Commonwealth Fund

Study: Majority of patients want EMRs

Anne Zieger — Fri, 08 Aug 2008 10:44:56 -0400

A new study from the Commonwealth Fund suggests that the majority of patients would like to see doctors move to electronic medical records, with many suggesting that EMRs would help to improve care quality and improve care coordination within the healthcare system as a whole. The study, which was conducted by Harris Interactive, found that almost 90 percent of respondents want their doctors to be able to share data electronically with other practices or hospitals. Meanwhile, another 71 percent of patients responding said that they want their doctors to be able to use e-prescribing technology to order their prescriptions.

While patients came out strongly in favor of physicians using technology for their care, they were less emphatic when it came to their own part in the process. A comparatively modest 44 percent said that they'd access their own medical records over the internet if available. Forty-eight percent said they'd book appointments and e-mail their doctors if they could. (Right now, only 8 percent were able to book appointments online, and 18 percent had e-mail access to their doctors.)

To learn more about this study:
- read this Modern Healthcare piece (reg. req.)

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Study: Nursing homes benefit from culture changes

Mon, 12 May 2008 06:59:54 -0400

Nursing homes that change their culture to make care more resident-directed, foster staff autonomy and make the facility function more like a home than hospital do better on several measures of success, according to a new study from the Commonwealth Fund. The study, which looked at a representative sample of 1,435 nursing homes between February and June 2007, classed about 31 percent of nursing homes as "culture-change adopters," 25 percent as "culture-change strivers," and the remaining 43 percent as traditional homes.

Of the "adopters" group, 58 percent allowed residents to set their own schedules, compared with 22 percent of traditional homes. Also, 59 percent of homes that had adopted a changed culture included direct-care workers and even residents on the senior management teams, while only 24 percent of traditional nursing homes did so. Researchers found that 78 percent of homes implementing seven or more culture-change initiatives improved their competitive advantage in the market. Such homes also improved operational costs, staff retention and occupancy rates, the Fund said.

To learn more about the study:
- read this Modern Healthcare piece (reg. req.)

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Study: MDs who treat minorities face quality challenges

Wed, 23 Apr 2008 06:59:55 -0400

Doctors who treat minorities tend to face a unique set of quality and financial challenges, according to a new study appearing in Health Affairs. The researchers, who used data from the 2004-05 Community Tracking Study Physician Survey, concluded that 26 percent of physicians in high-minority practices disagreed that it was possible to provide high-quality care to all patients, while only 16 percent of low-minority practices agreed with this statement. What's more, high-minority practices were more likely to report that having too little time during office visits impacted their ability to provide high-quality care. This study was supported by The Commonwealth Fund.

To learn more about this study:
- read this Modern Physician article

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IOM backs national clinical-effectiveness effort

Fri, 25 Jan 2008 06:59:55 -0500

In a new report, the Institute of Medicine is recommending that Congress establish a national program to evaluate the clinical effectiveness of products and services, in an effort to give providers a single, reliable source of information. This dovetails with recent recommendations by researchers with The Commonwealth Fund, who argue that the country should establish a "Center for Medical Effectiveness and Health Care Decision-Making."

Right now, IOM members note, clinicians have far too many sources to evaluate when looking at the clinical effectiveness of treatments and products, and researchers sometimes end up duplicating existing effectiveness research. The 16-member group, which includes academics, providers and insurers, would like to see Congress ask HHS to create a well-funded program with the resources and clinical expertise to offer a single, unified review of major clinical effectiveness issues.

To learn more about this recommendation:
- read this Modern Healthcare piece (reg. req.)

