To Err Is Human: What's Changed Five Years Later?
According to two of the authors of the Institute of Medicine's landmark report on medical errors, there have been modest improvements in patient safety over the past five years, but medicine has still not achieved a true culture of safety. In their Fund-supported commentary, "Five Years After To Err Is Human: What Have We Learned?" (Journal of the American Medical Association, May 18, 2005) Harvard University's Lucian Leape, M.D., and Institute for Healthcare Improvement president Donald Berwick, M.D., argue that physicians' fears of losing their autonomy, the complexity of medicine, the lack of safety measures, and the current reimbursement system remain barriers to change.
Current Pay-for-Performance Programs Not Saving Costs
Paying health care providers to improve their care has significant potential, Fund grantee Meredith Rosenthal, Ph.D., told a House subcommittee hearing on May 17. But current pay-for-performance efforts, which number about 100, are not designed to reap cost savings, particularly since most of them target underuse of care. For financial incentives to raise the value of health care, purchasers will require targeted decision support; standardized clinical domains and quality measures; and leadership from the Centers for Medicare and Medicaid Services.
Impact of Coverage Proposals Would Vary by State
Most studies of health coverage expansion policies focus on their potential national impact. However a Fund-supported study finds that diversity across states means that different federal strategies will have greatly varied effects across the nation. In "Variations in the Impact of Health Coverage Expansion Proposals Across States" (Health Affairs Web Exclusive, June 7, 2005), Sherry Glied, Ph.D., and Douglas Gould examined variability among states with regard to numbers of uninsured, economic characteristics, and health care markets. They found that states with low non-group premiums, low average incomes, and few prior expansion efforts gained the most under expansion proposals.
Top Women in Health Care Named
Fund president Karen Davis was one of 25 women named by Modern Healthcare in its first-ever list of the most powerful women in health care. Others include Senator Hillary Rodham Clinton, who has advocated for health care quality improvement and use of information technology; University of Pennsylvania School of Nursing researcher Linda Aiken; Carolyn Clancy, M.D., director of the Agency for Healthcare Research and Quality; Suzanne Delbanco, founder and CEO of the quality-focused Leapfrog Group; Margaret O'Kane, president of the National Committee for Quality Assurance; and Diane Rowland, executive vice president of the Kaiser Family Foundation. Noting that health care is no longer an old boys' network, the feature pays tribute to women leaders who have made significant contributions to improving the health care system.
New Commission Wants to Revamp Health System
On June 1, The Commonwealth Fund announced the creation of a Commission on a High Performance Health System, which aims to spur greater access, improved quality, and higher efficiency in the U.S. health care system. The Commission, which will place particular emphasis on those in society who are the most vulnerable due to income, race/ethnicity, health, or age, will seek opportunities to change the delivery and financing of health care to improve system performance, while identifying public and private policies that would lead to those improvements.
Minority Health Policy Fellowships Awarded
The Fund announces the class of 2005–06 in the Commonwealth Fund/Harvard University Fellowship in Minority Health Policy. The one-year, full-time program, based at Harvard Medical School, is designed to create physician-leaders who will pursue careers in minority health and health policy.
Opinion Leaders Sound Off on Health Coverage, Cost
In the March edition of the Fund's Health Care Opinion Leaders Survey, respondents said that the proportion of uninsured Americans can be cut to 8 percent in 10 years, less than half the current rate. And they have some specific ideas on how to get there....May's survey found consensus on strategies to control health costs. Respondents agreed that to get value for money, the nation needs to change the way it pays for care, streamline administration, and foster collaboration among payers.
Chartbook Examines Quality in Medicare
A new Fund chartbook presents a comprehensive picture of the quality of care for Medicare beneficiaries, finding progress (better preventive services and treatment of chronic conditions) and work to be done (gaps in screening and unjustified variations in care). To point the way forward, the authors present exemplary interventions that have improved care for beneficiaries.
Many Seniors Don't Take Their Meds as Prescribed
Four of 10 seniors told researchers in a recent survey that they haven't taken all the drugs their doctors prescribed in the past year—either because costs were too high, they didn't think the drugs were helping, or they didn't think they needed them. Results from the survey, which was conducted by the Kaiser Family Foundation, Commonwealth Fund and Tufts–New England Medical Center, also showed that many seniors deal with complex and costly drug regimens. Of the 89 percent who reported taking prescription drugs in the past year, nearly half (46%) take five or more and more than half (54%) have more than one doctor who prescribes medicine.
