To advance its goal of a high performance U.S. health care system, The Commonwealth Fund gathers and disseminates evidence of excellence in health care from across the country and the world. This work is intended to show what it is possible to achieve, and to stimulate health care providers, policymakers, and stakeholders to take action to improve performance in all facets of care.

The Fund's capacity for Health System Performance Assessment and Tracking enables it to:

• track and compare health system performance, by identifying benchmarks for patient care experiences, health outcomes, and cost that states, health care providers, and others can use to set improvement targets;
• assess trends in health insurance coverage, access to care, and patient-reported quality of care; and
• monitor public and private actions to transform health care delivery, including payment innovations, health information technology adoption, and the organization of care.

The Fund's Health System Performance Assessment and Tracking activities are closely coordinated with Fund initiatives in Delivery System Innovation and Improvement, Health Reform Policy, and International Health Policy and Innovation.

Performance Assessment and Tracking Activities

Health system performance scorecards. Since 2006, The Commonwealth Fund and its Commission on a High Performance Health System have tracked the performance of U.S. health care through a series of national and state scorecards. The National Scorecard on U.S. Health System Performance (2006 and 2008), focuses on health care outcomes, quality, access, efficiency, and equity. The State Scorecard on Health System Performance (2007 and 2009) assesses states' performance on health care relative to achievable benchmarks for 38 indicators of access, quality, costs, and health outcomes. The upcoming Scorecard on Long-Term Care in the U.S. will report on care delivered by America's nursing homes, assisted-living facilities, home health agencies, and other long-term care providers (for more information, see Picker/Commonwealth Fund Program on Long-Term Care Quality Improvement).

WhyNotTheBest.org. The Fund's benchmarking and quality improvement Web site for health care providers, WhyNotTheBest.org enables users to compare hospitals within and among states, read case studies of top performers and innovative programs, and access a variety of quality improvement resources.

Surveys. The Fund conducts a wide range of surveys, both in the United States and abroad, to monitor trends in health care access and quality, explore public views on health care matters, and assess the policy perspectives of health care leaders. Recent and ongoing surveys include:

• Commonwealth Fund Biennial Health Insurance Survey. Over the years, these surveys have produced a wealth of information about the extent and quality of health care coverage in the U.S. Specific topics covered in past surveys include: the stability and quality of adults' health insurance coverage, cost-related difficulties in accessing care, medical bill problems, and medical debt.
• Commonwealth Fund International Health Policy Survey (annual). Now including 11 industrialized countries, these annual surveys explore such topics as health system performance and responsiveness from the perspective of seriously ill adults and primary care physicians. Visit the Fund's online International Health Policy Center for more information.
• Commonwealth Fund Survey of Public Views of the U.S. Health Care System (2006 and 2008). The 2008 survey assessed the public's experiences and perspectives on the organization of the nation's health care system and ways to improve patient care.
• Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey (quarterly). Since 2004, these surveys have sampled key professional audiences about important health policy issues and options for addressing them. The four surveys in 2010 asked opinion leaders for their views on payment system reform, priorities for the Obama administration, slowing the growth of health care costs, and health reform legislation.
• Commonwealth Fund Survey of Young Adults (2009). Young adults ages 19 to 29 are one of the largest uninsured segments of the population. This nationally representative survey found that nearly half have gone without insurance at some time during the year.
• Commonwealth Fund National Survey of Federally Qualified Health Centers (2009). With the likely increase in demand for community health center services following enactment of health reform legislation, this survey explored these clinics' ability to provide access to care, coordinate care across settings, engage in quality improvement and reporting, adopt and use health information technology, and serve as patient-centered medical homes.
• Commonwealth Fund 2009 Survey of Clinic Patients in New Orleans. One of the many things Hurricane Katrina devastated when it hit New Orleans in 2005 was the city's health care system. To find out how well community clinics were serving their high-need populations, The Commonwealth Fund conducted interviews with patients at 27 clinics in 2009. The findings were encouraging.

To access all Fund surveys, visit Surveys at commonwealthfund.org.

Multinational comparisons of health system data. Comparing the health care system in the United States with the systems of other industrialized countries reveals striking differences in spending, availability and use of services, and health outcomes. Each year, the Fund produces a chartbook depicting key health data for the 30 member nations of the Organization for Economic Cooperation and Development (OECD), as well as analyses based on those data. Visit the Fund's online International Health Policy Center for more information.