New Directions in Health Care
New Directions in Health Care aims to bring the work of our programs to life though audio interviews with the health care professionals, administrators, policymakers, advocates, and patients on the frontlines of health care.
Episodes
What Health Reform Means for Safety Net Providers
This podcast examines the implications of the Affordable Care Act for the nation's safety net health care providers, which include clinics and hospitals that serve low-income patients and those who have no insurance.
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Employer-Sponsored Health Insurance Premiums Double but Affordable Care Act to Reverse Trend
Sandy Hausman looks at a new study on state trends for employer-sponsored insurance premiums and deductibles that found a 50 percent increase in premiums between 2003 and 2010, and a 63 percent increase in the employee share of the premium for a family plan. Also discussed are Affordable Care Act provisions that should help lower premiums.
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Dual Eligibles: Coordinating Care for People with Medicare and Medicaid
One of the biggest challenges in health care reform is how to care for people who qualify for both Medicare and Medicaid. This group tends to be sicker, poorer, and more costly than the average person in either program. This episode looks at reducing duplication of care and providing assisted living, among other strategies for helping "dual eligibles" and getting their health care costs under control.
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Scorecard Offers Vision of Improved Long Term Services
The first of 70 million baby boomers turn 65 this year, and long-term services and supports (LTSS), which include home care, assisted living, and nursing home care, are on the rise. To help states identify gaps, AARP’s Public Policy Institute, The Commonwealth Fund, and The SCAN Foundation, developed the first state LTSS scorecard.
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Patient Compensation for Medical Injuries: International Approaches
In the U.S., the complex process of seeking compensation for medical injuries makes it difficult for patients to receive compensation, and fear of lawsuits leads to defensive medicine. This episode looks at countries like New Zealand, which separate patient compensation and issues of medical malpractice.
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Health Reform—Opportunities and Challenges for Providers
Relatively little attention has been paid to the ways the health reform law seeks to strengthen the delivery system. This episode addresses how provisions to improve transparency, encourage more organized care, and promote payment reform affect those on the frontlines.
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Covering and Caring for Kids
This episode focuses on a new report evaluating how well the nation cares for its kids. Producer Sandy Hausman explores why children's coverage has improved in 35 states despite the recession, what states can learn from each other, and how health reform can help.
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Transparency in Health Care
Americans usually know what they can expect to pay for products—and most understand that you get what you pay for—but when it comes to health care, that's not the case. This episode looks at how sharing information about quality and costs with the public, payers, and health care professionals may change the way health care is delivered.
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Transforming Safety Net Clinics into Medical Homes
Sandy Hausman reports on the Safety Net Medical Home Initiative, a Commonwealth Fund-supported demonstration project designed to help clinics that serve low-income patients become medical homes.
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Sharing Resources to Improve Care
Today, many primary care practices are sharing clinical and technical services with other providers so that they can become certified medical homes, which provide patients with coordinated, around-the-clock care. In Massachusetts, 95 percent of pediatric practices rely on the Child Psychiatry Access Project for guidance in mental health care.
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How the U.S. Health System Stacks Up
Commonwealth Fund president Karen Davis discusses how the Affordable Care Act might improve U.S. health system performance relative to six other industrialized countries surveyed by The Commonwealth Fund.
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How Will Community Health Centers Fare Under Health Reform?
This episode of the New Directions in Health Care series looks at the findings from a survey of federally qualified health centers. Community health centers are the core of the ambulatory care safety net—serving some 16 million Americans, regardless of their ability to pay.
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Health Care Abroad and Reform at Home—Controlling Health Care Costs
This episode of the New Directions in Health Care series looks at the costs of providing medical services in other parts of the world and considers how health care reform might change the bottom line in this country. It explores ways in which proposed health reforms in Congress—such as an emphasis on primary care and new approaches to delivery and payment—could help ensure value for our health care dollars.
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Rebuilding Primary Care in New Orleans
After Hurricane Katrina, New Orleans had "an unprecedented opportunity to redefine its health system." This episode looks at the network of safety-net clinics that was created following the disaster, and how many of these clinics have become medical homes that provide coordinated, accessible, and affordable primary care.
