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Creating a national center charged with comparing the effectiveness of drug treatments and medical procedures could help health plans, hospitals, and public programs "spend smarter" on health care, according to a Fund-supported study in Health Affairs (Nov. 7). Gail Wilensky, John M. Olin Senior Fellow at Project HOPE, says such a center would facilitate better-informed decisions with regard to patient care, coverage, and reimbursement—and ultimately could lead to improved health outcomes and better-controlled costs. Noting the approach is used in several countries, Wilensky examines options for placing and financing comparative effectiveness center in the United States.

Reforming Well-Child Care: Lessons from Abroad
Unlike the United States, where a single physician provides most of a child's health care, many other countries—like Sweden and Spain—divide responsibilities among several health professionals, each with specific training and expertise and funded through a variety of sources. According to the authors of a Fund-supported article in Pediatrics, that is just one of the practices followed abroad that the U.S. might consider when addressing the shortcoming of its well-child care system, among them lack of adequate physician time, resources, and training, and a shortage of referral options for children at risk for developmental delay. Another promising practice is "co-locating" certain child health care services in community-based centers.

Same Benefit, Different Experience
Under Medicare Part D, many beneficiaries must choose among dozens of prescription drug plans—each with different benefit designs and formulary structures. A new Fund issue brief that examines Part D plans in the four most populous Medicare states—California, Florida, New York, and Texas—finds similar variation in the number of drugs covered by individual plans, the ease with which enrollees can obtain specific drugs, and cost-sharing requirements. The authors also find that enrollees in plans with lower premiums are more likely to face barriers in obtaining specific drugs.

Will the Mid-Term Elections Resuscitate Health Reform?
The change in the makeup of the U.S. Congress—and in statehouses across the country—signals a new opportunity for health care reform, says Fund president Karen Davis in her new Web column. Davis says a truly bipartisan approach could help the country begin to address the rising numbers of uninsured and soaring health care costs—issues that Americans have said are top priorities. We may also see new efforts to strengthen or expand the State Children's Health Insurance Program, grant Medicare the authority to negotiate prescription drug prices, and speed adoption of health information technology. "If Democrats and Republicans are willing to commit to working together," Davis says, "all Americans will benefit."

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