Who Cares What Patients Think?

The growing complexity of our health care system, and time demands on providers, can cause patients’ non-obvious needs to get lost in the shuffle. Sometimes, the result can be less-than-optimal care. In response, providers are trying to be more responsive to patients’ cultural traditions, family situations, personal preferences and values. Some have tagged this movement “patient-centered care.”

State Health Reform Initiatives: Are There Lessons for Federal Policymakers?

Polls consistently show that addressing problems in our health care system remains a top concern for most Americans. But while major health care reform efforts have stalled in Washington, many states are attempting to address the rising number of uninsured on their own. This briefing focused on such efforts in three states – Massachusetts, Vermont and Utah.

Measuring Up: A Comprehensive Scorecard for America’s Health System

A new assessment by The Commonwealth Fund finds that deficiencies in the nation’s health care system cost 100,000 to 150,000 lives and $50 to $100 billion annually. The scorecard compares national averages for the U.S. to national and international benchmarks for 37 indicators. The U.S. received a composite score of 66 out of 100. On one quality measure, mortality, the U.S. ranked 14th out of 19 countries.

Helping the Medicare Savings Programs Get Savings to Seniors

The Medicare Savings Programs provide assistance with premiums — and in some instances, cost sharing requirements — to Medicare beneficiaries of limited income and resources who do not qualify for full Medicaid benefits. Medicare Part B premiums currently amount to over $1,000 annually — which can be a large sum for some beneficiaries.

Rewarding Quality Performance: The Multidisciplinary Approach

In today’s health care system it is clear that there needs to be a multidisciplinary approach toward improving quality. Nurses are on the front lines of implementing this quality improvement. By using the highest quality measurements and optimizing the delivery of care, those outside the nursing community would understand the importance of their role in quality performance.

The Massachusetts Health Plan: How Did They Do It?

On April 4, the Massachusetts legislature approved a plan that requires all adults to purchase health insurance by July 2007, or face a fine. The plan is projected to expand coverage to 95 percent of the state’s uninsured residents over the next three years.

Patient Safety: Why It’s Getting More Visibility

The enactment of the Patient Safety and Quality Improvement Act last year sets the stage for health care providers to be able to report medical errors confidentially to designated entities known as “Patient Safety Organizations” (PSOs).

Exploring Realistic Coverage Options for the Uninsured

The enactment of the Patient Safety and Quality Improvement Act last year sets the stage for health care providers to be able to report medical errors confidentially to designated entities known as “Patient Safety Organizations” (PSOs).

Toward A High Performance Health System: Public-Private Efforts to Make Health Care Safer and More Effective

The U.S. health care system is the most expensive in the world. Yet it is clear that by many measures, Americans are not receiving commensurate value for the health care dollars they spend. Is it possible to simultaneously improve health coverage and quality, while generating savings for health care consumers, employers, government and health care providers? What are the characteristics of a high performance health system? What realistic steps does the private sector need to take, contrasted with government bodies, to move the U.S. toward such a system? What policy changes would be most helpful to the most vulnerable populations – the uninsured, and those facing disparities in care or coverage due to income, race/ethnicity, health or age?

Pay-for-Performance: Taking Health Care Quality Improvement to the Next Level

Pay-for-performance programs have been touted by some as a way to improve the overall quality of care provided to patients, while being criticized by others who fear unintended consequences in attempting to change physician behavior. The Medicare Payment Advisory Commission has recommended that pay-for-performance be incorporated into Medicare reimbursement policy in a number of areas. Recent laws, including the Medicare Modernization Act, have mandated pay-for-performance demonstration projects, including one for chronically ill Medicare patients.

How Good is the Quality of Care in Medicare?

The federal government’s responsibility to provide access to health care for the nation’s 41 million Medicare beneficiaries implies another obligation: to spend taxpayer dollars wisely. This means assuring that the $250 billion+ spent for Medicare goes for services that are safe, timely and effective.

Checking Up: What Are Your Hospital’s Vital Stats?

A newly launched website known as “Hospital Compare” is the most comprehensive attempt yet by the Centers for Medicare and Medicaid Services (CMS) to display voluntary, self-reported information by hospitals on steps that can be taken to reduce the impact of three major causes of morbidity and mortality – heart attack, heart failure, and pneumonia – in a consumer-friendly format.

The Reality and Potential of Evidence-Based Medicine

Evidence-based medicine offers a win-win proposition: improve the quality and effectiveness of care while at the same time identifying opportunities to reduce waste of valuable health care resources. But what evidence should employers, health care providers and consumers pay attention to? And how should this information be disseminated to those who need it?

Consumer-Directed Health Care: The Next Big Thing?

Some market-oriented economists have long contended that the best way to get a handle on rising health care costs is to give patients more control over the type of services they consume and the prices they pay for them. There are increasing signs that the market is gravitating in this direction. In the last several years employers have been setting up so-called “consumer-directed” plans, which put more responsibility for selecting the appropriate provider at the right price in the hands of employees—in exchange for potential financial gains.

Malpractice Reform: Beyond the Current Debate

Medical errors and claims of malpractice are a fact of daily life, according to the Institute of Medicine and other researchers. For doctors, hospitals and other providers, so are rising malpractice premiums, which recent reports suggest may be hurting providers’ ability to administer care in some regions of the country and in some specialties, such as obstetrics.

Medicare Reform Legislation: An Update

After years of discussion and debate, both Houses of Congress passed bills providing for Medicare prescription drug coverage in July, 2003. In September 2003, conferees from both the House and Senate resumed their attempt to iron out the differences between the two bills and enact the most extensive expansion of the Medicare program since its inception.