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Commission Offers Framework for High Performance

While acknowledging that the United States provides some of the best medical care in the world, the Commonwealth Fund Commission on a High Performance Health System believes that overall, the nation fails to achieve adequate value for the resources it devotes to health care.

In August, the Commission issued its Framework for a High Performance Health System for the United States, a consensus statement that describes the most critical sources of failure in our health system and outlines a vision of a uniquely American, high performance system.

The Commission, which includes prominent experts and leaders from every sector of health care, identifies concrete steps that could be taken to improve value, including:

  • broad implementation of policies and practices known to improve quality and safety
  • expanded use of information technology in health care
  • rewarding high performing providers through our payment systems
  • expanding the public reporting of data on health care quality and costs
  • expanding health insurance coverage to all.

Such changes will require much greater coordination and cohesion within the health system, the Commission says, noting that this could take a number of forms—from highly organized networks of physicians and hospitals, to large medical group practices, to more loosely affiliated networks of rural hospitals and physicians achieving virtual integration through advanced information technology.

At the same time, the Commission believes that providers must be held accountable for meeting benchmarks for quality, safety, and efficiency.

"There is wide agreement among the public, policymakers, and health care professionals that we should get much more from our health care system," said Commission Chair James J. Mongan, M.D., president and CEO of Partners HealthCare System in Boston. "Our message to the nation is that our future health and economic well-being depends on acting now to begin the transformation."

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