{"title":"A High-Performing System for Well-Child Care: A Vision for the Future","authors":"D. Bergman, P. Plsek, M. Saunders","doi":"10.2510/417069","DOIUrl":"https://doi.org/10.2510/417069","url":null,"abstract":"Standardization of well-child care services is intended to ensure that families receive core services and key information. But standardization also encourages a “one-size-fits-all” approach that subjects many families to unnecessary office visits. At the same time, many children at risk for physical, developmental, or behavioral problems fail to get needed services due to time and resource constraints. This report presents a vision for a high performing system of well-child care and a guide for future policy and research efforts. Based on their extensive research, the authors conclude that an ideal system would be characterized by advanced access to services, teambased care, individualized developmental and behavioral screening, care coordination through a medical home, electronic health records, and tools for information and knowledge transfer. Some reforms are ready to be implemented, while others would require additional resources, new technology, and/or policy changes. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. This report and other Fund publications are available online at www.cmwf.org. To learn more about new publications when they become available, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 959. iii CONTENTS List of Tables and Figures iv About the Authors v Executive Summary v","PeriodicalId":366047,"journal":{"name":"Commonwealth Fund Fund Reports","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128936609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Schoen, S. How, Ilana Weinbaum, J. Craig, K. Davis
{"title":"Public Views on Shaping the Future of the U.S. Health Care System","authors":"C. Schoen, S. How, Ilana Weinbaum, J. Craig, K. Davis","doi":"10.2510/394606","DOIUrl":"https://doi.org/10.2510/394606","url":null,"abstract":"","PeriodicalId":366047,"journal":{"name":"Commonwealth Fund Fund Reports","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130950368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"State Behavioral Health Innovations: Disseminating Promising Practices","authors":"S. Perlman, R. Dougherty","doi":"10.2510/392669","DOIUrl":"https://doi.org/10.2510/392669","url":null,"abstract":"According to reports issued by the President’s New Freedom Commission on Mental Health and the Institute of Medicine, the delivery of mental health care in the United States requires radical improvement and reform. To help identify promising innovations in behavioral health care, the authors of this report interviewed experts in the field of mental health and substance abuse. Based on their suggestions, the authors selected and described 17 practices— all related to purchasing and quality improvement—being implemented by states in behavioral health care. Many of the projects result from the increasing demands placed on state agencies to meet needs with a reduced budget, leaving states with little choice but to increase efficiency and effectiveness. The innovations fall into six categories: enhancing consumer-centered care, criminal justice/mental health collaboration, system integration, the use of performance incentives, quality improvement, and other promising practices. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. This report and other Fund publications are available online at www.cmwf.org. To learn more about new publications when they become available, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 945.","PeriodicalId":366047,"journal":{"name":"Commonwealth Fund Fund Reports","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121663904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Automatically Enrolling Eligible Children and Families Into Medicaid and SCHIP: Opportunities, Obstacles, and Options for Federal Policymakers","authors":"Stan Dorn, G. Kenney","doi":"10.2510/376814","DOIUrl":"https://doi.org/10.2510/376814","url":null,"abstract":"Sixty-two percent of uninsured children and two-thirds of uninsured, poor parents qualify for publicly funded health coverage programs but are not enrolled. This study assesses the potential impact of automatically enrolling children and parents in Medicaid and the State Children’s Health Insurance Program (SCHIP) based on determinations of other means-tested programs. Current law permits states to cover some uninsured parents based on information in their children’s Medicaid case files. However, current federal law forbids states from providing Medicaid or SCHIP based on the final income determinations of non-health agencies—the type of auto-enrollment that could reach eligible children. For such auto-enrollment to succeed, federal policymakers need to provide states with additional flexibility in determining eligibility and new resources for investing in information technology. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. This report and other Fund publications are available online at www.cmwf.org. To learn more about new publications when they become available, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 931.","PeriodicalId":366047,"journal":{"name":"Commonwealth Fund Fund Reports","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129016069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Facilitating Implementation of Evidence-Based Guidelines in Hospital Settings: Learning From Trauma Centers","authors":"A. March","doi":"10.2510/378879","DOIUrl":"https://doi.org/10.2510/378879","url":null,"abstract":"This study examines issues contributing to slow and partial compliance with evidence-based clinical guidelines. It focuses on guidelines for management of severe traumatic brain injury (TBI). Because severe head trauma enlists so many providers and often involves injury to multiple body systems, it maximizes the challenges of delivering timely, consistent, and coordinated care. Management of TBI thus offers a valuable perspective on the structural problems that impede the delivery of care and the implementation of clinical guidelines. The study identifies barriers to compliance with TBI guidelines, describes how three trauma centers lowered or overcame such barriers, and identifies common threads in their approaches. Based on this analysis, the study presents a model for implementing clinical guidelines to achieve consistency, continuity, and coordination of patient care. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the author and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. This and other Fund publications are online at www.cmwf.org. To learn more about new publications when they become available, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 930.","PeriodicalId":366047,"journal":{"name":"Commonwealth Fund Fund Reports","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126530002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Instability of Public Health Insurance Coverage for Children and Their Families: Causes, Consequences, and Remedies","authors":"C. Mann, L. Summer","doi":"10.2510/376823","DOIUrl":"https://doi.org/10.2510/376823","url":null,"abstract":"This report examines the extent, causes, and consequences of instability in public coverage programs for children and families. It focuses particularly on the phenomenon of “churning,” which occurs when individuals lose and regain coverage in a short period of time. It also looks at strategies to make public program coverage more stable for children and families. Findings are drawn from a variety of sources, including national and state-based studies, roundtable discussions and interviews with stakeholders and experts, and an examination of the effect of state and local policies on instability and churning in four states: Louisiana, Rhode Island, Virginia, and Washington. The experiences of these states demonstrate that coverage instability can be averted to a significant degree by adopting key policies and procedures, like limiting the frequency of required renewals; developing easy, seamless transitions among public coverage programs; and setting affordable limits on premium costs. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. This report and other Fund publications are available online at www.cmwf.org. To learn more about new publications when they become available, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 935.","PeriodicalId":366047,"journal":{"name":"Commonwealth Fund Fund Reports","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115807629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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