Commonwealth Fund Tackling Better Care for Uninsured, Minorities

A new strategy report issued by the Commonwealth Fund Commission on a High Performance Health System  has the goal of creating a road map to improve healthcare for the uninsured, minorities and low-income Americans.

The commission, which looks for opportunities to enhance the delivery and financing of healthcare, recommends three broad strategies for achieving that improved care in the report, Ensuring Equity:  A Post-Reform Framework to Achieve High Performance Health Care for Vulnerable Populations.  The recommendations seek to assure the safety net’s stability and stimulate higher performance; strengthen delivery systems for susceptible populations; and coordinate healthcare delivery systems with public health services and community resources.

“Our current economic situation has increased the number and proportion of people who are vulnerable, leaving even more families at risk of suffering from our healthcare system’s inequities,” said Dr. David Blumenthal, chairman of the commission, and Samuel Their, professor of medicine and professor of health care policy at Massachusetts General Hospital/Partners HealthCare System and Harvard Medical School, Boston.

According to the report, there is a significant divide between vulnerable populations and their more secure counterparts in rates of receiving recommended screening and preventive care, control of chronic diseases, and hospital admissions for conditions that may be preventable with good primary care and community health outreach.  By way of example, only four of 10 low-income adults receive all recommended screenings and preventive care, compared with six of 10 higher-income adults.  Approximately three of 10 (29 percent) uninsured adults diagnosed with diabetes do not have it under control, twice the rate of the insured (15 percent).  Black adults are hospitalized for heart failure at rates (959 per 100,000) that are more than twice the rate for Hispanic adults (466 per 100,000); that’s nearly three times the rate for white adults (349 per 100,000).

“This policy framework builds on the great strides we expect to be made for vulnerable populations once the Affordable Care Act takes full effect in 2014,” said Commonwealth Fund Executive Vice President for Programs Anthony Shih, M.D. “By addressing crucial issues like access to care, affordability, quality improvement, and better coordinated care, these recommendations seek to assure that the uninsured, those with low incomes, and racial and ethnic minorities see the full promise of health reform and experience a truly equitable healthcare system.” 

“The Affordable Care Act is a big step forward in terms of addressing the significant needs of vulnerable groups and the healthcare providers who serve them,” said Commonwealth Fund President Karen Davis. “However, the inequity in our healthcare system is significant and” as defined in the Commission’s report, “more work must be done to close that gap and assure that we have a healthcare system that provides all of us with access to high quality healthcare.”

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