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The Commonwealth Fund Connection

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




November 28, 2022

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International Survey: Primary Care Doctors Stressed, Burned Out
Large numbers of primary care doctors say they are burned out and stressed, according to the latest Commonwealth Fund International Health Policy Survey. The study of more than 9,500 primary care physicians in the U.S. and nine other high-income countries finds that since the beginning of the pandemic, more than half of physicians in most countries have experienced job stress or emotional distress, and many feel it’s affecting the quality of care they provide to their patients. Moreover, most primary care physicians with emotional distress, regardless of age, are not seeking professional help.

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Listening to the WHO: How to Assess Health System Performance
Earlier this year, the World Health Organization released a guide for countries seeking to assess how well their health system is performing. As Munira Gunja reports in our latest International Insights newsletter, such evidence-based assessments can be helpful in illustrating the link between how a system is structured and how well it serves people overall. Their accuracy and usefulness, however, depend on having a standardized approach as well as a holistic view of the health system.

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Uncared For Podcast Looks at Maternal Health in U.S. and Abroad
The United States may be the most unsafe developed country for maternal health, particularly if you’re Black. Episodes 1 and 2 of Uncared For, the new Commonwealth Fund–supported podcast from Lemonada Media, unpack the tangled roots of America’s maternal health crisis. Then, in Episode 3, host SuChin Pak talks to midwives, parents, and early education experts in Germany — where having a midwife present during pregnancy and in the months following birth is standard procedure — to understand what it’s like to have ample support throughout pregnancy, childbirth, and childrearing.

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COVID-19 Booster Campaign Could Keep Kids in School
During the COVID-19 pandemic, children have faced tremendous upheaval in their lives, including disruptions to their education from frequent school closures. A new analysis from the University of Maryland’s Meagan C. Fitzpatrick and colleagues models the effects of a broad COVID booster vaccination and its impact on children’s health and schooling. It finds that up to 29 million lost school days, along with up to 51,000 pediatric hospitalizations, could be averted.

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Congress Can Help Reduce Medicaid’s Coverage Gaps
The Families First Coronavirus Response Act provided states with added funding for Medicaid in exchange for keeping people continuously enrolled through the end of the public health emergency. As a result, millions of people gained and retained Medicaid. But as the Commonwealth Fund’s Sara R. Collins and Lauren Haynes note on To the Point, millions may lose Medicaid when the emergency ends. They say now is an opportune time for Congress to apply the lessons of the pandemic and consider making it easier for states to keep those who remain eligible for Medicaid enrolled for longer periods.

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Will the Supreme Court Preserve Medicaid Judicial Protections?
A case before the Supreme Court case hinges on whether beneficiaries in federal programs administered by states, like Medicaid and the Supplemental Nutrition Assistance Program, have the right to sue in federal court if they believe their rights were violated, or if they must use alternative avenues to seek remedy. Based on the proceedings so far, legal expert Timothy Jost thinks current beneficiaries’ protections will survive — at least for now.

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Free Coverage of Preventive Health Services in Jeopardy
Under the Affordable Care Act, private plans are required to cover critical preventive services without cost sharing. But a federal judge ruled much of the rule unconstitutional, and the Supreme Court may agree. Georgetown University’s Justin Giovannelli and colleagues say that while states are barred from regulating self-insured employer plans, they aren’t totally powerless: 15 states already have laws in place requiring individual-market insurers to cover, without cost sharing, the same categories of preventive services required by the ACA.

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Health Care’s Increasing Focus on Drivers of Health
What people eat, where they live, and how much they earn are inextricably linked to their health. Now, for the first time, federal policymakers are trying to measure and screen for what are known as the drivers of health. On The Dose podcast, Alice Chen, M.D., chief medical officer at Covered California, talks about gathering momentum in the health sector to acknowledge and address nonmedical risk factors for health.

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Investigating Algorithms for Racial Bias
This month, Kaiser Health News reported that California’s newly elected attorney general will
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investigate the decision-making software used by many hospitals, seeking to determine whether algorithms direct more attention and resources to white patients than patients of color. A recent Transforming Care feature looked at similar efforts — led by academic medical centers, medical specialty societies, and even the House Ways and Means Committee — to
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examine the use of race in clinical algorithms .

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Will Congress Address Health Care Issues Before Year’s End?
With the midterms behind us, what health care items remain on the 2022 legislative agenda? Experts from the Wynne Health Group highlight policy reforms that Congress could consider in a year-end spending package, including mandating 12 months of postpartum Medicaid coverage, allowing people released from incarceration to enroll in Medicaid, enacting mental health coverage and payment reforms, and passing the PREVENT Pandemics Act to strengthen public health, medical preparedness, and response systems.

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