Drug overdose deaths more than doubled between 2005 and 2016, according to the Commonwealth Fund's 2018 Scorecard on State Health System Performance. In a new To the Point post, the Commonwealth Fund's Susan Hayes, David Radley, and Douglas McCarthy compare state rates for deaths from drug overdoses, as well as alcohol abuse and suicide, using the most recently available data. The authors also highlight successful strategies for expanding access to opioid addiction treatment, which often rely on cooperation and engagement across the health care, social service, and criminal justice sectors.

The Yale University School of Management this week launched a new Commonwealth Fund–supported fellowship dedicated to training clinicians who want to improve care for vulnerable populations. In a new To the Point post, Commonwealth Fund President David Blumenthal, M.D., observes that the new fellowship reaffirms the Fund's historical commitment to addressing inequities in the U.S. health care system.

Former Harkness Fellow Jan C. Frich and Ivan Spehar of the University of Oslo in Norway explore U.S. health care executives’ perspectives on physician leadership development in an article for BMJ Leader. Their study of the potential benefits and challenges associated with multidisciplinary training programs finds different views on the value of mixing professional groups.

"With the states' individual markets remaining upright despite repeated pounding, it has become clear that the Affordable Care Act's premium tax credits have acted as a central stabilizing force," write the Commonwealth Fund's Sara Collins and Munira Gunja on To the Point. Despite attempts by the Trump administration and Congress over the last year to weaken the health care law, data show not only that enrollment in the health insurance marketplaces is higher in 2018 than last year, but that this year is shaping up to be the most profitable one ever for insurers selling plans in the individual market.

The end of the individual mandate penalty in 2019 and the Trump administration's promotion of short-term health plans are among recent policy changes that could significantly erode people's ability to find affordable, comprehensive coverage in the individual insurance market. In a Commonwealth Fund report, RAND researchers Jodi Liu and Christine Eibner examine several options for making health insurance more accessible to Americans who shop for their own coverage. These include increasing the generosity of premium tax credits, extending credits to people with higher incomes, and expanding the availability of reinsurance, which helps insurers cover high-cost claims.

Health care sharing ministries are not traditional insurance; instead, they provide people who follow a common set of religious beliefs with financial assistance for medical expenses. A Commonwealth Fund report by researchers with the Georgetown University Health Policy Institute examines state laws governing health care sharing ministries and reviews five ministries' membership requirements and benefits. Its findings reveal potential risks: the exclusion of coverage for preexisting conditions, higher rates based on health status, and uncapped out-of-pocket expenses. And by drawing healthier individuals out of the marketplaces, ministries may create smaller and sicker risk pools there.

Medicare beneficiaries who also qualify for Medicaid coverage — so-called dual-eligible beneficiaries — use more health care and incur much higher costs than those enrolled in Medicare only. But a Commonwealth Fund–supported study in Health Affairs led by Laura M. Keohane of Vanderbilt University Medical Center suggests that the spending gap between duals and Medicare-only beneficiaries does not appear to be widening.

Critical providers of health services in low-income communities are struggling with funding shortfalls as they try to meet increased demand for a wide range of patient services. To learn how these providers and communities are coping, Harvard's Katherine Swartz and colleagues conducted dozens of interviews in eight North Carolina, Ohio, Pennsylvania, and Wisconsin counties. A post on To the Point highlights the often daunting challenges they face in trying to ensure the safety of public water supplies, provide adequate prenatal and infant care, meet oral health needs, and treat mental illness and substance use disorders.

This round-up of international health policy news stories reports on Australia’s launch of a website to help people with end-of-life planning; Ontario’s move to offer free prescription drugs to seniors; England’s deployment of pharmacists to nursing homes to reduce overprescribing; and more.