The Commonwealth Fund Connection is a roundup of recent Fund publications, charts, multimedia, and other timely content.
The Affordable Care Act's state health insurance exchanges for small businesses could cover nearly 10 million people, in addition to the 15.3 million who will gain coverage through the individual exchanges when the health reform law is fully implemented, according to an article in the February issue of Health Affairs. The article, by Fredric Blavin and colleagues at The Urban Institute, is one of a group of articles in the journal examining the Small Business Health Care Options Program (SHOP), the formal name for the small business exchanges.
The collection of articles, supported by The Commonwealth Fund, examines SHOP's potential to provide affordable insurance options for small firms that now face high premiums and administrative costs when they insure their workers. Under the Affordable Care Act, the SHOP exchanges, along with the exchanges for individuals, are expected to open on January 1, 2014.
To learn more, join a Commonwealth Fund webinar, The Small Business Health Insurance Exchanges: Opportunities and Challenges, on February 22 at 1:00 p.m., E.S.T. Use the hashtag #SHOPex to share insights on Twitter during the live event. And continue the conversation by commenting on a follow-up blog post on the State Refor(u)m Web site.
Americans who have low or moderate incomes are more likely to lack health insurance and a regular source of health care, and more likely to struggle getting the care they need, according to the first Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults. As reported in the new issue brief The Income Divide in Health Care: How the Affordable Care Act Will Help Restore Fairness to the U.S. Health System, 57 percent of adults in low-income families (those earning less than about $30,000 for a family of four) were uninsured for some time in the past year, as were 36 percent of those in moderate-income families (earning between about $30,000 and $56,000). In contrast, just 12 percent of adults in families earning above $89,000 were uninsured during the year.
In a new blog post, The Commonwealth Fund's Anne-Marie Audet, M.D., and Shreya Patel, M.P.H., call for changes in health care delivery to respond to the growing prevalence of chronic illness in the U.S. The real challenge, they write, is not what to do—but how to do it. "It is a question of execution, and even more so of scalability," they write. "Organizing the delivery of care to respond to the needs of patients, particularly those with chronic conditions, requires crossing traditional institutional boundaries and creating networks that threaten a health care culture that is currently based on professional and institutional autonomy."
Two recent Commonwealth Fund–supported studies focus on the role of patient engagement in health care. Writing in the Journal of General Internal Medicine (Nov. 30, 2011), the University of Oregon’s Jessica Greene, Ph.D., and Judith H. Hibbard, Dr.P.H., examined the relationship between patients' level of engagement—as measured by their score on the Patient Activation Measure—and health outcomes. In another article published in the International Journal of Person Centered Medicine (Dec. 2011), the researchers investigated whether patients' use of Web-based portals encourages them to take on active roles in their care.
Two other Commonwealth Fund–supported studies, led by Salomeh Keyhani, M.D., of the University of California, San Francisco, and Deborah Korenstein, M.D., of Mount Sinai School of Medicine, look at overuse of health care services. In the first, published in the Archives of Internal Medicine (Jan. 23, 2012), the researchers reported on findings of a literature review they conducted to better understand the scope of overuse and to spot trends over time. In the second study (Medical Care, March 2012), the authors examined the relationship between geographic variations and overuse of health care services.
A new survey from the National Partnership for Women and Families exploring consumers' views of health information technology found that consumers overwhelmingly see value in electronic health records and believe they can help improve the quality of care. The survey, which also explored consumers' concerns about the safety and privacy of their health information, was conducted with support from The Commonwealth Fund.
There are more than 9 million "dual eligibles" enrolled in both Medicare and Medicaid. Because of the challenges of integrating efforts across the two programs, the care these beneficiaries receive is often poorly coordinated. A new technical assistance brief, created by the Center for Health Care Strategies with support from The Commonwealth Fund, describes opportunities for states to establish reimbursement models and performance incentives that encourage integrated care for dual eligibles.
We invite you to join a March 1, 2012 (3:00–4:30 p.m., E.S.T.) webinar, hosted by the Health Research and Educational Trust and The Commonwealth Fund, exploring hospitals' readiness to participate in accountable care organizations (ACOs). The webinar will review recent research on the number of hospitals participating in ACOs and their capacity to assume responsibility for care management, financial management, information management, and performance improvement. To be moderated by Commonwealth Fund vice president Anne-Marie Audet, M.D., who heads the Fund’s Program on Health System Quality and Efficiency, the program will feature speakers Rita Potter, director of managed care at Nebraska Medical Center, and Alison Fleury, senior vice president of business development at Sharp HealthCare.
Join a March 6, 2012, webinar from the University of Iowa College of Public Health to find out the latest results from a Commonwealth Fund–supported study examining the key structures, processes, and leadership behaviors associated with clinical quality performance. Speakers include Commonwealth Fund vice president Anne-Marie Audet, M.D.. To register, go to http://hlqatwebinar.eventbrite.com/
Visit the Health Reform Resource Center to explore the Affordable Care Act's provisions and new regulations, as well as Commonwealth Fund publications on the law's impact. While on commonwealthfund.org, explore the new Events section to find webinar recordings and slides, blog posts, e-forums, and other materials related to recent Commonwealth Fund events.