The Commonwealth Fund Connection

In the last two years, an estimated 9 million working-age adults became uninsured after losing a job with health benefits, according to The Commonwealth Fund's 2010 Biennial Health Insurance Survey. The results underscore the great difficulties unemployed Americans face today in finding affordable health care coverage—only a quarter of people who lost their employer health benefits found another source of insurance, and just 14 percent elected COBRA coverage. But the report also discusses the promise of the health reform law to shore up families' health security.

Several Affordable Care Act provisions are already bringing some relief, like allowing young adults to stay on their parents' plans until age 26. And once the law is fully implemented, nearly all 52 million adults who were uninsured for a time in 2010 will have access to comprehensive health coverage through an expanded Medicaid program, or through tax credits to purchase private health plans fortified by consumer protections.

Also check out a blog post and an interactive feature that enables you to explore the survey findings.

It has been just over a decade since the Institute of Medicine (IOM) issued To Err Is Human, the landmark report that vividly documented the scope of patient safety problems within the U.S. health care system. A series of Commonwealth Fund case studies released on the fifth anniversary of that report highlighted health care organizations that had taken promising steps toward creating an organizational culture of safety—one of the IOM's key recommendations. In a follow-up to that earlier series, The Commonwealth Fund released a new set of case studies exploring the progress made by four of these early leaders:

• Johns Hopkins Medicine, an academic medical center and nonprofit integrated health care system in Maryland that set a goal in 2002 of making its care the safest in the world.
• Sentara Healthcare, an integrated system serving parts of Virginia and North Carolina that developed a program to foster a culture of safety throughout its member hospitals.
• OSF HealthCare, a system based in Illinois and Michigan that has promoted a collaborative approach to ensuring patient safety.
• U.S. Department of Veterans Affairs, which formed the National Center for Patient Safety to instill an organizational culture of safety in its nationwide network of hospitals and clinics.

In recent studies, Commonwealth Fund–supported researchers explored:

• The current state of health policy education for medical students (New England Journal of Medicine, March 10). Based on a national survey of U.S. medical school deans, the authors found significant variation among educational approaches, with an average of just 14 hours of instruction over four years. "Health policy literacy," they conclude, "should no longer be considered an ancillary skill, but rather a core competency of a 21st-century physician."
• Communication about health care cost reduction strategies among health plans, employers, and physicians (Annals of Internal Medicine, March 15). As payers discuss the need to reduce health care costs, physicians may hear an indiscriminate call for cutting services and prioritizing dollars over patients. Focusing instead on identifying overuse and underuse of services can raise practitioners' comfort level, the author says.