Part D Should Be Boost for Nursing Home Residents
Even with its deductibles, coinsurance, and coverage gap, the new Medicare prescription drug benefit should provide "considerable financial relief" to nursing home residents, particularly those with low incomes. According to a recent Fund-supported study in the journal Medical Care by Bruce Stuart, Ph.D., and colleagues at the University of Maryland, an estimated one-fifth of those living in nursing homes were without any prescription coverage in 2001, and many of them were poor. Still, given the difficulties with the new benefit encountered by many Medicare/Medicaid "dual eligibles," it will be important to monitor low-income residents' access to needed medications, the authors say, throughout the transition from Medicaid to Medicare drug coverage.
Kids' Mental Health on States' Minds
With Fund and other support, five states are working together to develop strategies for improving the care of young children who are at risk for, or have, social or emotional developmental delays. A new report from the National Academy for State Health Policy and the Fund outlines early lessons from the states' collaboration, including the need to follow up screening for developmental delays with needed interventions. All five states are improving the delivery of care without seeking new appropriations, changing state law, or obtaining federal approval. Instead, they have leveraged existing resources and partnered with stakeholders, including their sister agencies, private organizations, and providers.
A Matter of Interpretation
New Fund-supported research finds that medical interpreters can significantly improve patients' experiences, while substantially reducing racial and ethnic disparities. For the study, a research team led by UCLA's Leo S. Morales, M.D., Ph.D., analyzed data from 26,298 parents of children enrolled in SCHIP health plans between 2000 and 2001. The researchers found that patients who always had an interpreter reported the highest levels of satisfaction with their care. In fact, non-English speakers who always had an interpreter during medical visits reported higher ratings than English speakers who did not need interpreters. The study was published in Medical Care Research and Review.
Creating a 'Culture of Safety'
For years, experts have cautioned that patient safety hinges as much on significant shifts in the culture of health care as on specific changes in the processes of care. In a Fund–supported article, "Stories from the Sharp End: Case Studies in Safety Improvement" (Milbank Quarterly, March 2006) Douglas McCarthy and David Blumenthal, M.D., showcase promising techniques for stimulating cultural change. By studying the efforts undertaken by leading health care organizations, the authors demonstrate that patient injuries are not an inevitable side-effect of care. A culture of safety does not just evolve, they argue, but is actively created. To read the complete case studies, see the Fund report Committed to Safety: Ten Case Studies on Reducing Harm to Patients.
Mongan Joins Fund Board
James J. Mongan, M.D., a nationally known health policy expert with long-standing experience in clinical care and health system management, has been named to The Commonwealth Fund's Board of Directors. Mongan, president and chief executive officer of Partners HealthCare in Boston, chairs the Fund's Commission on a High Performance Health System. "Dr. Mongan has been a leader in academic medicine for decades," said Samuel O. Thier, M.D., who chairs the Fund board. "He also has invaluable personal experience in the day-to-day workings of the health care system, and an intimate knowledge of policy from years of federal government service." Earlier in his career, Mongan served under President Jimmy Carter as deputy assistant secretary for health and then in the White House as associate director of the domestic policy staff.