The Commonwealth Fund Connection

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

16.6 Million Small Business Employees Stand to Benefit from ACA

More than 16 million small business employees work in firms that will be eligible for tax credits under the Affordable Care Act (ACA), according to a new Commonwealth Fund issue brief and blog. The credits, designed to offset health insurance premium costs and help small businesses afford and maintain health insurance, are available beginning this year. Researchers estimate that by 2013, 3.4 million workers may work in firms that take advantage of the tax credit. The tax credits increase in value in 2014, from up to 35 percent of the employer's premium contribution to up to 50 percent.

"The Affordable Care Act is a big step forward for small businesses and their employees," said Commonwealth Fund President Karen Davis, one of the authors of the study. "Not only will business owners see immediate benefits from the tax credits, but owners and employees alike will be protected from steep premium increases and high out-of-pocket costs, ensuring they will have access to the stable, secure health insurance they deserve."

The issue brief is the part of a series that examines the way the Affordable Care Act will benefit different populations and groups, as well as improve insurance coverage and change the delivery of care.

All-Payer Claims Databases: State Initiatives to Improve Health Care Transparency
Comprehensive information on disease incidence, treatment costs, and health outcomes is essential for informing and evaluating state health policies, but it is not readily available. To address these information needs, some states are developing all-payer claims databases. In a new Commonwealth Fund issue brief based on a study of current state and private initiatives, experts show how these databases are proving to be powerful tools for filling in longstanding gaps in health care information and providing essential trend data that will be needed to guide policymakers through the transitions health care reform will bring.
Systems of Care Coordination for Children: Lessons from the States
There are few organized systems of referral and care coordination for children with early developmental delays, complex medical conditions, and difficulties negotiating the medical and related support systems, but some promising models are emerging. A new issue brief summarizes lessons from programs in five states that refer families to appropriate community or state programs, help coordinate their care, provide support and follow-up to ensure they receive needed services, and provide a feedback loop to primary care providers.
Health IT Adoption in New Zealand: Lessons for the U.S.
New Zealand stands out among developed nations in its use of health information technology: all of the country's general practitioners use electronic medical records; physicians are increasingly using the Web to communicate with patients; and primary care providers, hospitals, laboratories, radiologists, and most specialists are connected through standard electronic messaging systems. This issue brief describes New Zealand's primary health care system, discusses its successes and challenges in adopting and promoting health IT, and draws lessons for the United States.
Survey of Long-Term Care Specialists
The Commonwealth Fund Survey of Long-Term Care Specialists is the first attempt to ask experts about the current state of long-term care in the United States and potential reforms in the delivery and financing of such services. Respondents included consumer advocates, providers, public officials, policy experts, business representatives, foundation officers, and others. Survey findings and analysis are published in a series of articles in a special supplement to Medical Care Research and Review.
Quality Matters: Multidisciplinary Teams in Primary Care
The latest issue of Quality Matters focuses on the use of interdisciplinary health care teams—including nurse practitioners, nurses, pharmacists, and social workers—to meet demand and improve the quality of primary care. It includes a case study of Aetna's embedded case managers—specially trained nurses who work alongside providers in their offices to help manage patients' conditions. Thus far, the program has involved some 20,000 patients, all members of Aetna's Medicare Advantage plan, and has resulted in improved care processes, some improvements in outcomes, and reduced numbers of hospitalizations.
SABEW Conference Panel: Health Care Reform and Small Businesses
Many small businesses in New York are facing health care premium increases of more than 20 percent this year. Will health care reform help them cope with rising costs? The Society of American Business Writers and Editors (SABEW) is holding a panel discussion as part of its Economic Recovery Conference, to be held the afternoon of Oct. 1 at the CUNY Graduate School of Journalism near Times Square. Panelists include Mark Wagar, chief executive of Empire Blue Cross Blue Shield; Rima Cohen, counselor to the secretary for health policy of the U.S. Department of Health and Human Services; and small business owner Rosina Rubin, who recently got notice of another double-digit rate hike for her small New York–based transportation company. The panel, sponsored by the Commonwealth Fund, will be moderated by Elizabeth MacBride, who oversees small business coverage for Crain's New York Business. To register, go to: http://sabew.org/events/annual-conferences/2010-fall-conference/.
2011–12 Harkness Fellowship Deadline Next Week

The Commonwealth Fund's 2011–12 Harkness Fellowships in Health Care Policy and Practice 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 Harkness Fellowships 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.