Tag: Commonwealth Fund
Commonwealth Fund reports on ways to increase specialty care access to Medicaid patients
Posted by Nikki Hurt on June 7, 2013
There are several barriers in place that decrease access to specialty care for many Medicaid beneficiaries. Some of these deterrents to specialty care include low physician reimbursements, administrative burdens of treating Medicaid patients, and non-medical challenges often experienced by Medicaid beneficiaries. A new study released by The Commonwealth Fund examines six models that are currently being used by safety-net hospitals, community health centers, and state Medicaid programs to help Medicaid patients gain access to specialty services. Some of the strategies in these models include: delivering specialty care at primary care facilities, expanding the role of primary care physicians, and hiring staff that coordinate care among different providers for Medicaid beneficiaries.
Commonwealth finds millions of Americans still lacking affordable coverage
Posted by Nikki Hurt on April 26, 2013
According to a new survey released by the Commonwealth Fund, 84 million Americans were either uninsured or under-insured in 2012. In addition, 75 million Americans in 2012 were either actively paying or having difficulty paying their medical bills, indicating that medical debt is still a prominent issue. Findings were not bleak for all demographics, however, as the 2012 Biennial Health Insurance Survey also found that the proportion of uninsured individuals ages 19-25 decreased from 48% to 41% in 2012. This phenomenon is most attributable to the Affordable Care Act’s (ACA) provision that allows children to remain on their parents’ health insurance until age 26.
Commonwealth Fund study finds insurers spend less than 1% of premium dollars on health care quality improvement
Posted by Nikki Hurt on March 22, 2013
The medical loss ratio (MLR), a requirement within the Affordable Care Act (ACA), states that insurers must spend either 80% or 85% of their premium dollars on medical claims or quality improvement. A new Commonwealth Fund study found that in 2011, insurers spent less than 1% of their premium dollars on quality improvement measures, which translates to a combined spending of $2.3 billion, or $29 per subscriber. The study describes how different insurer types (publicly traded, nonprofit, provider-sponsored, etc.) allocate their premium dollars, specifically focusing on measures for quality improvement.
Commonwealth Fund publishes field report on ACOs
Posted by Nikki Hurt on March 14, 2013
In a field report published yesterday, the Commonwealth Fund discusses the progress made by accountable care organizations (ACOs) in improving health care quality and efficiency. ACOs, established by the Affordable Care Act (ACA) as a Medicare delivery system option, are designed to systematically improve health care delivery and mitigate cost increases by forming contractual relationships between physicians and payers.
This report details the successes and challenges experienced by seven hospital-physician groups that are considered early-adapters of the ACO model. These entities are involved, or will soon be involved, in risk-sharing arrangements with public and private payers. Representatives from the featured ACOs discuss their strategies for integrating clinicians, managing practices, designing incentives, and sharing rewards. The goal of this report is to educate providers in methods that promote partnership and success in ACOs.
Commonwealth Fund study describes how states chose benchmark plans
Posted by Nikki Hurt on March 13, 2013
The Commonwealth Fund published a study today describing how 24 states and the District of Columbia selected the benchmark plans to offer in their respective state insurance marketplaces. The Affordable Care Act (ACA) calls for a set of essential health benefits that state insurers must offer to ensure comprehensive and adequate coverage. The federal government permitted states to choose their own benchmark plans, pursuant to ACA requirements, that serve as a reference point for the essential health benefits package. All but five states have selected a small-group plan. This study analyzes the methodology used to select state benchmark plans, which included approaches such as intergovernmental collaboration, research, and stakeholder engagement.
NAMD publishes white paper on Medicaid system reform
Posted by Michal McDowell on February 12, 2013
The National Association of Medicaid Directors (NAMD) recently published a white paper on Medicaid system reform efforts. Over the past year, NAMD has been working, with support from the Commonwealth Fund, to collect a growing catalog of “best practices” and innovative state initiatives. NAMD details the results of these efforts in the paper, which identifies and addresses the major barriers and the most likely pathways to Medicaid-driven and Medicaid-relevant health system reform.
Commonwealth Fund study finds most states unprepared for 2014 implementation
Posted by Michal McDowell on February 1, 2013
An issue brief recently released by the Commonwealth Fund examines state action on a subset of Affordable Care Act provisions, including guaranteed access to coverage and a ban on preexisting condition exclusions. These protections go into effect in 2014. The analysis finds that, to date, only one state passed new legislation on all of these protections, and an additional 10 states and the District of Columbia passed new legislation or issued a new regulation on at least one of the two. The analysis also finds that some states face limitations in fully enforcing these reforms. According to the report, these findings suggest an acute need for states to take action in 2013 to help ensure that consumers are fully protected by and benefit from the ACA’s most significant reforms.
Commonwealth Fund report identifies strategies to control health spending growth while improving performance
Posted by Michal McDowell on January 10, 2013
According to a new report released by the Commonwealth Fund, a new set of proposed policies designed to accelerate innovation in care delivery could slow health spending growth by $2 trillion over the next decade. The report outlines a comprehensive set of policies to modify the way public and private purchasers pay for care, improve the accessibility of high-value care options, and address forces driving skyrocketing health care expenditures. Commonwealth estimates indicate that if the policies are implemented soon, with public and private payers acting in concert, federal spending could be reduced by $1.04 trillion, state and local government spending by $242 billion, and employer spending by $189 billion over the next decade. The proposed policies would also realize significant savings for families ($537 billion over a decade) as a result of lower future health insurance premiums and out-of-pocket costs. Click here for an executive summary of the report.
Commonwealth study finds premiums, deductibles on the rise
Posted by Michal McDowell on December 17, 2012
A Commonwealth Fund analysis of state trends in private employer-based health insurance from 2003 to 2011 reveals that premiums for family coverage increased 62 percent across states. This increase was far steeper for middle and low-income families. Researchers also found that deductibles more than doubled in large and small firms. Thus, workers are paying more, but receiving less-protective benefits. If trends continue increasing at this rate, the average premium for family coverage will reach nearly $25,000 by 2020. The Affordable Care Act (ACA) should begin to moderate costs while improving coverage. With private insurance costs projected to grow at a rate faster than income, more efforts to rein in costs are necessary, according to the study.
Commonwealth Fund releases paper on MLR
Posted by Michal McDowell on December 5, 2012
The Affordable Care Act’s (ACA’s) medical loss ratio (MLR) rule requires health insurers to pay out at least 80 percent of premiums for medical claims and quality improvement, as opposed to administrative costs and profits. A new issue brief from the Commonwealth Fund examines whether insurers have reduced administrative costs and profit margins in response to the new MLR rule. In 2011, the first year under the rule, insurers reduced administrative costs nationally, with the greatest decrease, over $785 million, occurring in the large-group market. Small-group and individual markets decreased administrative costs by about $200 million each.