State health system performance and state health reform.
State policy officials are focusing on improving health insurance coverage, but other important dimensions of performance, including quality and cost, are receiving less attention. This paper explores the implications of new data on state personal health spending, quality, and health system performance. Personal health spending is not related to mortality or quality, but Medicare spending is closely linked to preventable hospitalization. States need to link improved insurance coverage with policy strategies to improve quality and efficiency--such as requiring those covered to designate a medical home and changing payment methods to reward care coordination and more prudent stewardship of resources.
Davis
Karen
K
Commonwealth Fund in New York City, USA. kd@cmwf.org
Schoen
Cathy
C
D017048:Health Care Costs; D018166:Health Care Reform; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D019458:Insurance Coverage; D006278:Medicare; D011787:Quality of Health Care; D013221:State Health Plans / Q000191:economics / Q000592:standards; D014481:United States