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  • 4 Things to Know About Keeping Personal Health Information Safe - The Commonwealth Fund
    Print Findings from Keeping Personal Health Information Safe The Importance of Good Data Hygiene There were more than 29 1 million health records affected by data breaches over a recent three year period Between 2010 and 2013 there were 949 separate events two thirds of which involved electronic data Current laws such as the Health Insurance Portability and Accountability Act HIPAA aren t effective in protecting patient information HIPAA was enacted before the Internet and electronic medical records existed so large gaps remain in health data protections More than 80 percent of data breaches occur because basic precautions aren t taken Health care organizations often fail to implement simple procedures such as encrypting health data prohibiting the storage of confidential information on personal electronic devices and authenticating authorized users We can t have a successful nationwide health IT system if patients are worried about the safety of their personal information Patients with these concerns will resist sharing their information electronically which may compromise their care as well as future research e Alerts and Newsletter Sign up Publication Details Publication Date August 19 2015 Authors David Blumenthal M D and Deven McGraw Summary Writer Samantha Chase Related Publications April 14 2015 Keeping Personal Health Information Safe The Importance of Good Data Hygiene May 3 2016 Envisioning a Digital Health Advisor Related Topics Health Care Delivery Mission The mission of The Commonwealth Fund is to promote a high performing health care system that achieves better access improved quality and greater efficiency particularly for society s most vulnerable including low income people the uninsured minority Americans young children and elderly adults About Us Topics Publications Surveys Data Grants Fellowships Newsroom Log In Recent Tweets Commonwealth Fund commonwealthfnd Nine of the 10 states with the highest mortality rates are below the Mason Dixon line

    Original URL path: http://authoring.commonwealthfund.org/publications/other/2015/aug/keeping-personal-information-safe-list (2016-04-30)
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  • Estimating the Affordable Care Act's Impact on Health - The Commonwealth Fund
    given that recent surveys estimate between 12 million and 17 million adults have already gained coverage Regardless these are eye catching numbers And they tell only a piece of the story as hypertension treatment is just one of the innumerable pathways through which health insurance can improve health Other pathways have been documented by a substantial body of literature summarized in a 2009 report from the Institute of Medicine now the National Academy of Medicine Some other examples of the benefits of health insurance include Being less likely to have cancer diagnosed at an advanced stage Among people with diabetes achieving better glycemic control Having a lower risk of death when admitted to the hospital with a severe acute illness Receiving significantly more care and being less likely to die after a car accident Of course along with these health benefits insurance also provides financial protection against unaffordable health care costs Some may caution against overemphasizing the link between health insurance and health After all the Oregon Medicaid study which employed a uniquely powerful methodology based on randomized assignment of coverage did not find that gaining insurance led to statistically significant improvements on several clinical measures of physical health However the Oregon findings are best seen as complementing the literature on health benefits and coverage rather than running counter to that literature Because the study had relatively small sample sizes of patients with health problems quite large clinical improvements would have been needed to meet the threshold of statistical significance And the study did find statistically significant improvements in self reported health and a 30 percent reduction in the rate of observed depression Depression can lead to or exacerbate physical health problems like heart disease diabetes and stroke particularly when it goes untreated The Oregon study also was limited to only 17 months which is a short time frame for measuring an effect that likely compounds over time Another important study on the subject compared trends in health status in Massachusetts to other areas of the country after the state s 2006 health insurance expansion The authors found that the Massachusetts reform was associated with a significant reduction in mortality equivalent to about 1 death prevented for every 830 adults who gained insurance To put that in perspective if the Massachusetts results hold for the ACA it could already be saving tens of thousands of Americans lives each year Individually none of the studies is perfect but together they point to the same conclusion health insurance leads to healthier longer lives If health insurance were a drug these potent effects on health would create a huge clamor for the FDA to approve it As the political sparring over the ACA s implementation continues in the coming months and years we should keep it mind the proven health benefits of health insurance Tags Affordable Care Act health insurance Medicaid health spending Add to My Library Print Please enable JavaScript to view the comments powered by Disqus blog comments powered by Disqus

