The Commonwealth Fund Connection

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

Health Reform Law Could Extend Coverage to 13.7 Million Uninsured Young Adults

Most of the 13.7 million currently uninsured young adults in the U.S. could gain health insurance coverage under the recently enacted health reform law, according to a new report from The Commonwealth Fund. The law's provision requiring health insurers to extend dependent coverage up to age 26 for young adults on their parents' plans will go into effect in September 2010, and could provide coverage to an estimated 1.2 million young adults next year, of whom 650,000 are uninsured and 550,000 have coverage in the individual market and would likely switch to more comprehensive, affordable coverage through their parents' plans. In 2014, expanding Medicaid eligibility could provide health insurance for up to 7.1 million uninsured young adults, and insurance exchanges and premium subsidies for lower- and moderate-income families could provide coverage for more than 6 million uninsured young adults.

"The Commonwealth Fund has issued this report annually since 2003, and every year the results show increasing numbers of young adults who cannot afford the health care they need and end up skipping needed care or struggling with medical debt," said Sara Collins, lead author and Commonwealth Fund Vice President for Affordable Health Insurance. "This new legislation will not only make coverage more affordable, but also more comprehensive and secure, allowing young adults to pursue careers and start families without having to worry about losing their health insurance or falling into medical debt."

You can view a video or listen to a podcast from a May 24 Alliance for Health Reform/Commonwealth Fund briefing on health reform and young adults.

Health Reform's Impact: Health Spending to Shrink by $590 Billion, Family Premiums by $2,000, Over Next Decade
New estimates from Center for American Progress Senior Fellow and Harvard economist David Cutler, Commonwealth Fund President Karen Davis, and Commonwealth Fund Senior Research Associate Kristof Stremikis show that the health reform law could reduce annual growth in health care spending from 6.3 percent to 5.7 percent over the next decade—a savings of $590 billion—while lowering annual premiums by nearly $2,000 for the typical family and extending coverage to 32 million previously uninsured individuals by 2019. The analysis concludes that significant payment and system reform provisions in the Patient Protection and Affordable Care Act will begin to realign incentives within the health care system and reduce cost growth to a greater extent than predicted by the Congressional Budget Office and the Centers for Medicare and Medicaid Services' Office of the Actuary.
Assessing Community Health Centers' Capacity to Provide High-Quality Care

Community health centers that are closely affiliated with hospitals have fewer difficulties getting their patients appointments for specialty procedures like X-rays, diagnostic tests, and visits with specialist physicians, according to a new Commonwealth Fund survey of community health centers. Centers without hospital affiliations reported they had more difficulty getting off-site specialty appointments regardless of a patient's insurance status—pointing to the need for incentives that will promote connections between health centers and specialty care providers.

Listen to a podcast in which Michelle M. Doty, assistant vice president and director of survey research at The Commonwealth Fund and lead author of the report, Melinda Abrams, assistant vice president and director of the Commonwealth Fund's Patient-Centered Coordinated Care program, and Paul Kaye, chief medical officer of Hudson River HealthCare, a network of 16 community health centers, discuss the survey findings and strategies to help centers prepare for the anticipated increase in demand for services under health reform's insurance expansions.

A Nationwide Survey of Patient-Centered Medical Home Demonstration Projects
The medical home has been promoted as a model for delivering comprehensive, coordinated, patient-centered health care. In interviews with leaders at 26 demonstration sites around the country where the patient-centered medical home is being pilot-tested, researchers found substantial diversity in terms of size, scope, and design. Most of the projects use a payment approach that combines fee-for-service payments with a fixed, monthly case management fee and bonuses based on clinical performance.
Lessons from Efforts to Improve Primary Care in the U.K.
An ambitious program in the United Kingdom that links physician payment increases to achievement of quality-of-care targets reduced a shortage of general practitioners, improved income and morale, and reduced working hours, a new study found. Socioeconomic disparities in chronic disease treatment narrowed as well, but the program's impact on medical professionalism and long-term patient outcomes has yet to be determined.
Sharing Commonwealth Fund Research and Analysis
Users of the Commonwealth Fund Web site can share publications, newsletters, data, surveys, and other resources through Facebook, Twitter, and other media by clicking on the "Share" buttons at the top of most Web pages. Users also can save content to their Commonwealth Fund library (through a simple registration process) and e-mail Web content to colleagues.
AHCJ Media Fellowships on Health Performance

The Commonwealth Fund is pleased to announce the Association of Health Care Journalists (AHCJ) Media Fellowships on Health Performance, a 10-month program enabling mid-career journalists to pursue a significant reporting project examining health care systems. With Commonwealth Fund support, reporters attend seminars on health system performance and consult with AHCJ fellowship leaders and experts. Fellows may also receive financial support for field reporting, health data, or other research needs.

The fellows continue working their regular jobs and pursue the project with the support of their newsrooms, which will publish or air the projects. Freelance reporters are also welcome to apply.

To learn more about the fellowships or to apply, visit the AHCJ Web site.
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/.