uilding on its long history of supporting state efforts to improve health care, The Commonwealth Fund established the State Innovations program in April 2005. The new program encourages states to develop and implement major improvements in health system performance, including efforts to expand insurance coverage, promote high-quality care, enhance value and efficiency, and meet the health needs of vulnerable populations. The hope is that successful models will spur other states—perhaps even the federal government—to undertake similar reforms.
While no state could currently be described as a model of high performance, there has been movement in the right direction. States are exploring opportunities to achieve universal coverage, offer accessible performance information, and align public and private purchasing strategies and incentives for quality, efficiency, and simplification. An ideal system—whether on the state or national level—would feature "zero tolerance" of health disparities, affordable personal health care costs, and public coverage that is simple and seamless to access.
To support states in these efforts, the Fund is targeting four types of activities. The first one will be to generate new data about health system performance at the state level. This information will allow states to measure and compare progress to develop specific goals for achieving best-practice outcomes. Work already in progress includes an initiative of the National Academy for State Health Policy to identify policies and practices in all 50 states that are likely to support high performance. In a parallel effort, the Rutgers Center for State Health Policy has begun identifying quantitative indicators of high performance for states. Both projects, with reports slated for release in 2006, will be closely aligned with the performance measures used by the Fund's Commission on a High Performance Health System.
Second, the State Innovations program is supporting case studies of innovative efforts for achieving high performance. The Economic and Social Research Institute is currently investigating public and public-private efforts targeting insurance coverage expansion and efficiency in state health care spending, and the Fund will continue seeking to identify innovations that merit further exploration.
Third, the Fund is seeking to support evaluations of promising practices so that states may better understand what works, what does not work, and where future opportunities lie. Finally, the Fund is disseminating its work directly to state policy leaders through the newsletter States in Action (launched in May 2005) and through partnerships with organizations that convene state leaders.
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