    Original URL path: http://authoring.commonwealthfund.org/publications/blog/2015/aug/estimating-the-acas-impact-on-health (2016-04-30)
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  • Could the Affordable Care Act Make the U.S. More Competitive Abroad? - The Commonwealth Fund
    many focused on the things that keep us well like prevention telehealth and promoting healthy lifestyles and living environments To the extent that these succeed the benefits will be felt in workforce productivity and business competitiveness Second taming our nation s astronomical health care bill would further improve our ability to compete in foreign markets We spend more on health care than any other wealthy country health spending represents nearly one fifth of the U S economy compared with one tenth in the average industrialized nation This leaves fewer resources available for research infrastructure education and other investments that are foundational to economic competitiveness Warren Buffett went so far as to call our health system the tapeworm essentially of the American economy In recent years health care spending has grown at historically low rates Some believe the ACA has played a role though the jury is still out If the spending slowdown lasts however the long term prospects for U S competitiveness are considerably brighter Third the ACA marketplaces created a functional health insurance market for people buying health insurance on their own weakening the link between employment and coverage This promotes entrepreneurship by allowing workers to leave jobs and start their own businesses without losing their insurance The resulting start ups could grow over time into the cutting edge companies that so enhance U S competitiveness It s possible that this is already occurring Rates of entrepreneurship and business creation have risen over the past year and while this is most likely the result of generally favorable economic conditions the ACA policies support this type of growth Some people argue that aspects of the ACA weaken our competitiveness by imposing new costs on U S businesses These fears are likely exaggerated For starters not all businesses sell in foreign markets Three of the largest exporting sectors in the U S are manufacturing mining and agriculture Manufacturers and mining companies already tend to offer job based insurance and are therefore untouched by most provisions of the law Exhibit 1 Thus the price of these exports should not be seriously affected by the ACA When and if the ACA s so called employer mandate goes into effect applying to companies with 50 or more employees some agriculture businesses could face additional short term expenses related to purchasing health insurance for their employees Over the longer term economists predict these costs will be absorbed by workers in the form of reduced wages and other benefits which could moderate adverse effects on competitiveness And in the short term the agricultural industry does not appear to be suffering and has in fact created jobs at a faster clip than the rest of the U S economy since the ACA became law Exhibit 2 Whether and how the ACA affects the international competitiveness of the U S economy remains to be seen But it is essential to remember the original rationale for health reform The problems plaguing our health system are felt beyond the hospital

    Original URL path: http://authoring.commonwealthfund.org/publications/blog/2015/aug/could-the-affordable-care-act-make-the-us-more-competitive-abroad (2016-04-30)
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  • 5 Ways Medicaid Makes a Difference - The Commonwealth Fund
    all year in 2014 have a regular doctor and more than half say they received excellent or very good care 2 Paying medical bills Medicaid beneficiaries have less difficulty paying medical bills than people with private insurance They are also less likely to be contacted by a collection agency or to feel they need to change their way of life to pay their medical bills 3 Helping people get better access to care Since they re less likely to worry about being able to afford health care people with Medicaid are less likely than those without any insurance to skip care because of the cost 4 Making it easier to get specialty care Those who are uninsured or covered by private insurance had more trouble accessing specialty care because of cost than those with Medicaid 5 Receiving preventive care Patients with Medicaid are about as likely as those with private insurance to receive preventive screenings such as flu shots and blood pressure and cholesterol checks e Alerts and Newsletter Sign up Publication Details Publication Date June 29 2015 Authors David Blumenthal M D Petra W Rasmussen Sara R Collins Michelle M Doty Summary Writer Samantha Chase Related Publications April 13 2016 Obama Administration Moves Forward with New Continuity of Care Protections How Will They Affect Existing State Laws March 30 2016 What Will Happen to Medicaid Beneficiaries If Kentucky Dis Kynects Related Infographics Does Medicaid Make a Difference Related Topics Health Care Coverage Medicaid Expansion State Health Policy and Medicaid Mission The mission of The Commonwealth Fund is to promote a high performing health care system that achieves better access improved quality and greater efficiency particularly for society s most vulnerable including low income people the uninsured minority Americans young children and elderly adults About Us Topics Publications Surveys Data