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Health Reform in Massachusetts: Lessons for the Nation
It's been three years since Massachusetts implemented sweeping health reform. In this episode, Sandy Hausman looks at how satisfied consumers, employers, and physicians are with the new system. Key players also discuss how a good public education campaign and a general spirit of cooperation contributed to the program's success.
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Changing the Culture of Nursing Homes Through Regulation
Over the last 20 years, the quality of life and care in nursing homes has improved dramatically. But some experts say federal and state regulations of nursing homes can get in the way of these important changes, if caregivers and home operators see surveyors—who visit homes to make sure they are complying with standards—as the enemy. A new Commonwealth Fund report suggests that state inspectors could, in fact, be agents of change.
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Keeping Young Adults Insured
More than 13.2 million young adults in the U.S. have no health insurance coverage, finds a Commonwealth Fund study. While many young adults are healthy, this age group is in need of preventive care for the chronic conditions so many Americans develop. Learn how federal and state policies can help keep young people insured.
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Help for Health Care Providers Putting Policy into Practice
Given the tightly packed schedules of health care providers, there can be a lag time of as long as a decade in getting national recommendations into practice. Public-private improvement partnerships, a concept developed with Commonwealth Fund support by the Vermont Child Health Improvement Program, provide regional training, site visits, and more, to help with the process of change.
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Reducing Rehospitalizations: New Initiative Addresses Readmissions as a Community Problem
Being discharged from the hospital is something most patients eagerly anticipate, but many patients find themselves back in the hospital far too soon. A new Commonwealth Fund-supported initiative administered by the Institute for Healthcare Improvement called STAAR--State Action on Avoidable Rehospitalization--is a multi-state, multi-stakeholder collaborative that aims to reduce rehospitalization rates by 30 percent.
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Why Women Aren't Getting the Health Care They Need
Women are disproportionately affected by health care costs, according to a new Commonwealth Fund study. The study authors say that medical debt--which affects women across all income levels--is forcing many women to skip care or make other sacrifices.
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Health IT in Hospitals: How It Can Help
In this episode, producer Sandy Hausman visits a V.A. hospital in Virginia to see how electronic record keeping has improved quality on almost every measure of care. She also talks with the author of a Commonwealth Fund-supported study that provided crucial evidence linking health information technology, such as automated order entry, notes and decision-support, with lower mortality rates as well as lower costs.
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Coalition Is Improving Quality in Nursing Homes
Advancing Excellence in America's Nursing Homes is a group of long-term care providers, caregivers, consumers, and others that has engaged almost half of the nursing homes in the U.S. in its quality improvement efforts. For this episode, Emily Schifrin talked with the organization leadership and frontline workers to find out what has made the campaign so successful.
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The Green House: A New Model of Care
Residents, families, and staff say that Green Houses, based on a radically different model for long-term care created by geriatrician Bill Thomas, M.D., make warm, wonderful homes for elders. In this episode, Emily Schifrin visits two new Green Houses, in San Angelo, Texas, for elders with Alzheimer's disease.
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Retail Clinics: A Look at Who Picks Up Primary Care at the Pharmacy
Producer Sandy Hausman explains the role retail clinics, which operate in pharmacies, supermarkets and big-box retailers, play in providing basic health care to certain Americans who lack affordable alternatives.
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Telemedicine in Rural America
In North Dakota, a trip to the doctor can involve "a lot of windshield time," explains Mary Wakefield, director of the Center for Rural Health at the University of North Dakota. In this episode, Sandy Hausman looks at how telemedicine--where health care is delivered by computer--is making it easier for people in rural areas to get the care and medication that they need.
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Investing in Children's Health and Development
The Assuring Better Child Health and Development initiative was designed to improve the delivery of developmental services though policy and practice change in selected states. In Iowa, a focus on screening, as well as on the mental health of the family and referrals to appropriate providers for treatment, has led to more comprehensive care.
