months in Australia conducting research and working with leading Australian health policy experts on issues relevant to both countries. For further information and to obtain an application, please see http://www.commonwealthfund.org/fellowships/.

NYAM Lecture Series: Health Reform and New York State
On May 12, the New York Academy of Medicine's (NYAM) Section on Health Care Delivery will present "Health Care Reform and Access to Coverage," the final lecture in its series on health care reform and New York State. For more information or to register, visit the NYAM Web site.
Jon Kingsdale Joins Fund's Commission
This month, The Commonwealth Fund's Commission on a High Performance Health System welcomed a new member, Jon M. Kingsdale, Ph.D., the executive director of the Commonwealth Health Insurance Connector Authority. The Connector Authority was established in 2006 under Massachusetts' landmark health reform legislation. As its founding executive director, Kingsdale leads key initiatives to make health insurance universally available and to reform health care financing in Massachusetts. He received a doctorate in economic history from the University of Michigan and his bachelor's degree from the University of Pennsylvania. He has taught at the Harvard School of Public Health, the Boston University School of Public Health, and Tufts University School of Medicine. Visit the Commonwealth Fund Web site to see all of the Commission members and learn more about its work.