A new survey of health care opinion leaders supports expanding SCHIP to cover legal immigrant children, families with higher incomes, and parents of covered children. The program should also incorporate high-quality health care standards and innovative mechanisms to encourage better care.
A new report by the National Women's Law Center finds that women are more likely to struggle with medical bills and go without needed care due to high healthcare costs. The report also highlights a gender gap in health coverage, with more women than men facing underinsurance or uninsured status.
The study found that most current pay-for-performance programs focus on women's, children's, and adolescents' health issues, while new programs are shifting emphasis to chronic diseases like asthma and diabetes. The majority of existing programs operate in managed care or primary care case management environments.
Current Congressional proposals could significantly reduce the number of uninsured Americans and decrease overall healthcare expenditures. Representative Stark's AmeriCare proposal would cover nearly all of the uninsured as well as strengthen employer-based health insurance, reducing overall health spending by $60.7 billion.
A new Commonwealth Fund study highlights the importance of comprehensive well-child health services in preparing children for school and helping determine their future success. States are urged to preserve and expand Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program to ensure access to high-quality preven...
The Commonwealth Fund Health Care Opinion Leaders survey found that expanding coverage for the uninsured (88%) and moderating rising healthcare costs (81%) are top priorities. Experts also suggest increasing recommended care levels and reducing inappropriate services to achieve a high-performance healthcare system.
Adults in consumer-driven plans spend large shares of their income on out-of-pocket costs and premiums. People with lower incomes are less likely to contribute to their accounts.
A report from the Commonwealth Fund estimates that private Medicare Advantage (MA) plans were paid $922 more for each beneficiary than traditional Medicare's fee-for-service program in 2005, totaling over $5.2 billion. Eliminating these extra payments could save Medicare $30 billion over five years and be redirected to enhance benefits.
Employers covering over 90% of the nation's workforce see health benefits as a crucial factor in attracting and retaining top talent. Many firms are open to sharing the cost of health insurance and supporting incremental reforms aimed at expanding coverage, improving quality, and reducing administrative expenses.
A new report from the Commonwealth Fund finds that nearly nine of 10 individuals who seek individual market health insurance are unable to secure coverage due to unaffordability or pre-existing conditions. Those with high-deductible plans face significant cost burdens, including higher out-of-pocket expenses and increased medical debt.
Two-fifths of US adults report experiencing unsafe, wasteful, or poorly coordinated healthcare. This is a significant concern, as three-quarters of adults advocate fundamental changes in the healthcare system.
The Commonwealth Fund Commission recommends implementing major quality and safety improvements, expanding information technology, and increasing public reporting on quality and costs. The report aims to establish more organized systems of care to improve value and provide reliable comparison of results among providers.
Sixty-two percent of Hispanic adults were uninsured, with three-quarters having no health insurance due to low income. Uninsured rates for African Americans are also high, with one-third experiencing gaps in coverage during the year. These disparities affect access to care and confidence in managing health problems.
Majority of healthcare opinion leaders support the Medicare Part D program, but favor changes to reduce complexity and improve coverage for vulnerable populations. Opinion leaders recommend policy changes such as filling the donut hole and eliminating the asset test to benefit low-income beneficiaries.
A study by Dahlia Remler and Sherry Glied found that Health Savings Accounts (HSAs) may not reduce healthcare spending for the lowest and biggest spenders. In fact, cost-sharing increases for mid-range spenders, while tax subsidies benefit higher-income individuals disproportionately.
Young adults are the fastest growing group of uninsured, with nearly 14 million lacking health coverage. They face significant health and financial risks, including delayed or foregone medical care due to cost concerns.
A new study found that Medicare Advantage (MA) plans can be a bad deal for beneficiaries in poor health, with some facing annual out-of-pocket costs of up to $7,522. Despite extra payments to MA plans, many vulnerable enrollees are still at risk of not getting needed healthcare services due to high cost burdens.
