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Use of All-Payer Claims Databases Increasing in States
A recent report in USA Today found 19 states have or are in the process of creating all-payer claims databases, which combine data on medical, dental, and pharmacy claims from commercial and public payers. These databases are often used to build consumer-friendly tools to compare health care prices, to design cost-effective benefit packages, and to inform health policies and measure providers' performance. Eleven states now have mandatory all-payer databases, five more are developing them, and three have voluntary databases created by insurers and employers.

AMA Endorses Competency-Based Approach to Medical Education
Earlier this month, the American Medical Association (AMA) approved a policy that encourages the development of a competency-based framework for undergraduate medical education. Under this approach, medical students would progress through training at their own speed, moving ahead as they demonstrate competency in particular areas, and potentially graduating in less than the traditional four years. This policy builds on the AMA's Accelerating Change in Medical Education initiative, which granted 11 medical schools $1 million each to reform medical education by implementing pilot programs that promote competency-based training.

U.S. Health System Ranks Last Among Eleven Countries
Despite having the most expensive health care system, the United States ranks last among 11 industrialized countries on measures of health system quality, efficiency, access to care, equity, and healthy lives, according to a new Commonwealth Fund report. The other countries included in the study were Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. While there is room for improvement in each country, the U.S. stands out for having the highest costs and lowest performance: the U.S. spent $8,508 per person on health care in 2011, compared with $3,406 in the United Kingdom, which ranked first overall. The report attributed the United States' weak performance in part to deficiencies in access to primary care and inequities and inefficiencies in its health care system. However, it noted that provisions in the Affordable Care Act that have extended coverage to millions of people in the United States may improve the country's standing in some areas—particularly by expanding access to affordable and timely primary care.

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