The Commonwealth Fund Connection

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

  • February 4, 2011 Issue
New State Scorecard on Children's Health Care Finds Wide Geographic Disparities

Two years after the reauthorization and expansion of the Children's Health Insurance Program (CHIP), a new Commonwealth Fund state-by-state scorecard evaluating how the health care system is working for children finds that federal and state action on behalf of children has helped preserve, and even expand, health coverage for this group, despite the severe recession.

Yet across the states, wide differences persist in coverage rates, the affordability of health care, children's receipt of preventive care and treatment, and their opportunity to lead healthy lives. According to the scorecard's findings, children living in the five top-ranked states—Iowa, Massachusetts, Vermont, Maine, and New Hampshire—are more likely to be insured and to receive recommended medical and dental check-ups than children living in poorer-performing states like Florida, Texas, Arizona, Mississippi, or Nevada.

An interactive map enables comparisons among states on the 20 scorecard indicators and demonstrates the potential gains states could make by achieving benchmark levels of performance. Also available is a podcast that explores what states can learn from each other, and how health reform will help improve child health system performance.

Making Health Insurance Cost-Sharing Clear to Consumers
The Affordable Care Act calls for a new health insurance disclosure form, called the Summary of Coverage and Benefits, which uses a fixed layout and standard terms and definitions to enable consumers to compare health insurance plans and understand terms of coverage. This new issue brief reports on findings from a Consumers Union study that examined consumers' reactions to an early version of the form. While testing revealed that people were able to use the forms to make hypothetical choices among health plans, there was also deep-seated confusion about health plan cost-sharing. The disclosure form has since been revised based on testers' feedback.
State Roles in Promoting Accountable Care Organizations
The Affordable Care Act provides incentives for providers to form accountable care organizations (ACOs) as a way to encourage care coordination and reduce health costs. A new report from The Commonwealth Fund and the National Academy for State Health Policy examines key ways in which states have supported development of the ACO model, focusing on Colorado, Massachusetts, Minnesota, North Carolina, Oregon, Vermont, and Washington.
Recent Commonwealth Fund–Supported Articles
In recently published studies, Commonwealth Fund–supported researchers explored:

  • the effects on health outcomes of collaborations between primary care physicians and specialists for patients with diabetes, psychiatric conditions, and cancer, in the Annals of Internal Medicine;
  • current knowledge about a particular type of community-based housing for elderly adults, affordable clustered housing, in Cityscape: A Journal of Policy Development and Research;
  • whether performance-based financial incentives for medical groups were associated with improved primary care patient experiences, in the Journal of General Internal Medicine;
  • patterns of palliative and chronic care medication use among elderly Medicare beneficiaries as the probability of death increased, in the Journal of the American Geriatrics Society;
  • the amount of household resources allocated to out-of-pocket health spending in the year before Medicare's Part D drug benefit took effect, in Medical Care; and
  • patients' views of the care they receive in community health centers, in the Journal of Health Care for the Poor and Underserved.
Lessons from Abroad for U.S. Health Care

A series of Commonwealth Fund–sponsored articles about international health system issues offers lessons for the U.S. The articles explore:

Blog: Focusing Only on Federal Budget Outlays Won't Bend the Health Care Cost Curve
The spotlight in Washington on the federal budget deficit has renewed debate over how best to control health care costs. Recently released budget-reduction proposals, most notably from the National Commission on Fiscal Responsibility and Reform and the Bipartisan Policy Center's Debt Reduction Task Force, include options for reducing federal health spending. In a new blog post, Karen Davis, Cathy Schoen, and Stuart Guterman of The Commonwealth Fund say that, although the proposals contain several ideas that merit consideration, their focus on reining in federal spending, rather than health spending overall, could simply shift costs from the federal government to state and local governments, businesses, and families.
Blog: Building on the Early Success of Health Reform

In a blog post, Commonwealth Fund president Karen Davis responds to the State of the Union address, in which President Obama highlighted some of the benefits that Americans are seeing from this landmark piece of legislation. Among those already being helped:

  • adults and children with preexisting conditions, who now have improved access to affordable, comprehensive coverage;
  • seniors, who have reduced prescription drug costs with the phasing out of the "doughnut hole" in Medicare Part D coverage;
  • young adults up to age 26, who can stay on or join their parents' health plans; and
  • small business owners, who can receive a tax credit to cover a portion of health insurance premiums for employees.

"The changes included in the Affordable Care Act should enable us to enter an era of efficiency in health care that will make our health system truly sustainable," says Davis, pointing to upcoming health care payment and delivery reforms, such as new incentives for hospitals to reduce potentially preventable readmissions.

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