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Docs Need Not Fear Quality Reporting
Fears that physician-level quality reporting could increase the risk of malpractice lawsuits may be part of the reason that doctors are wary of having their performance assessed. But according to a recent Fund-supported study in the Journal of the American Medical Association, performance data in the form of process measures and patient satisfaction surveys are not likely to be admissible as evidence in malpractice claims. The study team, led by Aaron S. Kesselheim, M.D., of the Harvard School of Public Health, says that judges could, however, determine that outcomes of care are relevant to certain cases.

U.S. Lagging in Health IT
Compared with other industrialized nations, the U.S. spends far more per capita on health care. But we lag far behind other countries in adopting health information technology (HIT). Are these two factors related? In a Fund-supported article published in Health Affairs, researchers led by Gerard F. Anderson, Ph.D., of Johns Hopkins Bloomberg School of Public Health, put U.S. spending and HIT initiatives in an international context. They suggest that the U.S. could learn from the problems with interoperability and privacy that have hampered other nations' HIT efforts--and that, eventually, HIT systems could lower the costs and improve the quality of care.

When Race Really Matters
Medical professionals often take into account a patient's race or ethnic background when diagnosing conditions or determining treatment options. For the condition known as hyperbilirubinemia--an acute and potentially devastating form of neonatal jaundice--hospitals use the race of the newborn's mother to predict risk, with blacks being at lowest risk for developing the condition. However, a Pediatrics study by the Fund's Anne Beal, M.D., finds that how mothers define themselves in terms of race does not always match the race categories assigned to them by hospital staff, potentially undermining efforts to identify and treat the condition. Of the mothers documented as black in the medical record, only 70 percent described themselves as black.

Higher Patient Cost-Sharing Won't Rein in Health Spending
"Increasing patient cost-sharing is a misguided solution for reining in U.S. health care costs," the Fund's Sara R. Collins, Ph.D., told a House Ways and Means Committee hearing on health savings accounts (HSAs) held June 28. In her invited testimony, Collins said there is no evidence backing the claim that Americans spend too much on health care because they are protected from its real cost--one of the principal justifications used for promoting HSAs and high-deductible plans. Americans already pay far more out-of-pocket for health care than citizens in other industrialized countries, she noted, adding that HSAs are most likely to appeal to healthier and more affluent taxpayers who already have health coverage and can afford to take on greater financial risk.

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