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The Connection
A roundup of recent Fund publications, charts, multimedia, and other timely content.
April 24, 2023
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A Proposed Public Option Plan for California
While several states have developed “public option” health plans in recent years, they have had only limited success in lowering costs. In a Commonwealth Fund issue brief, Richard Scheffler and Stephen Shortell of the University of California, Berkeley, lay out their proposal for a different type of public option plan. Designed for California’s delegated model of health care — in which provider organizations accept the financial risk for delivering health services — the “Golden Choice” plan would be the most affordable plan available throughout most of the state.
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The Dose on Bias in AI and Obesity as a Disease
On The Dose podcast, host Joel Bervell spoke with Dr. Ziad Obermeyer, from the UC Berkeley School of Public Health, about the potential of AI to improve health outcomes. He says algorithms can predict who is likely to get sick, but they can also entrench racism and inequality in the system. On another episode, Bervell spoke with Dr. Fatima Stanford of Massachusetts General Hospital about obesity: its history, including the racist origins of the body mass index (BMI), and the flawed science, misperceptions, and stigma that people with obesity encounter.
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FEATURED CHART
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Easing the Primary Care Crisis with Value-Based Payments
The current crisis in primary care — a shortage of providers, burnt-out physicians, and unsatisfied patients — can be attributed in part to the piecemeal way we pay for care in the United States. On To the Point, the Commonwealth Fund’s Celli Horstman and Corinne Lewis write that value-based payment, or VBP, could help. They say provider participation in VBP requires upfront investment and the ability to manage financial risk. They note that small, rural, and independent practices — among the least likely to participate — may especially benefit from help acquiring the additional staff and technology needed to make VBP work.
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How Gun Violence Burdens the U.S. Health Care System
Americans are all too familiar with the human toll of gun violence. The United States, where civilian-owned guns outnumber people, stands apart among high-income countries in its rate of firearm deaths. Less publicized is how gun violence burdens the U.S. health care system. Commonwealth Fund research highlights how firearm injuries lead to some 30,000 inpatient hospital stays and 50,000 emergency room visits every year, resulting in more than $1 billion in medical costs.
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Congress Can Help Reduce Medicaid’s Coverage Gaps
Seeking to control costs and improve quality of care, more than a dozen states have established accountable care organizations, or ACOs, for their Medicaid-covered residents since 2010. But relatively little is known about their impact in Medicaid, or what factors into their successful adoption. In a Commonwealth Fund report, Harvard University’s Meredith Rosenthal and colleagues reviewed evidence from 30 previous studies and interviewed state Medicaid agency leaders and safety-net providers to document the performance of Medicaid ACOs to date, the facilitators and barriers to their spread, and federal policies that could support them.
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How Hospitals Can Reduce Emissions and Curb Climate Change
In addition to all the other harms it causes, climate change has a profound impact on our health, exacerbating chronic conditions and worsening mental health. But the health system itself contributes to climate change, creating about 8.5 percent of total U.S. greenhouse gases. Hospitals and health systems can do a lot to reduce their carbon emissions. The first step, say the Commonwealth Fund’s Lovisa Gustafsson and coauthors on To the Point, is for organizations to understand their emissions footprints and define their targets. Then it’s a matter of prioritizing and implementing decarbonization strategies, the authors write.
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Improving Health Care in Rural America
The U.S. Centers for Disease Control and Prevention has opened an Office of Rural Health, aiming to reduce health disparities between urban and rural communities by
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strengthening the capacity for public health interventions in rural areas. In partnership with the Bassett Research Institute, the Commonwealth Fund is publishing a series of articles showcasing solutions to unique challenges in rural health, including gaps in
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behavioral health services and
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chronic disease management.
International Insights Wants to Hear from You
It’s been six months since we launched International Insights, our biweekly look abroad at potential solutions to U.S. health policy challenges. The series has allowed us to explore health system innovations in countries we’ve never before covered — we’ve looked at Nigeria’s successful initiative to lower HIV rates during the COVID-19 pandemic and Argentina’s efforts to protect health care for all people, among other stories. Which Insights have captured your attention? Which countries and topics are you curious to learn more about? How have you shared these Insights with others? We invite you to email the Commonwealth Fund’s international team at
mailto:
[email protected]?subject=
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Affordable, quality health care. For everyone.
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