The Commonwealth Fund Connection

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

The Toll of Job Loss on Health Insurance Coverage

In this period of chronically high unemployment, millions of Americans are losing their health insurance coverage along with their jobs. This has serious repercussions: Nearly three-quarters of people who lost their employer-sponsored health insurance when they lost their jobs over the last two years said that they skipped needed health care or did not fill prescriptions because of cost, according to a new Commonwealth Fund brief and blog post. The same proportion is struggling with medical bills or medical debt, compared with about half of those who lost jobs but not their health insurance.

The brief, by Commonwealth Fund researchers Michelle M. Doty, Ph.D., Sara R. Collins, Ph.D., and colleagues, finds that unemployed workers have few affordable coverage options. While continuing health coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA) is an option for certain workers, the cost is prohibitively high and few choose to purchase it.

When fully implemented in 2014, the Affordable Care Act will dramatically increase health insurance options for people who lose their jobs. Even so, the authors say there will still be a role for COBRA to minimize costs associated with filling short gaps in coverage.

Using Shared-Savings Strategies to Cut Health Care Costs
New approaches to health care payment that encourage providers to reduce medical spending by allowing them to share in the net savings have attracted considerable interest. For a new Commonwealth Fund issue brief, Michael Bailit and Christine Hughes interviewed leaders at payer and provider organizations and state agencies about their shared-savings approaches. These wide-ranging approaches have been driven by the push for performance-based payment for medical homes and other providers, as well as the Affordable Care Act's accountable care organization provisions.
Recent Commonwealth Fund–Supported Articles

In recent studies, Commonwealth Fund–supported researchers explored:

  • better methods for identifying high-performing hospitals;
  • ways to promote interdisciplinary teamwork, based on a survey of hospital staff;
  • a new tool to help nursing home managers determine how staff changes might affect quality;
  • the effects of health information technology on nursing home residents’ satisfaction and clinical outcomes;
  • proven strategies to engage physicians in quality and safety efforts;
  • the association between emergency department waiting times and subsequent mortality and hospital admission; and
  • a tool to evaluate patient-centered medical home interventions in safety-net clinics.

Another group of Commonwealth Fund–supported studies examined health care systems abroad, focusing on:

  • evidence of lower-quality care in U.S. territories;
  • the path to transformation for the Canadian primary health care system;
  • the effects of financial incentives on provider performance in the U.K.; and
  • a scorecard to assess the performance of New Zealand’s health system.
Using Data on Patients' Race and Ethnicity to Improve Care
This Commonwealth Fund–supported study of eight hospitals, health plans, and community health centers that collect data on patients’ race and ethnicity as part of efforts to address health care disparities found that the organizations vary in their approaches to defining and measuring disparities and in their ability to design effective disparity-reduction programs.
EHR Use for Quality Improvement in Community Health Centers
In this issue brief, researchers describe the networks that help community health centers make effective use of electronic health records (EHRs). Networks helped centers improve chronic and preventive care by providing assistance with EHR software and developing reports on provider performance and on patients needing services.
Rates of Parent-Centered Developmental Screening
Although experts in pediatric care recommend that all young children undergo screening for developmental problems, less than 20 percent of U.S. children under age 6 received a parent-completed screening at the request of a health care provider. A new study by Commonwealth Fund vice president Melinda K. Abrams and former vice president Edward L. Schor, M.D., and colleagues found that high-risk children who are screened are more likely to receive early intervention services than their unscreened high-risk peers.
New Blog Post: Priorities for State Health Insurance Exchanges
Across the country, state policymakers and federal regulators are working out the details of new health insurance exchanges, which will help families and small businesses purchase coverage. But the exchanges can also serve as tools for reforming the health system even further. In a new blog post, Rhode Island Health Insurance Commissioner Christopher Koller calls on the designers of the exchanges to clarify and prioritize the additional goals for the exchanges, such as reforming health care delivery, setting and enforcing performance standards for health insurers, and stimulating insurers to enter local markets.
Commonwealth Fund News Feeds and Widget
The Commonwealth Fund has made available new topic-based RSS feeds and the ability to select topics, such as Affordable Health Insurance and Patient-Centered Care, to create a custom feed. RSS (Really Simple Syndication) is a format for sharing and distributing Web content. Using an RSS reader or aggregator, you can view data feeds from sites such as The Commonwealth Fund that offer headlines, summaries, and links to the full text. You can also now embed a Commonwealth Fund news widget on your blog or Web site to display the latest Fund releases on your site.
New Events Page
We have added an Events section to our Web site to feature archived webinar recordings and slides, blog posts, e-forums, and other materials related to recent Commonwealth Fund events. You can also visit this page to sign up for upcoming webinars.
Modern Healthcare Names Karen Davis Among 100 Most Influential in Health Care

In its Aug. 22 issue, Modern Healthcare once again named Commonwealth Fund president Karen Davis one of the 100 most influential people in health care. Also included on this year's list were Maureen Bisognano, president and CEO of the Institute for Healthcare Improvement and the newest member of The Commonwealth Fund's Board of Directors as well as a member of the Commonwealth Fund Commission on a High Performance Health System; and fellow Commission members George Halvorson, chairman and CEO of Kaiser Permanente, and Glenn Steele Jr., M.D., president and CEO of Geisinger Health System.

Karen Davis was named one of the Top 25 women in health care by Modern Healthcare in 2011 and in the previous three years.