Where minority patients get health care can influence the quality of care they receive and may be a major underlying cause of health care disparities, according to an article published June 25 by the Health Research and Educational Trust (HRET) in the Archives of Internal Medicine. The Commonwealth Fund–supported researchers, led by Romana Hasnain-Wynia, Ph.D., found consistent differences between minority and nonminority hospital patients in the quality of care across eight of 13 quality measures for acute myocardial infarction, congestive heart failure, community-acquired pneumonia, and patient counseling. On many measures, lower-performing hospitals tended to treat a higher percentage of minority patients than higher-performing hospitals.
Physicians and Pharma: Too Close for Comfort?
According to a study in the New England of Journal Medicine, 94 percent of physicians in the U.S. have some type of relationship with the pharmaceutical industry—from receiving drug samples or food in the workplace, to being reimbursed for professional meetings, to receiving consulting fees. The authors document the often close links between physicians and the pharmaceutical, medical device, and other medically related industries, which vary according to type of specialty, practice setting, and other factors. The study was conducted by Eric G. Campbell, Ph.D., and former Commonwealth Fund Harkness Fellows Russell L. Gruen, M.D., Ph.D., and James Mountford, M.D., among others.
Physician-Industry Relationships, by Benefit Received | |
| Benefit | Percent of Respondents |
| Drug samples | 78 |
| Gifts | 83 |
| Food or beverages in workplace | 83 |
| Tickets to cultural or sporting events | 7 |
| Reimbursements | 35 |
| For admission to continuing medical education meetings (free or subsidized) | 26 |
| For meeting expenses (e.g., travel, food, lodging) | 15 |
| Payments | 28 |
| For consulting | 18 |
| For serving as a speaker or on a speakers' bureau | 16 |
| For serving on an advisory board | 9 |
| For enrolling patients in clinical trials | 3 |
| Any of the above relationships | 94 |
| Source: E. G. Campbell., R. L. Gruen, J. Mountford et al., "A National Survey of Physician-Industry Relationships," New England Journal of Medicine, Apr. 26, 2007 356(17):1742-50. |
The Human Cost of Medicare's Waiting Period
Americans under age 65 who have severe and permanent disabilities can qualify for Medicare coverage. But there's a catch: before enrolling, they must wait two years after receiving their first disability benefit check. In the Commonwealth Fund report, Too Sick to Work, Too Soon for Medicare, researchers from the Medicare Rights Center tell the real-life stories of 21 adults who are struggling through the waiting period and the financial hardship, pain, and suffering it causes. As the stories reveal, many contend with enormous debt, compromised health, and devastated personal lives. The report highlights the true impact of a policy targeting some of the most vulnerable members of society.
A Better Way to Pay Providers?
While the fee-for-service provider payment system has contributed to the rapid rise in health costs and insurance premiums, capitation systems have often set payments too low and put providers at unfair financial risk. In a recent Fund report, researchers describe a promising new payment model that could address these failings while also improving quality of care and reducing administrative burden. Developed by Prometheus Payment, the model is based on the "evidence-informed case rate"—a single, risk-adjusted payment that reimburses providers across health care settings for treating a specific condition. Payment amounts are based on the resources required to provide care as recommended by the best available clinical guidelines.