New Directions in Health Care

The 11 million undocumented immigrants in the United States are excluded from all provisions of the Affordable Care Act. Find out why improving access to care for these workers could benefit all Americans.      

Today, Medicare pays health care providers based the number of services they provide, rather than the quality of that care. Sandy Hausman talks with Commonwealth Fund vice president Stuart Guterman and Michael Chernew of Harvard Medical School about how to reform Medicare payment in an effort to control health care spending growth while improving care.       

The use of health care decision aids such as multimedia programs, videos, and even brochures can help patients become more engaged with their care, and lead to better health outcomes and lower health care costs.      

A promising new program has reduced the number of hospitalizations among nursing home residents, sparing them unnecessary risk and saving significant amounts of money. Learn more about The Commonwealth Fund–supported INTERACT program, which helps nursing home staff identify problems early.      

The new state-based health insurance exchanges, established under the Affordable Care Act, are where individuals, families, and small businesses will be able to buy affordable private health insurance starting in 2014. In this episode, Sandy Hausman interviews experts Sara Collins, Timothy Jost, and Sara Rosenbaum about how the exchanges will work and whom they will help.      

"Accountable care is a shift in focus from payment for units of service to payment for taking good care of patients over time," explains The Dartmouth Institute's Elliott Fisher, M.D., in this episode about accountable care organizations, or ACOs. Through interviews with Dr. Fisher and Commonwealth Fund experts, Sandy Hausman explores how ACOs will change the way we think about care and how we pay for it.       

This episode looks at a new scorecard on local health system performance from The Commonwealth Fund Commission on a High Performance Health System, and how communities can use its data to improve.      

This podcast examines the implications of the Affordable Care Act for the nation's safety net health care providers, which include clinics and hospitals that serve low-income patients and those who have no insurance.      

Sandy Hausman looks at a new study on state trends for employer-sponsored insurance premiums and deductibles that found a 50 percent increase in premiums between 2003 and 2010, and a 63 percent increase in the employee share of the premium for a family plan. Also discussed are Affordable Care Act provisions that should help lower premiums.      

One of the biggest challenges in health care reform is how to care for people who qualify for both Medicare and Medicaid. This group tends to be sicker, poorer, and more costly than the average person in either program. This episode looks at reducing duplication of care and providing assisted living, among other strategies for helping "dual eligibles" and getting their health care costs under control.       

The first of 70 million baby boomers turn 65 this year, and long-term services and supports (LTSS), which include home care, assisted living, and nursing home care, are on the rise. To help states identify gaps, AARP’s Public Policy Institute, The Commonwealth Fund, and The SCAN Foundation, developed the first state LTSS scorecard.      

In the U.S., the complex process of seeking compensation for medical injuries makes it difficult for patients to receive compensation, and fear of lawsuits leads to defensive medicine. This episode looks at countries like New Zealand, which separate patient compensation and issues of medical malpractice.      

Relatively little attention has been paid to the ways the health reform law seeks to strengthen the delivery system. This episode addresses how provisions to improve transparency, encourage more organized care, and promote payment reform affect those on the frontlines.      

This episode focuses on a new report evaluating how well the nation cares for its kids. Producer Sandy Hausman explores why children's coverage has improved in 35 states despite the recession, what states can learn from each other, and how health reform can help.       

Americans usually know what they can expect to pay for products—and most understand that you get what you pay for—but when it comes to health care, that's not the case. This episode looks at how sharing information about quality and costs with the public, payers, and health care professionals may change the way health care is delivered.      

Sandy Hausman reports on the Safety Net Medical Home Initiative, a Commonwealth Fund-supported demonstration project designed to help clinics that serve low-income patients become medical homes.      

Today, many primary care practices are sharing clinical and technical services with other providers so that they can become certified medical homes, which provide patients with coordinated, around-the-clock care. In Massachusetts, 95 percent of pediatric practices rely on the Child Psychiatry Access Project for guidance in mental health care.      

Commonwealth Fund president Karen Davis discusses how the Affordable Care Act might improve U.S. health system performance relative to six other industrialized countries surveyed by The Commonwealth Fund.      

This episode of the New Directions in Health Care series looks at the findings from a survey of federally qualified health centers. Community health centers are the core of the ambulatory care safety net—serving some 16 million Americans, regardless of their ability to pay.      

This episode of the New Directions in Health Care series looks at the costs of providing medical services in other parts of the world and considers how health care reform might change the bottom line in this country. It explores ways in which proposed health reforms in Congress—such as an emphasis on primary care and new approaches to delivery and payment—could help ensure value for our health care dollars.