Publications: Health Care Quality

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Forging Community Partnerships to Improve Health Care: The Experience of Four Medicaid Managed Care Organizations

4/18/2013 - This issue brief explores how four managed care organizations serving vulnerable populations are changing the way care is delivered by investing in a strong community presence.

Issue Brief

The Colorado Beacon Consortium: Strengthening the Capacity for Health Care Delivery Transformation in Rural Communities

4/18/2013 - This case study describes how one of the 17 Beacon sites, the Colorado Beacon Consortium, has strengthened the capacity of local health care providers to exchange health data and transform clinical care.

Case Study

Insurers' Medical Loss Ratios and Quality Improvement Spending in 2011

3/22/2013 - Health insurance companies reported spending an average of less than 1 percent of the premiums they collected from policyholders in 2011 on activities directly supporting improvement of health care quality, according to a new Commonwealth Fund study.

Issue Brief

Payments in Support of Effective Primary Care for Chronic Conditions

3/18/2013 - In this Commonwealth Fund–supported article, the authors suggest that "bundled payment" covering all services provided to a patient for treatment of a specific illness or injury would need to be risk-adjusted, so that providers do not have incentives to avoid patients, like those with chronic illness, who can be expected to have higher costs.

In Brief

Ethical Physician Incentives—From Carrots and Sticks to Shared Purpose

3/18/2013 - The Commonwealth Fund-supported authors of this study recommend using an array of financial and nonfinancial incentives—including performance rankings—to help facilitate a broad "shared-purpose orientation" embraced by all participating clinicians.

In Brief

Quality and Efficiency in Small Practices Transitioning to Patient-Centered Medical Homes: A Randomized Trial

3/18/2013 - Providing small primary care practices with supports that include more robust electronic health records, on-site care managers, and increased reimbursement helps them become medical homes.

In Brief

Early Adopters of the Accountable Care Model: A Field Report on Improvements in Health Care Delivery

3/13/2013 - Based on interviews with clinical and administrative leaders, this report describes the experiences of seven accountable care organizations (ACOs).

Fund Report

Publicly Reported Quality-of-Care Measures Influenced Wisconsin Physician Groups to Improve Performance

3/5/2013 - This Commonwealth Fund–supported study published in Health Affairs analyzed the effect of publicly reported ambulatory care measures for a voluntary consortium of physician groups known as the Wisconsin Collaborative for Healthcare Quality.

In the Literature

Attributing Patients to Accountable Care Organizations: Performance Year Approach Aligns Stakeholders' Interests

3/5/2013 - In a Commonwealth Fund–supported study, researchers evaluated the effects of the two main methods for assigning patients to accountable care organizations: prospective attribution, or assigning patients based on their use of services in the previous year; and retrospective attribution, in which patients are assigned at the end of the performance year.

In the Literature

Aligning Incentives in Medicaid: How Colorado, Minnesota, and Vermont Are Reforming Care Delivery and Payment to Improve Health and Lower Costs

3/1/2013 - Colorado, Minnesota, and Vermont are working to align incentives between health care payers and providers to improve care delivery and outcomes while controlling costs. This synthesis describes the common drivers of reform across the states and lessons learned.

Case Study

Medicaid Payment and Delivery Reform in Colorado: ACOs at the Regional Level

3/1/2013 - Colorado is one of a handful of states piloting innovative health care payment and delivery reforms through Medicaid. Under the Accountable Care Collaborative Program, which began enrollment in May 2011, the state Medicaid agency contracts with seven regional organizations to create networks of primary care providers and ensure care coordination for Medicaid enrollees.

Case Study

Medicaid Is One of Multiple Payers in Vermont’s Health Care Reforms

3/1/2013 - Vermont Medicaid is a key player as the state pioneers multipayer health care delivery and payment reforms. Under Vermont Blueprint for Health, most Medicaid beneficiaries and state residents will be served in 2013 by medical homes with community health teams, with additional support services for Medicaid enrollees with complex conditions.

Case Study

Health Care Payment and Delivery Reform in Minnesota Medicaid

3/1/2013 - Minnesota's Medicaid program is a leader in piloting innovative health care payment and delivery reforms. This case study is one of three in a series on innovations being undertaken by states to improve quality and efficiency in their Medicaid programs.

Case Study

The Value of Low-Value Lists

2/27/2013 - In this Commonwealth Fund–supported article, researchers examine the challenges to developing lists of “low-value” services and ensuring that insurers and provider organizations put them to optimal use.

In Brief

Turning Readmission Reduction Policies into Results: Some Lessons from a Multistate Initiative to Reduce Readmissions

2/25/2013 - In this study, researchers examine the early experiences of participants in the State Action on Avoidable Rehospitalizations (STAAR) initiative, a four-year effort begun by the Institute for Healthcare Improvement in 2009 and supported by The Commonwealth Fund.

In the Literature