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Report: Better access linked to better quality
Health scorecard ranks states
Health system performance varies widely across states, with better access associated with better quality, according to a scorecard released recently by a Commonwealth Fund commission.
The state scorecard assesses health system performance on 32 measures of access and quality, avoidable hospital use and costs, equity, and healthy lives. Results show no systematic relationship between the costs of care and quality across states.
If all states performed as well as the top quartile, the panel estimates the nation annually would save billions of dollars and have 90,000 fewer deaths under age 75 from preventable conditions, and half as many uninsured people.
States in the upper Midwest and Northeast were heavily represented in the top quartile of the scorecard, and those in the lowest quartile were concentrated in the South.
The 13 top states are Hawaii, Iowa, New Hampshire, Vermont, Maine, Rhode Island, Connecticut, Massachusetts, Wisconsin, South Dakota, Minnesota, Nebraska, and North Dakota. The 13 states at the bottom are California, Tennessee, Alabama, Georgia, Florida, West Virginia, Kentucky, Louisiana, Nevada, Arkansas, Texas, Mississippi, and Oklahoma.
Uninsured rates are well above average in the lowest quartile, and more than double those in the top quartile.
To improve performance across states, the commission calls for universal health coverage, more info on practices and policies that contribute to high or varying performance, and nationwide collaboration across public and private sectors.
Medicare beneficiaries to track health services
Some Medicare beneficiaries will be able to access and use a personal health record (PHR) to track their health care services under an 18-month pilot project announced recently by the Centers for Medicare & Medicaid Services (CMS).
Beneficiaries will have access to their registration information, such as name, address, and policy numbers, as well as to lists of their medications and medical conditions, which will be available at www.mymedicare.gov.
CMS also will seek to identify the minimum content and functionality of the PHR tools and assess the best methods for outreach and education to encourage adoption and ongoing use.
IRS issues Q&As on tax-exempt hospitals
The Internal Revenue Service has issued a question-and-answer document clarifying its earlier memorandum allowing tax-exempt hospitals to share health information technology (IT) with physicians.
The document explains that health IT arrangements between hospitals and medical staff physicians that are not entirely consistent with the memorandum "will not necessarily result in any impermissible private benefit or inurement."
The memorandum is not meant to describe the only permissible health IT arrangements, but the facts and circumstances of any such arrangement would need to be reviewed by the IRS to determine if it is permissible, the Q&A document states.
The May 11 memorandum was issued in response to tax-exempt hospitals' concerns that they risked their tax-exempt status if they shared health IT with physicians as new Stark and anti-kickback rules permit.