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SPOTLIGHT: Group gets grant to study patient-centered care

Mon, 07 Jan 2008 06:59:52 -0500

Group gets grant to study patient-centered care
Looks like interest is building in patient-centered care. The American College of Physicians has gotten a grant of nearly $225,000 from the Commonwealth Fund to conduct a 10-month study on how coordinated services through a primary care "base" can provide better care. Article

Report: Incentive program could save U.S. $368B

Thu, 20 Dec 2007 06:59:55 -0500

A new report suggests that if the U.S. created a program designed to provide the right incentives and improve decision making, payers could save $368 billion on health costs over the next 10 years. The report, which was published by The Commonwealth Fund, contends that the savings could mount up to more like $1.5 billion if this effort were to be combined with other efficiency programs. Among other things, the report proposes establishing a "Center for Medical Effectiveness and Health Care Decision-Making" which would squeeze information on relative clinical and financial effectiveness of treatments into an insurance benefit design. This same center would create incentives for key stakeholders--largely providers, payers and consumers--to use such information. The report also recommends that the healthcare industry boost healthcare IT investment, particularly to foster health data sharing.

To learn more from the report:
- read this Healthcare Finance News piece
- read the Commonwealth Fund press release

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SPOTLIGHT: Many Americans unsatisfied with care

Fri, 02 Nov 2007 07:59:52 -0400

Despite our high levels of medical spending, many Americans are still unsatisfied with their medical care, a new study suggests. Worse, U.S. patients have the highest out-of-pocket costs among seven Western countries, and the hardest time paying medical bills, according to the study, conducted by The Commonwealth Fund. Article

Study: Blacks get poorer nursing home care

Thu, 13 Sep 2007 06:59:54 -0400

African-Americans in the U.S. often get lower-quality nursing home care than whites, according to a new study published in the journal Health Affairs. The wide-ranging study, which was funded by the Commonwealth Fund, looked at data from 2000 on 7,196 nursing homes which took care of more than 800,000 residents across 147 metropolitan areas across the U.S.

Researchers conducting the study found that blacks were almost three times as likely as whites to live in homes with a large percentage of Medicaid beneficiaries, which often lack the resources to provide the best care. In addition, blacks were nearly 1.5 times as likely to live in nursing homes cited for dangerous violations of Medicare and Medicaid rules. Researchers also found that blacks were most likely receive worse care in racially-segregated nursing homes, which were particularly common in, for example, Cleveland, Gary, IN, Milwaukee, Detroit and Indianapolis.

To learn more about this research:
- read this Kaiser Daily Health Policy Report item

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Report: Young adults swell ranks of the uninsured

Wed, 08 Aug 2007 06:59:58 -0400

About 30 percent of the nation's estimated 44.4 million people without health insurance are 19-29 years old, making young adults the largest group of newly uninsured, according to a Commonwealth Fund study. In 2005, about 13.3 million people in this age range lacked coverage, up from 12.9 million a year earlier.

The researchers blame several factors for the bump, particularly the fact that many get dropped from their parents' health insurance or public coverage for children when they turn 19 or graduate from college. And when they enter the working world, young adults often settle for low-wage or temporary jobs without health benefits. Low-income Americans are disproportionately affected.

The report says lack of coverage puts their health at risk and can add financial stress to their lives just as they're starting out in the workforce.

For the full report:
- Start with the Commonwealth Fund's issue brief.

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Closing the racial care gap--ideas in play

Fri, 20 Jul 2007 06:59:59 -0400

While the problem of racial disparity in healthcare treatment is still huge (see story #5, below), it's interesting to note there's been several pieces of news lately that hint at some solutions. For example:

* A study by the Commonwealth Fund recently concluded that when minority patients have a "medical home," i.e. get organized care from a single, identified provider, they tend to get better care overall.

* In an effort to get more representative results from their trials, pharmas are working harder to recruit minority physicians for clinical trials, who are in turn more likely to find minority test subjects.

* Recent calls for Medicare to address some gaping racial care disparities hint at the obvious--that an organization with CMS's clout is in a better position than most to force care pattern and cultural changes where needed.

None of these are terribly revolutionary ideas, but sometimes, simply leveraging the obvious can get a lot done.

Let's hope that in the next year or two, healthcare leaders find ways to run with some of these emerging ideas. After all, the idea of ethnic minorities getting unequal care doesn't sit well with anyone--it's just a matter of doing the footwork. - Anne