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Geisinger Health System: A Leader in 21st Century Health Care
Geisinger Health is a physician-led, integrated system that cares for about 2.5 million patients in Pennsylvania. Learn about the radical changes Geisinger has made to improve care for its patients while also improving efficiency.
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The Polyclinic: Personalized Health Care in Downtown Seattle
A remodeled downtown location, same-day scheduling, and ready access to physicians have enhanced patient-centered care delivered by the Family Medicine Practice of The Polyclinic.
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A New Approach to Medical Interpreting
A new method of interpreting--where doctors and patients speak into enhanced telephones while an off-site interpreter translates--is helping improve patients' experiences and outcomes at Bellevue Hospital in New York City.
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The Rise of Resident-Centered Care in Nursing Homes: Transforming Jewish Home Lifecare
Hear how a culture change initiative at the Sarah Neuman Center in Mamaroneck, New York, and at Jewish Home Lifecare's Manhattan and Bronx campuses, is transforming life for residents and staff by deinstitutionalizing the physical environment, dining, the staffing structure, and more.
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RESPECT: Practicing Patient-Centered Care in Wisconsin
Because the U.S. health system is complex and fragmented, physicians find it difficult at times to put the needs of patients first. But some health care practices deliver patient-centered care despite the odds. In this episode, producer Sandy Hausman visits the Wheaton Franciscan Medical Group in Racine, Wisconsin, where staff are dedicated to exceptional patient service as well as superior clinical quality.
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Quality Matters
The Quality Matters Podcast, a feature of the bimonthly Commonwealth Fund newsletter "Quality Matters," offers interviews with leaders in health care quality improvement.
Episodes
The Future of Regional Health Collaboratives
An audio interview with Karen Wolk Feinstein, President and Chief Executive Officer, Pittsburgh Region Health Initiative.
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Maximizing the Value of Health Information Technology
Sarah Klein interviews Justin Starren, M.D., Ph.D., director of the Marshfield Clinic's Biomedical Informatics Research Center, about how health information technology can improve quality of care.
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Increasing the Value of Health Care
In this episode, Sarah Klein interviews Dr. A. Mark Fendrick, co-director of the Center for Value-Based Insurance Design of the University of Michigan, about health insurance that rewards providers for providing high-value care.
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Increasing Access to Hospice and Palliative Care
Vida Foubister interviews Howard Tuch, M.D., health policy director at The Hospice of Florida Suncoast in Clearwater, about current issues in the growing field of palliative care.
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Building Trust in the Indian Health Service
Sarah Klein interviews Peter Ziegler, M.D., clinical director of the Sells Service Unit of the Indian Health Service (IHS), a federally run hospital that provides inpatient and outpatient care in Arizona, about quality improvement within the IHS.
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Improving Efficiency in Ambulatory Care
Sarah Klein interviews David Watkins, a process improvement consultant at the Ann Arbor-based OMNEX, Inc., about techniques for eliminating inefficiencies in medical practices.
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The ABCD of Developmental Screening
Vida Foubister interviews Marian Earls, M.D., medical director of Guilford Child Health, Inc., a pediatric practice in North Carolina, who led The Commonwealth Fund-supported Assuring Better Child Health and Development (ABCD) project at that practice.
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The Frontline Perspective on Evidence-Based Guidelines
Martha Hostetter interviews Barb Markward, R.N., a heart failure advocate at St. Rita's Medical Center in Ohio, about the Catholic Healthcare Partners's program, Heart Failure Guidelines Applied in Practice, which is designed to improve care for heart failure patients by promoting the consistent use of evidence-based guidelines.
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The Patients Perspective
Vida Foubister interviews Debra L. Ness, president of the National Partnership for Women & Families, about the patient-centered medical home.
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Paying Attention to Hospital Performance Data
Sarah Klein interviews Harvard School of Public Health faculty Arnold M. Epstein, M.D., and Ashish K. Jha, M.D, M.P.H, about their two analyses of data on hospital performance measures. Their second analysis, performed 18 months after the first study, shows dramatic improvement in performance on these measures.
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