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Staying Insured Remains Big Problem for Young Adults
In 2003, the Fund first reported on the staggering uninsured rate among young adults in the U.S., and how simple, targeted policy changes could help this group obtain, and hold on to, health coverage. In an update of Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, Fund researchers report that in 2005, 13.3 million adults ages 19 to 29 were uninsured, up from 12.9 million in 2004. They also report that in the last four years, 16 states have enacted requirements that parents' insurance policies must cover children beyond age 18 or 19. Extending eligibility for Medicaid and SCHIP beyond age 18 would further expand coverage for young adults.

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Study: New-Style Nursing Homes Offer Better Quality of Life
A new study published in the Journal of the American Geriatrics Society finds that the innovative Green House nursing home model can improve quality of care—and quality of life—for seniors. In Green House nursing homes, residents enjoy privacy, community, and an environment designed to look and feel like a real home. The Fund-supported study, led by Rosalie A. Kane, Ph.D., of the University of Minnesota, compared the health outcomes and quality of life for Green House residents with residents of two traditional nursing homes. It found that Green House residents experience better quality of life, with the same or better quality of care than those in the comparison homes.

Medicare QIOs Yielding Dividends for Nursing Home Residents
To improve the quality of care Medicare beneficiaries receive, the Centers for Medicare and Medicaid Services contracts with Quality Improvement Organizations (QIOs) to help educate health care providers and supply them with technical assistance and resources for improving care. But is the QIO program producing enough results to justify the government's investment? A study in Health Care Financing Review, led by the Fund's Anthony Shih, M.D., M.P.H., finds that, based on QIOs' work with nursing home care providers, the program is indeed worth it. Over the period 2002–05, QIO nursing home quality improvement interventions cost $2,063 to $7,667 per "quality-adjusted life year" gained—an excellent return on investment, the researchers say.

Experts Polled on Keys to Improving Quality of Care
What is the secret to improving the quality and safety of health care? According to a recent Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey, the answer lies in implementing a national quality agenda, reforming the way health care providers are paid, and integrating provider care. Among the experts surveyed, more than half said they support the creation of a new public–private entity to coordinate quality improvement efforts and develop a national agenda. Nearly all agreed that fundamental payment reform is needed, while three-fourths said greater organization and integration of provider care are necessary to effect improvements in quality and efficiency.

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SCHIP Renewal Is Also Chance to Improve Quality
The State Children's Health Insurance Program (SCHIP) reauthorization process presents a golden opportunity to build on the impressive gains in children's insurance coverage and quality of care achieved over the last decade. In a recent Fund report, child health care experts discuss a number of policy options for streamlining program eligibility and enrollment processes, keeping eligible children from losing their coverage, strengthening provider capacity, measuring performance, and providing incentives for high-quality care, among other goals. According to lead author Lisa Simpson, M.B., B.Ch., M.P.H., "SCHIP reauthorization presents an opportunity to transform the 'good' coverage and quality of care provided by SCHIP into 'great' coverage and quality."

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