In her invited testimony before the Senate Health, Education, Labor, and Pensions Committee in January, Commonwealth Fund president Karen Davis described how the health system in the U.S. lags behind other industrialized nations—and what we as a nation can learn from innovations taking place overseas. "The key question is how to achieve improved coverage and greater efficiency while maintaining or improving quality," Davis told the committee. "Other countries are achieving universal coverage, much lower spending per capita, and better health outcomes." Among the innovations Davis highlighted were Denmark's system for after-hours care; Germany's hospital quality benchmarking; and the Netherlands' use of nurse practitioners to manage chronic disease.
Opinion Leaders: Congress Should Focus on Covering the Uninsured
Extending health coverage to the uninsured should be the top health care priority for the new Congress over the next five years, according to 88 percent of experts responding to the Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders survey. Other top priorities include moderating rising health care costs, reforming Medicare to ensure long-term solvency, and increasing use of information technology. The responses closely align with public views on health reform, as well as the principles laid out by the Fund's Commission on a High Performance Health System. This is the first survey in the series to be conducted in partnership with Modern Healthcare magazine, whose January issue also featured commentaries by Representative Pete Stark (D-Calif.) and Senator Mike Enzi (R-Wyo.) that outline their views on Congress's priorities for health reform.
How Do States Spend Fines Collected from Nursing Homes?
States could do much more with the civil monetary penalties and fines they collect from nursing homes that provide substandard care, a Commonwealth Fund-supported study in The Gerontologist finds. Between 1999 and 2005, 32 states reported spending $28 million on quality improvement projects, from a total balance of $61 million in collected monies. Lead authors Theodore Tsoukalas, Ph.D., and Cynthia Rudder, Ph.D., say policymakers need to find ways to use this potentially valuable resource for improving nursing home care.
Higher Quality in Integrated Medical Groups
Integrated medical groups provide higher quality than individual practice associations on selected measures of preventive care and chronic disease management, according to a Fund-supported study in Annals of Internal Medicine that evaluated the link between the organizational structure of physicians' practices and quality of care. Authors Ateev Mehrotra, M.D., Arnold M. Epstein, M.D., and Meredith B. Rosenthal, Ph.D., believe that centralized decision-making and close collaboration in integrated groups may account for the better performance.
Helping Hospitals Measure Disparities in Their Care
In a recent Commonwealth Fund report, Enhancing Public Hospitals' Reporting of Data on Racial and Ethnic Disparities in Care, Bruce Siegel, M.D., and fellow researchers at George Washington University assessed whether safety net hospitals treating large minority populations can use measures adopted by the Hospital Quality Alliance to collect quality data by patients' race and ethnicity. The five public hospitals participating in the study show that, despite some complications, collecting quality data by race and ethnicity is indeed possible. The report also found that these hospitals outperform the U.S. hospital average on several quality measures, and that high performance was mostly consistent across racial and ethnic groups.
Benefits Offices Testing New Ways to Provide Language Services
Having appropriate language services available for patients with limited English proficiency can greatly improve health care experiences. The Fund report, Providing Language Services in State and Local Health-Related Benefits Offices: Examples From the Field, outlines an eight-step approach to helping benefits offices develop language strategies tailored to their clients' specific needs. In their report, Mara Youdelman and coauthors include dozens of sample forms, protocols, and other documents used by states and localities, as well as contact information for each site profiled.
Check Out Chart Cart and Performance Snapshots
Chart Cart and Performance Snapshots are new online resources that offer free and convenient access to rich collections of charts. Chart Cart provides access to the wealth of graphical data depicted in hundreds of charts from Commonwealth Fund surveys, reports, and chartbooks. And, Performance Snapshots tracks health system peformance through its compendium of new charts and narratives. Both resources allow you to create your own collection and download it in either PowerPoint (PPT) or Portable Document File (PDF) format. Check them out today.