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The Commonwealth Fund Connection

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




March 18, 2022

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International Comparison: Primary Care in U.S. Sorely Lacking
According to a new study of primary care in 11 wealthy countries, the United States lags on multiple measures of access to services and coordination of care. The report, which draws on Commonwealth Fund survey data, finds: U.S. adults are least likely to have a primary care home; access to home visits or after-hours care is lowest in the U.S.; and just half of U.S. primary care physicians report adequate coordination with specialists and hospitals. The researchers attribute these deficiencies to decades of underinvestment in primary care.

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The Case for Investing in Primary Care
Spending less on primary care than on specialty care sends a message to our primary care workforce: we don’t value what you do. The result? Burnout, high turnover, physician shortages — all of which were crises even before the pandemic. On The Dose podcast, host Shanoor Seervai talks to Asaf Bitton, M.D., executive director of the health innovation center Ariadne Labs, about what it will take to rebuild the nation’s broken primary care system.

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How Medicare Can Expand Access to Primary Care While Controlling Costs
In 2020, 38 percent of Medicare beneficiaries who tried to find a new primary care provider had challenges — possibly because of how Medicare pays for primary care. In a new Commonwealth Fund brief, Jennifer Podulka and colleagues discuss 10 lessons from recent federal attempts to increase payment for primary care providers and improve beneficiaries’ access to services.

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Medicaid Disenrollment After the Public Health Emergency Ends
As part of the declaration of the COVID-19 public health emergency in 2020, Congress required states to maintain coverage for Medicaid enrollees or risk losing federal matching funds. When the emergency ends, scheduled for April 16, states will resume eligibility verification. According to George Washington University’s Leighton Ku and Erin Brantley, up to 15 million people could lose their coverage. Their analysis projects the likely economic and employment effects if enrollment declines rapidly rather than gradually.

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Surprise Medical Bills: New Map, Blog Post, and Webinar
The No Surprises Act, which took effect on January 1, aims to protect consumers from unexpected medical bills for out-of-network provider services. Use the Commonwealth Fund’s
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new interactive map to explore each state’s enforcement strategy. You can also join a webinar on March 24 at 1:00 pm ET for a discussion with leading experts on how the new law is rolling out, if it will work as intended, the status of litigation over enforcement, and potential effects on consumers and health care costs.
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Register here.


On To the Point, Georgetown University’s Katie Keith
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explains a ruling from a Texas district court judge on the No Surprises Act. The ruling eliminates key guardrails in the arbitration process for determining payment but doesn't affect the law’s core patient protections.

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Short-Term Health Insurance and the ACA Market
Since 2018, following changes made by the Trump administration, about half of states have loosened their restrictions on short-term health insurance plans — temporary coverage that doesn’t come with the Affordable Care Act’s consumer protections. In the other half of states, lawmakers established tighter restrictions on short-term plans or banned them altogether. Mark Hall and Michael McCue compare states to determine whether drawing people out of the regulated market and into short-term plans has affected risk pools and weakened private insurance markets.

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States with Strictest Abortion Laws Are Least Likely to Invest in Maternal and Child Health
Fourteen states have been especially aggressive in pursuing abortion restrictions, with 11 states poised to implement a ban on previability abortion if the Supreme Court votes to eliminate or severely curtail constitutional abortion rights. Health care law expert Sara Rosenbaum writes that these same states also invest the least in the people most likely to be affected by these bans, including people of color and communities with limited access to health care. These states also have the poorest maternal and child health outcomes.

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