Healthcare Executive - November/December 2013 - 70

Improving Patient Care

Improving Care and
Health for Low-Income
Populations
Commonwealth Fund report highlights areas
for improvement.
Since 2006, The Commonwealth
Fund’s health system scorecard
reports have documented wide variations in U.S. healthcare and provided health leaders and change
agents with tools and information to
assess the performance of their own
health systems, identify areas for
improvement and set realistic and
achievable performance targets.
Indeed, communities across the
country have adopted the scorecard
framework and are using the
resources available through the
Commonwealth Fund’s online data
center to guide their pursuit of a
high-performance health system.

Ultimately … improving the
health and healthcare of lowincome populations will depend
on strong leadership and
commitment from all
healthcare professionals.
The most recent scorecard report,
Health Care in the Two Americas:
Findings from the Scorecard on State
Health System Performance for LowIncome Populations (available on
commonwealthfund.org), presents
the first-ever comprehensive

70

Healthcare Executive
nOv/DEC 2013

state-by-state assessment of health
system performance for America’s
most economically vulnerable individuals and families. Drawing on
the most recent publicly available
data (typically from 2010 to 2012),
the report measures states’ performance across 30 key indicators
grouped into four broad dimensions:
access and affordability, prevention
and treatment, potentially avoidable
hospital use and healthy lives.
The report includes some striking
findings. In all states, low-income
populations have far more difficulty
accessing care, receive poorer quality
care and experience worse health
outcomes than higher income
groups. That such disparities exist
within the system may not come as a
surprise to many, but the size of
these disparities may.
Across a number of health system
indicators, there are two- to four-fold
differences between populations living below 200 percent of the federal
poverty level and those living at or
above 400 percent of poverty. These
income-based disparities are often
more severe than those associated
with race, ethnicity or gender.
Moreover, some of the largest disparities between income groups are evidenced on such key health system

indicators as avoidable emergency
department visits, hospital admissions
for ambulatory care-sensitive conditions and premature death.
Equally striking are the disparate
experiences of low-income populations from state to state. In fact, geographic variations within an income
group are often greater than variations observed between groups.
Clear geographic patterns are also evident. Top-performing states are largely
concentrated in the northeast and
Upper Midwest, while states in the
South tend to lag (see map on page
72). Indicating that gaps in quality of
care are often a shared concern for all
income levels in lagging states, the
scorecard finds that higher-income
individuals living in states in the lowest quartile of performance often had
worse care experiences on key indicators than low-income populations in
leading states. This includes Medicare
beneficiaries receiving high-risk medications that should generally be
avoided based on clinical guidelines.
All states face unique challenges in
caring for their vulnerable residents.
The relative size and composition of
low-income groups varies as widely
as the state policies that support
them. nonetheless, when it comes to



Healthcare Executive - November/December 2013

Table of Contents for the Digital Edition of Healthcare Executive - November/December 2013

