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Tucson and Southern Arizona: A Desert Region Pursuing Better Health and Health System Performance

4/17/2014 - The southern Arizona region encompassing Tucson outperforms many other regions with similar socioeconomic characteristics, which may stem from the emphasis providers place on delivery system innovation and best practices and the prevalence of managed care arrangements.

Case Study

Grand Rapids and West Central Michigan: Pursuing Health Care Value Through Regional Planning, Cooperation, and Investment

4/17/2014 - The region of West Central Michigan encompassing Grand Rapids and surrounding communities performs especially well on measures of prevention and treatment quality, avoidable hospital use, and costs of care.

Case Study

Opportunity for Regional Improvement: Three Case Studies of Local Health System Performance

4/17/2014 - Case studies of three U.S. regions that ranked relatively high on the Commonwealth Fund’s Scorecard on Local Health System Performance, 2012, despite greater poverty compared with peers, revealed several common themes.

Case Study

America's Underinsured: A State-by-State Look at Health Insurance Affordability Prior to the New Coverage Expansions

3/25/2014 - Thirty-two million people under age 65 were underinsured in the U.S. in 2012, meaning they had health coverage but it provided inadequate protection against high health care costs relative to their income. This report finds that the rate of underinsured ranged from a low of 8 percent in New Hampshire to highs of 17 percent in Idaho and Utah.

Fund Report

Assessing Care Integration for Dual-Eligible Beneficiaries: A Review of Quality Measures Chosen by States in the Financial Alignment Initiative

3/24/2014 - As part of the federal Financial Alignment Initiative, states have the opportunity to test care models for dual-eligible Medicare and Medicaid beneficiaries, with the goals of enhancing access to services, improving care quality, containing costs, and reducing administrative barriers.

Issue Brief

Implementing the Affordable Care Act: State Action to Establish SHOP Marketplaces

3/14/2014 - This brief examines state decisions to enhance the value of the small-business marketplaces for small employers and finds that most have set predictable participation and eligibility requirements and will offer a competitive choice of insurers and plans.

Issue Brief

"Now I Can Sleep at Night": Stories of Finding Health Insurance in the Affordable Care Act's Marketplaces

3/4/2014 - This new, photo-rich Commonwealth Fund feature, "'Now I Can Sleep at Night': Stories of Finding Health Coverage in the Affordable Care Act's Marketplaces," shares the stories of Americans who have found peace of mind and stronger financial security through the new insurance marketplaces.


Trends in the Financial Burden of Medical Care for Nonelderly Adults with Diabetes, 2001 to 2009

2/28/2014 - The financial burden borne by patients for treatment of diabetes has decreased. Patients' out-of-pocket spending on prescription medications dropped from $1,095 over the period 2001 to 2003 to $763 over 2007 to 2009, largely because of a shift from brand-name drugs to generics.

In the Literature

Young Adult Participation in the Health Insurance Marketplaces:
Just How Important Is It?

2/12/2014 - The participation of young adults may not be as critical to the success of the Affordable Care Act's health insurance marketplaces as is widely believed, according to this report based on the perspectives of prominent actuaries, insurers selling plans in the marketplaces, policy researchers, and federal officials.

Fund Report

Patient-Centered Medical Home Transformation with Payment Reform: Patient Experience Outcomes

2/10/2014 - Commonwealth Fund–supported researchers compared patients' experiences in a primary care clinic that implemented the PCMH model, along with lean process changes (which seek to maximize value and reduce waste) and a new approach to physician reimbursement, with patients' experiences in a similar clinic that did not make such changes.

In the Literature

Use of Telemedicine Can Reduce Hospitalizations of Nursing Home Residents and Generate Savings for Medicare

2/5/2014 - Results from a new Commonwealth Fund–supported study in Health Affairs led by Harvard Medical School's David C. Grabowski confirm that telemedicine can be a cost-effective alternative to a trip to the hospital.

In the Literature

Implementing the Affordable Care Act: The State of the States

1/31/2014 - Although their approaches may vary, most states have taken steps to prepare for the Affordable Care Act's health insurance market reforms, marketplaces, and Medicaid expansion, a new Commonwealth Fund report finds.

Fund Report

Two-Year Impact of the Alternative Quality Contract on Pediatric Health Care Quality and Spending

1/31/2014 - In the first two years of the Alternative Quality Contract, an incentive-based provider payment program implemented by Blue Cross Blue Shield of Massachusetts, there was a significant, albeit modest, improvement in the quality of children’s preventive care, but no change in health care spending.

In the Literature

The Effect of Bundled Payment on Emergency Department Use: Alternative Quality Contract Effects After Year One

1/31/2014 - In this study, Commonwealth Fund–supported researchers examined Blue Cross Blue Shield's experiment with a global payment system in Massachusetts and its impact on emergency department use.

In Brief

Global Budgets and Technology-Intensive Medical Services

1/31/2014 - This Commonwealth Fund-supported study found evidence that, over the first two years of Blue Cross Blue Shield's experiment with a global payment system in Massachusetts, overused medical services were successfully targeted.

In Brief