The Connection

A roundup of recent Fund publications, charts, multimedia, and other timely content.

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November 27, 2023

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Blueprint for Easing the Burdens of Family Caregivers

Tens of millions of Americans caring for a family member at home do so without payment, recognition, or any assistance. Many contend with poor health, emotional stress, and financial insecurity tied to their caregiving responsibilities. In a Commonwealth Fund issue brief, Barbara Lyons and Jane Andrews identify short- and longer-term Medicare policy options that could make a difference in the lives of people providing at-home care to a loved one.

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As Enrollment Increases, ACA Marketplaces Innovate

Enrollment in the Affordable Care Act’s insurance marketplaces is at an all-time high, and sign-ups are expected to rise with the return of Medicaid eligibility redeterminations. In a Commonwealth Fund report, Georgetown University’s Rachel Schwab and colleagues describe efforts by the federal and state-run ACA marketplaces to reduce consumers’ administrative burdens, help them navigate plan options, and reduce disparities in coverage and care.

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FEATURED CHART

Americans Find It Harder to Pay for Health Care

U.S. adults with low or average incomes are more likely to struggle to afford their health care than their counterparts in other high-income nations, according to a Commonwealth Fund study that explored how financial barriers affect people’s health care decisions. In some cases, even Americans with high income are more likely to face cost barriers to care than people with low income in other countries. The report also found that unmet social needs related to food, housing, or employment affect about a third of adults with low or average income in most of the eight countries studied.

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States Work to Improve Maternal Health Outcomes

With maternal mortality rates rising across the U.S., states are taking measures to improve care through Medicaid, which covers more than 16 million women of reproductive age and 41 percent of all U.S. births. On To the Point, Rebecca Johnson and colleagues and the Commonwealth Fund’s Laurie Zephyrin, M.D., discuss policy changes across the country in three areas: coverage and benefits, care delivery transformation, and data and oversight.

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For Better Maternal Care, Listen to Women

To ensure better maternal health outcomes and the end of racial and ethnic maternal health disparities, any new policy initiatives must align with the goals and preferences of women and other birthing people. The Commonwealth Fund’s Morenike Ayo-Vaughan and Laurie Zephyrin, M.D., and the Urban Institute’s Zara Porter and Sarah Benatar highlight themes that emerged from a series of focus groups with Black, Native American, and Latina pregnant and postpartum women. They note the challenges women living in rural maternity care deserts face, as well as the negative experiences many women have during provider visits.

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Private Equity’s Aggressive Move into Health Care

While private equity firms have long had a foothold in the health care sector, recently there’s been a dramatic rise in acquisitions of physician practices. In many metropolitan areas, a single private equity firm owns more than half of the market for certain medical specialties. In a new explainer, David Blumenthal, M.D., breaks down the changing role of private equity in health care, and what it means for patients, providers, and purchasers.

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Health Care Sharing Ministries Leave Members in the Lurch

Health care sharing ministries market themselves as health care coverage. Members, who follow a common set of religious or ethical beliefs, make monthly payments to help pay other members’ medical bills. But what they provide is not health insurance. These organizations are under no obligation to pay health care claims, and they often leave their members stuck with large medical bills. On To the Point, Georgetown University experts examine the experience of Colorado, the first state to require health care sharing ministries to report key data, to shed light on the risks that members face and the challenges for regulators and policymakers charged with protecting consumers.

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Lower Sodium Is Leading to Longer Lives in Japan

Americans die younger than people in every other high-income country. In Japan, people live an average of 8.1 years longer. But this wasn’t always the case. According to the Commonwealth Fund’s Evan D. Gumas, “things started to really change when the Japanese government developed a comprehensive public health program aimed at improving outcomes.” Reporting for International Insights, he says a key program component was a broad-based campaign to reduce the nation’s high salt intake, centered around sustained public education efforts and strict regulation of high-sodium processed foods.

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Getting Teens Access to Mental Health Treatment

As reported in HealthLeaders, New York City has begun partnering with the digital health company TalkSpace to offer teens access to a licensed therapist ([link removed] ) via phone, video, or text at no cost. Read our recent Transforming Care story describing other strategies for filling gaps in access to mental health treatment ([link removed] ) for teens and young adults.

Affordable, quality health care. For everyone.

The Commonwealth Fund, 1 East 75th Street, New York, NY 10021

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