According to two of the authors of the Institute of Medicine's landmark report on medical errors, there have been modest improvements in patient safety over the past five years, but medicine has still not achieved a true culture of safety. In their Fund-supported commentary, "Five Years After To Err Is Human: What Have We Learned?" (Journal of the American Medical Association, May 18, 2005) Harvard University's Lucian Leape, M.D., and Institute for Healthcare Improvement president Donald Berwick, M.D., argue that physicians' fears of losing their autonomy, the complexity of medicine, the lack of safety measures, and the current reimbursement system remain barriers to change.
Current Pay-for-Performance Programs Not Saving Costs
Paying health care providers to improve their care has significant potential, Fund grantee Meredith Rosenthal, Ph.D., told a House subcommittee hearing on May 17. But current pay-for-performance efforts, which number about 100, are not designed to reap cost savings, particularly since most of them target underuse of care. For financial incentives to raise the value of health care, purchasers will require targeted decision support; standardized clinical domains and quality measures; and leadership from the Centers for Medicare and Medicaid Services.
Impact of Coverage Proposals Would Vary by State
Most studies of health coverage expansion policies focus on their potential national impact. However a Fund-supported study finds that diversity across states means that different federal strategies will have greatly varied effects across the nation. In "Variations in the Impact of Health Coverage Expansion Proposals Across States" (Health Affairs Web Exclusive, June 7, 2005), Sherry Glied, Ph.D., and Douglas Gould examined variability among states with regard to numbers of uninsured, economic characteristics, and health care markets. They found that states with low non-group premiums, low average incomes, and few prior expansion efforts gained the most under expansion proposals.
Top Women in Health Care Named
Fund president Karen Davis was one of 25 women named by Modern Healthcare in its first-ever list of the most powerful women in health care. Others include Senator Hillary Rodham Clinton, who has advocated for health care quality improvement and use of information technology; University of Pennsylvania School of Nursing researcher Linda Aiken; Carolyn Clancy, M.D., director of the Agency for Healthcare Research and Quality; Suzanne Delbanco, founder and CEO of the quality-focused Leapfrog Group; Margaret O'Kane, president of the National Committee for Quality Assurance; and Diane Rowland, executive vice president of the Kaiser Family Foundation. Noting that health care is no longer an old boys' network, the feature pays tribute to women leaders who have made significant contributions to improving the health care system.
New Commission Wants to Revamp Health System
On June 1, The Commonwealth Fund announced the creation of a Commission on a High Performance Health System, which aims to spur greater access, improved quality, and higher efficiency in the U.S. health care system. The Commission, which will place particular emphasis on those in society who are the most vulnerable due to income, race/ethnicity, health, or age, will seek opportunities to change the delivery and financing of health care to improve system performance, while identifying public and private policies that would lead to those improvements.
Minority Health Policy Fellowships Awarded
The Fund announces the class of 2005–06 in the Commonwealth Fund/Harvard University Fellowship in Minority Health Policy. The one-year, full-time program, based at Harvard Medical School, is designed to create physician-leaders who will pursue careers in minority health and health policy.
Opinion Leaders Sound Off on Health Coverage, Cost
In the March edition of the Fund's Health Care Opinion Leaders Survey, respondents said that the proportion of uninsured Americans can be cut to 8 percent in 10 years, less than half the current rate. And they have some specific ideas on how to get there....May's survey found consensus on strategies to control health costs. Respondents agreed that to get value for money, the nation needs to change the way it pays for care, streamline administration, and foster collaboration among payers.
Chartbook Examines Quality in Medicare
A new Fund chartbook presents a comprehensive picture of the quality of care for Medicare beneficiaries, finding progress (better preventive services and treatment of chronic conditions) and work to be done (gaps in screening and unjustified variations in care). To point the way forward, the authors present exemplary interventions that have improved care for beneficiaries.
Many Seniors Don't Take Their Meds as Prescribed
Four of 10 seniors told researchers in a recent survey that they haven't taken all the drugs their doctors prescribed in the past year—either because costs were too high, they didn't think the drugs were helping, or they didn't think they needed them. Results from the survey, which was conducted by the Kaiser Family Foundation, Commonwealth Fund and Tufts–New England Medical Center, also showed that many seniors deal with complex and costly drug regimens. Of the 89 percent who reported taking prescription drugs in the past year, nearly half (46%) take five or more and more than half (54%) have more than one doctor who prescribes medicine.