New Directions in Health Care

After Hurricane Katrina, New Orleans had "an unprecedented opportunity to redefine its health system." This episode looks at the network of safety-net clinics that was created following the disaster, and how many of these clinics have become medical homes that provide coordinated, accessible, and affordable primary care.      

It's been three years since Massachusetts implemented sweeping health reform. In this episode, Sandy Hausman looks at how satisfied consumers, employers, and physicians are with the new system. Key players also discuss how a good public education campaign and a general spirit of cooperation contributed to the program's success.      

Over the last 20 years, the quality of life and care in nursing homes has improved dramatically. But some experts say federal and state regulations of nursing homes can get in the way of these important changes, if caregivers and home operators see surveyors—who visit homes to make sure they are complying with standards—as the enemy. A new Commonwealth Fund report suggests that state inspectors could, in fact, be agents of change.       

More than 13.2 million young adults in the U.S. have no health insurance coverage, finds a Commonwealth Fund study. While many young adults are healthy, this age group is in need of preventive care for the chronic conditions so many Americans develop. Learn how federal and state policies can help keep young people insured.      

Given the tightly packed schedules of health care providers, there can be a lag time of as long as a decade in getting national recommendations into practice. Public-private improvement partnerships, a concept developed with Commonwealth Fund support by the Vermont Child Health Improvement Program, provide regional training, site visits, and more, to help with the process of change.      

Being discharged from the hospital is something most patients eagerly anticipate, but many patients find themselves back in the hospital far too soon. A new Commonwealth Fund-supported initiative administered by the Institute for Healthcare Improvement called STAAR--State Action on Avoidable Rehospitalization--is a multi-state, multi-stakeholder collaborative that aims to reduce rehospitalization rates by 30 percent.      

Women are disproportionately affected by health care costs, according to a new Commonwealth Fund study. The study authors say that medical debt--which affects women across all income levels--is forcing many women to skip care or make other sacrifices.      

In this episode, producer Sandy Hausman visits a V.A. hospital in Virginia to see how electronic record keeping has improved quality on almost every measure of care. She also talks with the author of a Commonwealth Fund-supported study that provided crucial evidence linking health information technology, such as automated order entry, notes and decision-support, with lower mortality rates as well as lower costs.      

Advancing Excellence in America's Nursing Homes is a group of long-term care providers, caregivers, consumers, and others that has engaged almost half of the nursing homes in the U.S. in its quality improvement efforts. For this episode, Emily Schifrin talked with the organization leadership and frontline workers to find out what has made the campaign so successful.       

Residents, families, and staff say that Green Houses, based on a radically different model for long-term care created by geriatrician Bill Thomas, M.D., make warm, wonderful homes for elders. In this episode, Emily Schifrin visits two new Green Houses, in San Angelo, Texas, for elders with Alzheimer's disease.      

Producer Sandy Hausman explains the role retail clinics, which operate in pharmacies, supermarkets and big-box retailers, play in providing basic health care to certain Americans who lack affordable alternatives.      

In North Dakota, a trip to the doctor can involve "a lot of windshield time," explains Mary Wakefield, director of the Center for Rural Health at the University of North Dakota. In this episode, Sandy Hausman looks at how telemedicine--where health care is delivered by computer--is making it easier for people in rural areas to get the care and medication that they need.      

The Assuring Better Child Health and Development initiative was designed to improve the delivery of developmental services though policy and practice change in selected states. In Iowa, a focus on screening, as well as on the mental health of the family and referrals to appropriate providers for treatment, has led to more comprehensive care.      

Geisinger Health is a physician-led, integrated system that cares for about 2.5 million patients in Pennsylvania. Learn about the radical changes Geisinger has made to improve care for its patients while also improving efficiency.       

A remodeled downtown location, same-day scheduling, and ready access to physicians have enhanced patient-centered care delivered by the Family Medicine Practice of The Polyclinic.      

A new method of interpreting--where doctors and patients speak into enhanced telephones while an off-site interpreter translates--is helping improve patients' experiences and outcomes at Bellevue Hospital in New York City.       

Hear how a culture change initiative at the Sarah Neuman Center in Mamaroneck, New York, and at Jewish Home Lifecare's Manhattan and Bronx campuses, is transforming life for residents and staff by deinstitutionalizing the physical environment, dining, the staffing structure, and more.      

Because the U.S. health system is complex and fragmented, physicians find it difficult at times to put the needs of patients first. But some health care practices deliver patient-centered care despite the odds. In this episode, producer Sandy Hausman visits the Wheaton Franciscan Medical Group in Racine, Wisconsin, where staff are dedicated to exceptional patient service as well as superior clinical quality.