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Achieving Health Care Reform—How Physicians Can Help

May 21, 2009 - Rather than wait and see how health reform legislation unfolds, physicians should help lead the effort to establish affordable, high-quality health care in this country, say Elliott S. Fisher, M.D, M.P.H., Donald M. Berwick, M.D., M.P.P., and Karen Davis, Ph.D., in a New England Journal of Medicine "Perspectives" column.

Literature Abstract

Making Care Coordination a Critical Component of the Pediatric Health System: A Multidisciplinary Framework

May 21, 2009 - This report proposes a framework for care coordination in a high-performing pediatric health care system. It includes a definition of care coordination; outlines its principal characteristics, competencies, and functions; and sets forth a detailed process for its delivery.

Fund Report

The Long Wait: The Impact of Delaying Medicare Coverage for People with Disabilities

May 20, 2009 - At a particularly difficult point in their lives, disabled individuals must wait two years before they are eligible to begin receiving Medicare benefits--a delay that can block access to needed care and relief from financial pressures.

Perspectives on Health Reform Brief

The Valley Hospital: Leaders Set the Tone for Patient Service and Satisfaction

May 20, 2009 - At The Valley Hospital, hospital leaders exemplify on a daily basis the hospital's dedication to patient service.

Case Study

Health Insurance and Health Care Access Before and After SSDI Entry

May 20, 2009 - This report creates profiles of those with Social Security Disability Insurance (SSDI) during the three years before and after SSDI entry to illustrate changes in insurance status, health care access, and utilization.

Fund Report

What Does It Cost Physician Practices to Interact with Health Insurance Plans?

May 14, 2009 - Physicians spent on average nearly three weeks annually interacting with health plans, at an estimated annual cost to physician practices of $31 billion, or $68,274 on average per physician, per year, according to this Commonwealth Fund-supported survey.

In the Literature

Peering into the Black Box: Billing and Insurance Activities in a Medical Group

May 14, 2009 - Billing and insurance tasks in a large medical group practice consume $85,276 per full-time equivalent physician—or 10 percent of operating revenue, according to this Commonwealth Fund-supported study. Standardizing health plan benefits and billing procedures would reduce administrative complexity and costs, the authors say.

In the Literature

Initial Lessons from the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home

May 13, 2009 - Early findings from a Commonwealth Fund-supported evaluation of a two-year American Academy of Family Physicians demonstration suggests that medical home transformations require more money, time, and doctor and technology support than currently invested.

In the Literature

Meeting Enrollees' Needs: How Do Medicare and Employer Coverage Stack Up?

May 12, 2009 - In a national Commonwealth Fund survey, elderly Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than people covered by employer-sponsored plans. These findings, published in Health Affairs, support the development of a public insurance plan similar to Medicare that would be available to the under-65 population.

In the Literature

Women at Risk: Why Many Women Are Forgoing Needed Health Care

May 11, 2009 - Rising health care costs coupled with eroding health care benefits are having a substantial effect on Americans' ability to get needed health care, with women particularly affected. Women experience cost-related access problems and medical bill problems more often than men.

Issue Brief

Progressive or Regressive? A Second Look at the Tax Exemption for Employer-Sponsored Health Insurance Premiums

May 8, 2009 - This analysis finds that limiting the current exemption on employer-sponsored health insurance premiums could adversely affect individuals who are already at high risk of losing their health coverage. Evidence suggests that capping the exemption could disproportionately affect workers in small firms, older workers, and wage-earners in industries with high expected claims costs.

Issue Brief

Measuring Efficiency: The Association of Risk-Adjusted Hospital Costs and Quality of Care

May 5, 2009 - This study found that low-cost hospitals had modestly lower scores on process-of-care measures for two common heart conditions than did high-cost facilities. Strategies are needed to ensure that care is both high quality and low cost in all hospitals, the authors said.

In the Literature

The Continuing Cost of Privatization: Extra Payments to Medicare Advantage Plans Jump to $11.4 Billion in 2009

May 4, 2009 - The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, MA plans have, for the past six years, been paid more for their enrollees than they would be expected to cost in traditional fee-for-service Medicare.

Issue Brief

Increasing Participation in Benefit Programs for Low-Income Seniors

May 4, 2009 - A review of the literature shows that some of the most vulnerable Americans, low-income seniors, do not participate in benefit programs for which they are eligible. The two major obstacles to enrollment are lack of knowledge about public benefit programs and the complexity of application and enrollment processes.

Fund Report

Testimony--Vision of Health and Health Care Transformed

April 28, 2009 - In invited testimony before the National Committee on Vital and Health Statistics on April 29, 2009, Steve Schoenbaum, M.D., Ph.D., outlines the strategies recommended by the Commonwealth Fund Commission on a High Performance Health System.

Testimony