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Foreign-Born Have Tough Time Maintaining Health
Many foreign-born New Yorkers face difficulties accessing health services, and their health may decline after living in the United States, according to a report supported by The Commonwealth Fund and the Fund for Public Health in New York. The Health of Immigrants in New York City reveals that foreign-born immigrants are less likely than U.S.-born New Yorkers to have a regular primary care provider and to receive preventive services, with Spanish-speakers facing particular challenges. While foreign-born New Yorkers arrive in the city in better health than U.S.-born New Yorkers—with lower rates of smoking, obesity, and HIV—immigrants who have been living in the U.S. for four or more years have worse health and are more likely to be obese.

Delivering Better Behavioral Services…for Less
According to the president's New Freedom Commission on Mental Health and the Institute of Medicine, the delivery of mental health care in the U.S. needs reform. A recent Fund report identifies promising innovations in behavioral health care. The authors describe 17 promising practices, all related to purchasing and quality improvement. Many the innovations are a response to the increasing demands placed on state agencies to meet social needs with reduced budgets, which have left them with little choice but to increase efficiency and effectiveness. The innovations fall into six categories: enhancing consumer-centered care, criminal justice/mental health collaboration, system integration, the use of performance incentives, quality improvement, and other promising practices.

Part D Good, Could Be Better
Despite the controversy surrounding the Medicare prescription drug benefit, two-thirds of respondents to the latest Commonwealth Fund Health Care Opinion Leaders Survey agree that enactment of Part D was, on balance, good for beneficiaries. Still, the survey revealed considerable skepticism about key aspects of the program. The leaders endorse a range of potential changes: eliminating the late-enrollment penalty, reducing its complexity, minimizing coverage gaps, providing the benefit through the traditional Medicare program, and giving Medicare the authority to negotiate drug prices on behalf of beneficiaries. Overall, leaders representing business, health insurance, and other health care industries stand out as most supportive of the existing program.<?p>

New Site for Med Students Focuses on Health Policy
Harvard Medical School student Sachin Jain and his classmates have developed a Web site,, with Commonwealth Fund support, to equip physicians-in-training with information about health care policy and its effects on the practice of medicine. Through case studies, lectures, and other resources, medical students and residents can explore issues related to health care quality, access to care, and health disparities. Discussion boards and other tools encourage interaction among users.

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