Healthcare Executive - November/December 2013 - 73

program uses multidisciplinary teams
to provide centralized case management services to high-risk members.

Children’s is helping to reduce large
economic disparities in children’s
health in Ohio.

Team members connect patients to
community-based resources, help
them follow treatment plans, facilitate communication between
patients and providers and offer
assistance with behavioral health
needs. For those covered by both
Medicare and Medicaid (“dual eligible” individuals) who are enrolled in
the CareSupport program, hospital
readmissions within 30 days fell to
17 percent. To put this into perspective, the Commonwealth Fund’s
scorecard finds that, nationally, 22
percent of dual eligible adults admitted to the hospital in 2011 were
readmitted within 30 days, as were
19 percent of all Medicare
beneficiaries.

While it’s true that CareOregon and
Cincinnati Children’s are working
with a mere fraction of the more
than 100 million low-income adults
and children nationwide, we should
not discount the potential cumulative effect of local initiatives. Truly,
it is efforts such as these that help
distinguish the top-performing
states from the rest. And if all states
could achieve the same level of performance as top-performing states
for their low-income populations,
the number of low-income adults
with a usual source of care would
increase by an estimated 14 million,
the number of children with a medical home would increase by approximately 6 million, and there would
be roughly 400,000 fewer avoidable
emergency department visits among
Medicare beneficiaries.

Another bright spot is Cincinnati
Children’s Hospital Medical Center,
which has launched an initiative to
eliminate asthma-related hospitalizations and ED visits among Medicaidenrolled children in Hamilton
County, Ohio. Its approach centers
on partnering with community-based
organizations to address underlying
social and economic factors that
affect children’s health. This includes
helping at-risk patients and their families remove environmental barriers to
asthma control by strengthening
linkages to community resources.
Among a cohort of high-risk children who received intensive care
coordination services, the average
time between hospital encounters
(either an ED visit or hospital
admission) increased by more than
100 days. The work of Cincinnati

Closing the equity gap is not only
the right thing to do, it is also in the
best interest of the country as a whole.
And we can do it. The Commonwealth

Fund’s Scorecard on State Health
System Performance for Low-Income
Populations provides the data and
analysis to focus improvement
efforts where they are needed most
and offers strategies for achieving
results. Ultimately, however,
improving the health and healthcare of low-income populations will
depend on strong leadership and
commitment from all healthcare
professionals. s

Lippa

Radley

Schoen

Jacob A. Lippa is
senior research associate at the Institute
for Healthcare
Improvement. He
can be reached at
jlippa@ihi.org.
David Radley is senior
scientist at IHI. He
can be reached at
dradley@ihi.org.
Cathy Schoen is senior
vice president for policy, research and evaluation at the
Commonwealth Fund.
She can be reached at
cs@cmwf.org.

Related Resources:

The Commonwealth Fund U.S. Health System Scorecards
www.commonwealthfund.org/Publications/Health-System-Scorecards.aspx
The Commonwealth Fund Health System Data Center
http://datacenter.commonwealthfund.org/#ind=1/sc=1
“CareOregon: Transforming the Role of a Medicaid Health Plan from Payer to
Partner” (case study)
www.commonwealthfund.org/Publications/Case-Studies/2010/Jul/
CareOregon.aspx
“The Cincinnati Children’s Hospital Medical Center’s Asthma Improvement
Collaborative: Enhancing Quality and Coordination of Care” (case study)
www.commonwealthfund.org/Publications/Case-Studies/2013/Jan/CincinnatiChildrens.aspx

Healthcare Executive
nOv/DEC 2013

Healthcare Executive - November/December 2013

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