Employees in small firms pay 18% more for health insurance due to higher administrative costs and lower negotiated rates with insurers. States with urban populations tend to have better-adjusted premiums, while rural states face higher costs.
A new survey reveals that one in five working-age adults is paying off medical debt, while nearly two-thirds of those with chronic illnesses skip medications due to cost. The uninsured are also more likely to go without preventive care, screenings, and regular doctors, exacerbating existing health problems.
Eliminating disparities in children's healthcare will require a broad quality improvement effort involving federal oversight, increasing public insurance coverage, data collection, and workforce diversity. Key areas of focus include improving care for children in public programs, community health centers, and private physicians' practi...
Four New York City clinics improved primary care services for low-income patients by redesigning their systems using a learning collaborative approach. The initiatives achieved significant reductions in wait times, improved financial performance, and increased patient access.
The new Medicare drug law creates a coverage gap, or 'donut hole,' where chronically ill patients will bear the greatest burden. Many with chronic conditions will face high out-of-pocket costs for medications, exacerbating health problems and increasing healthcare expenses.
The policy of increasing payments to private managed care plans has added $2.75 billion to Medicare's costs in 2004, with benefits mainly going to urban plans that have more enrollees. Despite the increase, only 40% of Medicare beneficiaries can access a Medicare Advantage plan.
Physicians play a key role in improving patient safety by developing and implementing safety improvements, says study. The current medical liability system prioritizes capping malpractice awards over patient safety, contributing to unnecessary procedures and rising healthcare costs.
High rates of uninsured Hispanics and unstable coverage put them at risk for preventable health problems. One quarter of Hispanics aged 50-64 went without needed care due to costs.
The report compares six Democratic candidates' plans to address the problem of the uninsured, revealing a range of proposals from covering most or all of the uninsured to 1 in 10. Most Democratic candidates would repeal some or all of President Bush's tax cuts to help finance their health plans.
A study by The Commonwealth Fund found that children in Medicaid managed care receive significantly lower rates for clinical quality indicators, including childhood immunizations and well-child visits. High-performing plans with both commercial and Medicaid enrollees were able to achieve high HEDIS performance measures.
Health insurance scams have been on the rise as premiums increase at double-digit rates, leaving nearly 100,000 people with unpaid medical debts and without coverage. The Commonwealth Fund report recommends strengthening criminal penalties, expanding access to affordable coverage, and improving consumer education.
Many low-income Medicare beneficiaries will struggle with high drug costs despite new proposals in Congress. Beneficiaries living on $10,000-$20,000 annually face significant financial hardship due to limited coverage and increased out-of-pocket expenses.
A recent study found that providing Medicare coverage to previously uninsured adults increases access to life-saving preventive tests like cancer and cholesterol screenings. The gap in testing rates narrows significantly after eligibility.
The study reveals that out-of-pocket spending for Medicare PPO enrollees is nearly 50% higher than costs for Medicare+Choice enrollees, raising questions about the value of these plans. Costs have doubled since 1999, with sicker beneficiaries facing even higher cost burdens.
The Medicare waiting period affects 1.26 million seriously disabled Americans, with 400,000 having no health insurance. Eliminating the two-year wait could save states $1.8 billion per year and reduce federal Medicaid expenditures by $2.5 billion.
Private Medicare+Choice plans experience instability, with low participation rates and high turnover among physicians and hospitals. The complex choice of benefits and cost-sharing makes it difficult for beneficiaries to make informed decisions.
The US healthcare system faces a high-performance goal with increasing efficiency and effectiveness. Key steps outlined include public reporting of data on providers, health plans, and demonstrations of new approaches to insurance coverage, technology, and quality standards.
Federal regulations and hospital policies can leave patients in debt due to lack of clear guidelines on free or discounted care. Hospitals often do not have procedures for negotiating discounts with uninsured patients who cannot afford full charges.
Half of high school graduates who don't attend college full-time become uninsured for some time after graduation, with many unable to access health care due to cost concerns. Young adults face significant barriers to obtaining insurance coverage through various means.