    Original URL path: http://authoring.commonwealthfund.org/publications/other/2015/jun/medicaid-top-5 (2016-04-30)
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  • Coverage and Financial Security Preserved for Millions of Americans in the Supreme Court Ruling for the Government - The Commonwealth Fund
    of 10 remaining uninsured adults are living in the 22 states that have yet to expand eligibility for their Medicaid programs as allowed under the Supreme Court s 2012 Affordable Care Act decision People in these states with incomes under 100 percent of poverty are in a coverage gap they are ineligible for premium subsidies through the marketplaces because Congress assumed every state would expand Medicaid Uninsured rates among people in this income group in nonexpansion states have barely budged from 2014 while uninsured rates have fallen significantly for poor adults in states that have expanded their programs But the Medicaid expansion is not the only reason why people who are eligible for the law s coverage options are not yet enrolled The survey finds that many uninsured adults are either unaware of the coverage options available to them or have reasons for not exploring their insurance options including uncertainty about whether they can afford coverage Future gains in coverage will be dependent on states finding ways to expand eligibility for Medicaid and the pursuit by federal and state policymakers of targeted outreach and education efforts to help those eligible enroll Keeping premiums and deductibles affordable for consumers will be an ongoing challenge for federal and state governments and health industry stakeholders A Commonwealth Fund report found that a majority of people with marketplace plans found their premiums very or somewhat easy to afford But they were less likely than people with employer coverage to view their premiums as affordable While marketplace premiums did not change on average in 2015 there was significant variability across states Similarly while the law s cost sharing subsidies have been effective in reducing deductibles and copayments for people in marketplace plans with lower incomes many who are above the subsidy thresholds are left with high deductibles But the use of high deductibles in marketplace plans reflects broader trends in the U S health insurance industry Another recent Commonwealth Fund report found that the share of Americans in employer based plans with deductibles that are high relative to their incomes has climbed steadily over the past decade According to the report an estimated 31 million insured U S adults have such high out of pocket costs relative to their incomes that they are effectively underinsured While this estimate has held steady since 2010 if insurers and employers continue to use deductibles to contain their own health care costs underinsurance is certain to begin to climb again No policy whether at the federal or state level is static Both Medicare and Medicaid have evolved over time to adjust to changes in health care and the needs of beneficiaries The same is true of the Affordable Care Act States that have used the resources and tools provided to them by the law have created different approaches to implementation that reflect the unique characteristics of their residents and political cultures In 2017 every state can apply for the law s so called 1332 waivers to further meld the

    Original URL path: http://authoring.commonwealthfund.org/publications/blog/2015/jun/coverage-and-financial-security-preserved (2016-04-30)
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  • Does Medicaid Make a Difference? - The Commonwealth Fund
    with Medicaid but the differences were not statistically significant MEDICAID ENROLLEES HAD FEWER COST RELATED ACCESS PROBLEMS AND FEWER PROBLEMS PAYING MEDICAL BILLS THAN DID PRIVATELY INSURED AND UNINSURED ADULTS The survey also asked respondents whether they had cost related problems accessing care or problems paying medical bills On most measures adults with Medicaid coverage reported fewer problems than uninsured or privately insured adults Adults with Medicaid coverage were significantly less likely than either privately insured or uninsured individuals to report difficulty paying medical bills being contacted by a collection agency about unpaid bills having to change their way of life to pay medical bills or paying off medical bills over time Exhibit 4 Those with Medicaid were also significantly less likely to report skipping services because of the cost of care compared with adults who had spent a time uninsured Exhibit 5 In some cases differences in cost related problems getting needed care between adults with Medicaid coverage and those with private insurance were statistically significant For example privately insured adults reported skipping a recommended medical treatment test or follow up visit because of cost at twice the rates reported by adults with Medicaid 18 vs 7 Notably though Medicaid coverage is widely believed to afford poor access to specialists because Medicaid s provider payment rates tend to be lower than private plan reimbursement Medicaid enrollees were less likely than privately insured adults to report that cost was a reason not to pursue specialty care 5 vs 11 LIMITATIONS OF THIS STUDY Our findings have certain limitations They do not shed light on whether Medicaid or private insurance improves health outcomes for adults or whether one type of insurance is more effective in this regard than the other The analysis also focuses on adults with Medicaid or private insurance who had continuous coverage during the year prior to our survey Medicaid and privately insured adults who lose eligibility during a given year may have somewhat different experiences from those described here Still comparing the experiences of those with continuous coverage while controlling for demographic characteristics and health status enables us to isolate the effects of insurance on health care quality and access CONCLUSION The results from the Commonwealth Fund Biennial Health Insurance Survey 2014 suggest that people with Medicaid coverage have better access to health care services including proven preventive care and fewer medically related financial burdens compared with those who lack insurance Our findings also suggest that compared to those with private coverage Medicaid enrollees have nearly equivalent levels of access to care on many important dimensions Medicaid coverage also appears to offer better financial protection than private insurance against the cost of illness This last observation may reflect the steady increase in recent years in many private plans deductibles and copayments Notes 1 As of March 2015 12 2 million additional people had enrolled in Medicaid or the Children s Health Insurance Program since October 2013 http medicaid gov medicaid chip program information program information downloads 2015

