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As noted in the Institute of Medicine’s seminal report Crossing the Quality Chasm: A New Health System for the 21st Century, “health care today harms too frequently and routinely fails to deliver its potential benefits.” For over a decade, foundations have been showcasing to the field that improving health care quality is both needed and possible. GIH recognizes that this work is now an integral part of the health reform law and that bridging the “quality chasm” will require change at all levels of our health care system.

Contact Ann McMillan for more information about our programming in this area.

Issue Spotlight

September 2018

"Reference pricing" is an emerging health benefit design being piloted in the United States that offers a way to price pharmaceuticals based on evidence of clinical effectiveness. It sets a ceiling for what an insurer or employer will contribute toward the cost of prescription drugs — particularly those that have therapeutic equivalents with widely varying prices — but doesn't exclude any drugs from coverage. In a new Commonwealth Fund issue brief, the author describes the prerequisites for effective referencing pricing, and what it would take for this benefit design to take hold in the U.S.

September 2018

New research in the Journal of the American Medical Association supported by the Commonwealth Fund may help to quell fears that bundled payment models (a method of lowering health care costs paying providers upfront for all the services included in a single episode of care) would have negative unintended consequences. Bundled payments do not appear it could encourage hospitals to perform more procedures than they otherwise would under fee-for-sefice and do not appear to encourage hospitals to cherry-pick patients who are younger or in better health.

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