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A New Agenda for a Post–Health Reform Landscape

With the Affordable Care Act bringing new health insurance coverage options to millions, and a wide range of payment and delivery reforms under way, U.S. health care is at a turning point. In light of this change, The Commonwealth Fund has chosen to redefine its grantmaking and research focus. The new direction comes eight months after David Blumenthal, M.D., joined The Commonwealth Fund as the seventh president of the 95-year-old philanthropy.

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As Dr. Blumenthal explains in a blog post, "The new focus is the result of eight months of staff work and dozens of conversations with outside experts―leaders in the worlds of policy, care delivery, academia, and philanthropy, to name just a few. It explicitly takes into account the rapidly changing environment that defines our health care system―shifting demography, rising costs, the ongoing implementation of the health reform law, the spread of information technology―and it offers a 'next step' on the path toward high performance."

Building on a long history of work to strengthen the U.S. health system and learn from innovative models, Commonwealth Fund staff and grantees will concentrate on tracking the results of the Affordable Care Act, improving how health care is delivered to the sickest patients, ensuring access and improving quality of care for low-income, minority, and immigrant populations, and supporting breakthroughs in health care. The Commonwealth Fund will also expand its policy analysis to focus more explicitly on controlling health care costs, improving Medicare, and tracking the nation’s health system performance.

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The Fund’s work going forward will be organized into four program areas: 

Health Care Coverage and Access: Work in this area will continue to inform the successful implementation of the Affordable Care Act and support initiatives to expand health insurance and access to care, with a focus on coverage gaps that will not be addressed by the health reform law.

Health Care Delivery System Reform: Work in this area will promote the broad delivery system changes necessary to improve patient outcomes and control costs, focusing initially on those with high health care costs and needs and vulnerable populations. Four levers for improving care will be used: payment reform, primary care, coordinated care systems, and Medicare.

International Health Policy and Practice Innovations: The Fund will continue the work of its longstanding International Program in Health Policy and Practice Innovations, with an enhanced focus on efforts to learn from successful interventions abroad and to establish health system benchmarks through its annual international survey and international symposium on health care policy. 

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Breakthrough Health Care Opportunities: The Fund will develop a new infrastructure to identify, evaluate, and shape new ideas that can potentially disrupt the health care system in positive ways. Information technology–enabled consumer engagement and clinical processes; frugal innovations, or innovations at work in developing countries; and next-generation health care provider incentives are among the topics that will be explored.

The Commonwealth Fund will continue to produce scorecards tracking the performance of the health system in achieving the goals of improving quality, access, and health outcomes, maintain its online Data Centers, and engage federal and state health policymakers by convening briefings and conferences. The Mongan Commonwealth Fund Fellowship Program in Minority Health Policy, Harkness Fellowships in Health Policy and Practice, and other fellowship programs will also continue.

Read Dr. Blumenthal’s perspective on the Fund’s new agenda in a blog post and learn more about his vision of a high-performing health system in a new video.

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