    Original URL path: http://authoring.commonwealthfund.org/publications/issue-briefs/2015/jun/does-medicaid-make-a-difference (2016-04-30)
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  • The Affordable Care Act: What Are the Facts After Five Years? - The Commonwealth Fund
    diverge greatly across the country with rates falling to the lowest levels in states that have expanded Medicaid eligibility All told as many as 16 4 million previously uninsured people have gained coverage since the law passed in 2010 But our new publications also point to signs that the law is starting to change the way care is paid for and delivered to patients A newly released Fund report on the ACA focuses on three broad areas testing new models of care and spreading successful ones encouraging the shift toward payment based on the value of care provided and developing resources for systemwide improvement For example the law contains provisions that support the spread of accountable care organizations and medical homes and that strengthen primary care Additionally the Center for Medicare and Medicaid Innovation created by the law is testing an array of changes to how health care providers are organized and paid that together are affecting thousands of hospitals 60 000 clinicians and 2 5 million patients across all 50 states While health spending growth has slowed in recent years and there are signs such as falling rates of hospital acquired infections that care is improving we can t yet comment definitively on the impact of the law s delivery reforms But we offer some promising examples To learn more about how the Affordable Care Act is changing the face of U S health care I encourage you to read The Affordable Care Act at Five Years How the Law Is Changing the Delivery of Care in the U S and How the Law Is Changing Health Coverage in the U S two infographic rich digital features a New England Journal of Medicine Health Policy Report that reviews the law s implementation and impact The Affordable Care Act s

    Original URL path: http://authoring.commonwealthfund.org/publications/blog/2015/may/aca-facts-after-five-years (2016-04-30)
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  • Measuring Vital Signs: An IOM Report on Core Metrics for Health and Health Care Progress - The Commonwealth Fund
    collect hundreds of measures aimed at dozens of medical conditions leading to confusion and inefficiency In response the Institute of Medicine IOM has identified a set of standardized measures along with steps for implementing and refining them What the Study Found In a JAMA Viewpoint Commonwealth Fund President David Blumenthal M D a member of the IOM Committee on Core Metrics for Better Health at Lower Cost and coauthor J Michael McGinnis M D highlight the 15 measures identified by the IOM life expectancy wellbeing overweight and obesity addictive behavior unintended pregnancy healthy communities preventive services care access patient safety evidence based care care match with patient goals personal spending burden population spending burden individual engagement and community engagement The committee reached a number of important conclusions in developing these measures including Measurement is not an end but rather is a means to accomplishing health goals Composite measures are needed in certain areas like healthy communities and patient safety Although core measure sets may differ depending on the setting for instance a state agency versus a group of cardiologists all sets should be aligned toward common goals Conclusions Across regions organizations and partisan lines there is increasing agreement that we cannot commit more resources to health care without accounting for value the authors say Measuring and monitoring performance will be critical to this endeavor Read the article e Alerts and Newsletter Sign up Publication Details Publication Date April 28 2015 Authors David Blumenthal M D and J Michael McGinnis Contact Mary Mahon Vice President Public Information The Commonwealth Fund E mail mm cmwf org Citation D Blumenthal and J M McGinnis Measuring Vital Signs An IOM Report on Core Metrics for Health and Health Care Progress Journal of the American Medical Association Viewpoint published online April 28 2015 View full

    Original URL path: http://authoring.commonwealthfund.org/publications/in-brief/2015/apr/iom-report-on-core-metrics (2016-04-30)
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