Healthcare Executive - November/December 2013
Contents
ACHE Online
Take Note
Perspectives
Managing Your Career in Transformative Times
Generation Now: The New Era of Leadership
Aspirations of a Servant Leader
Professional Pointers
Healthcare Management Ethics
Satisfying Your Customers
Community Health Innovations
Public Policy Update
Careers
Governance Insights
Improving Patient Care
CEO Focus
Executive News
On the Move
Member Accolades
Chapter News
Professional Development Calendar
2013 Editorial Index
Healthcare Executive - November/December 2013 - Healthcare Executive - November/December 2013
Healthcare Executive - November/December 2013 - Cover2
Healthcare Executive - November/December 2013 - Contents
Healthcare Executive - November/December 2013 - 2
Healthcare Executive - November/December 2013 - 3
Healthcare Executive - November/December 2013 - ACHE Online
Healthcare Executive - November/December 2013 - 5
Healthcare Executive - November/December 2013 - Take Note
Healthcare Executive - November/December 2013 - 7
Healthcare Executive - November/December 2013 - Perspectives
Healthcare Executive - November/December 2013 - 9
Healthcare Executive - November/December 2013 - Managing Your Career in Transformative Times
Healthcare Executive - November/December 2013 - 11
Healthcare Executive - November/December 2013 - 12
Healthcare Executive - November/December 2013 - 13
Healthcare Executive - November/December 2013 - 14
Healthcare Executive - November/December 2013 - 15
Healthcare Executive - November/December 2013 - 16
Healthcare Executive - November/December 2013 - 17
Healthcare Executive - November/December 2013 - 18
Healthcare Executive - November/December 2013 - 19
Healthcare Executive - November/December 2013 - Generation Now: The New Era of Leadership
Healthcare Executive - November/December 2013 - 21
Healthcare Executive - November/December 2013 - 22
Healthcare Executive - November/December 2013 - 23
Healthcare Executive - November/December 2013 - 24
Healthcare Executive - November/December 2013 - 25
Healthcare Executive - November/December 2013 - 26
Healthcare Executive - November/December 2013 - 27
Healthcare Executive - November/December 2013 - 28
Healthcare Executive - November/December 2013 - 29
Healthcare Executive - November/December 2013 - Aspirations of a Servant Leader
Healthcare Executive - November/December 2013 - 31
Healthcare Executive - November/December 2013 - 32
Healthcare Executive - November/December 2013 - 33
Healthcare Executive - November/December 2013 - 34
Healthcare Executive - November/December 2013 - 35
Healthcare Executive - November/December 2013 - 36
Healthcare Executive - November/December 2013 - 37
Healthcare Executive - November/December 2013 - 38
Healthcare Executive - November/December 2013 - 39
Healthcare Executive - November/December 2013 - Professional Pointers
Healthcare Executive - November/December 2013 - 41
Healthcare Executive - November/December 2013 - Healthcare Management Ethics
Healthcare Executive - November/December 2013 - 43
Healthcare Executive - November/December 2013 - 44
Healthcare Executive - November/December 2013 - 45
Healthcare Executive - November/December 2013 - 46
Healthcare Executive - November/December 2013 - 47
Healthcare Executive - November/December 2013 - Satisfying Your Customers
Healthcare Executive - November/December 2013 - 49
Healthcare Executive - November/December 2013 - 50
Healthcare Executive - November/December 2013 - 51
Healthcare Executive - November/December 2013 - Community Health Innovations
Healthcare Executive - November/December 2013 - 53
Healthcare Executive - November/December 2013 - 54
Healthcare Executive - November/December 2013 - 55
Healthcare Executive - November/December 2013 - Public Policy Update
Healthcare Executive - November/December 2013 - 57
Healthcare Executive - November/December 2013 - 58
Healthcare Executive - November/December 2013 - 59
Healthcare Executive - November/December 2013 - 60
Healthcare Executive - November/December 2013 - 61
Healthcare Executive - November/December 2013 - Careers
Healthcare Executive - November/December 2013 - 63
Healthcare Executive - November/December 2013 - 64
Healthcare Executive - November/December 2013 - 65
Healthcare Executive - November/December 2013 - Governance Insights
Healthcare Executive - November/December 2013 - 67
Healthcare Executive - November/December 2013 - 68
Healthcare Executive - November/December 2013 - 69
Healthcare Executive - November/December 2013 - Improving Patient Care
Healthcare Executive - November/December 2013 - 71
Healthcare Executive - November/December 2013 - 72
Healthcare Executive - November/December 2013 - 73
Healthcare Executive - November/December 2013 - 74
Healthcare Executive - November/December 2013 - 75
Healthcare Executive - November/December 2013 - CEO Focus
Healthcare Executive - November/December 2013 - 77
Healthcare Executive - November/December 2013 - 78
Healthcare Executive - November/December 2013 - 79
Healthcare Executive - November/December 2013 - Executive News
Healthcare Executive - November/December 2013 - 81
Healthcare Executive - November/December 2013 - 82
Healthcare Executive - November/December 2013 - 83
Healthcare Executive - November/December 2013 - On the Move
Healthcare Executive - November/December 2013 - 85
Healthcare Executive - November/December 2013 - 86
Healthcare Executive - November/December 2013 - 87
Healthcare Executive - November/December 2013 - Member Accolades
Healthcare Executive - November/December 2013 - 89
Healthcare Executive - November/December 2013 - Chapter News
Healthcare Executive - November/December 2013 - 91
Healthcare Executive - November/December 2013 - Professional Development Calendar
Healthcare Executive - November/December 2013 - 93
Healthcare Executive - November/December 2013 - 2013 Editorial Index
Healthcare Executive - November/December 2013 - 95
Healthcare Executive - November/December 2013 - 96
Healthcare Executive - November/December 2013 - Cover3
Healthcare Executive - November/December 2013 - Cover4
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