The Commonwealth Fund

Conditional cash transfers (CCTs), which offer people financial incentives for meeting goals such as visiting health care facilities or attending school, have spread to over 100 low- and middle-income countries since the 1990s. While CCTs are less common in high-income countries, their potential to address health disparities is now being explored in the U.S. In this issue of International Insights, Evan D. Gumas explores Pakistan’s early successes in improving maternal health outcomes and draws lessons for the U.S.

U.S. companies spend more than 1 trillion dollars every year on health care for employees and their families – more than 165 million Americans. It’s a huge part of a company’s budget. But even employees with generous health plans complain it’s tough to find a doctor for affordable, primary care. In recent years, several large firms have tried to fix the broken system themselves by providing employees with low-cost, primary health care right in their offices. For an examination of one big bank’s plan to ensure its employees get convenient, regular check-ups and other routine care, tune into this episode of Tradeoffs.

?? The State of Primary Care Around the World For many people, a #primarycare provider is their first point of contact with the health system. Decades of evidence shows that primary care is critical for population health, health equity, and the overall efficiency of health care systems. ? But many nations, including the United States, face challenges in delivering and sustaining high-quality primary care. Health systems across the globe struggle to ensure access to comprehensive, coordinated care and address chronic workforce shortages and physician burnout. ? In this data brief,?Finger on the Pulse: The State of Primary Care in the U.S. and Nine Other Countries, Commonwealth Fund researchers assess the state of primary care in the United States and nine other countries from the patient and provider perspectives, looking at such measures as use of telehealth, preparedness to treat behavioral health conditions, care coordination, and more. Round out #primarycareweek with a look at how the U.S. compares with other high-income nations and what steps policymakers can take to strengthen primary care.

?? Listen: Reforming Mental Health Support for Students and Health Care Workers Evidence of a mental health crisis is everywhere — from the recent surgeon general advisory about social media’s effects on our youth to the pandemic’s documented impact on medical professionals. To whom does a college student turn for help so far from home? And who cares for the mental health of those caring for us? Enter Jessi Gold, MD MS, a psychiatrist and the University of Tennessee System’s first chief wellness officer, who aims to change the way student #mentalhealth is addressed on campus. She favors an open, flexible approach to helping students find the kind of help that’s right for them. Off campus, Dr. Gold has been conducting research into the overlooked mental health needs of our medical professionals. On this episode of The Dose podcast, host Joel Bervell talks with Dr. Gold about the systemic changes needed to support mental wellness across our college campuses and the entire ecosystem of medical professionals.

The #Medicare complaints process was created for beneficiaries to file grievances about services provided in their plans, and to alert the Centers for Medicare and Medicaid Services (CMS) to how plans are working. Advocates and stakeholders say that the process is complicated and obscure, resulting in many beneficiaries not filing complaints. To understand these problems and explore potential solutions, Laura Skopec of Urban Institute and Judith Feder of Georgetown University conducted three roundtable discussions with beneficiary advocates, provider advocates, and SHIPs. Based on their findings, they identified six actions CMS could take to improve and expand the Medicare complaints process. Learn more here: https://buff.ly/4d9RHdI

U.S. companies spend more than 1 trillion dollars annually on health care for employees and their families. It’s a huge part of a company’s budget. But even employees with generous health plans complain it’s tough to find a doctor for affordable primary care. In recent years, several large firms have tried to fix the broken system themselves by providing employees with low-cost primary health care right in their offices. Alexandra Olgin and Dan Gorenstein examine one big bank’s plan to ensure its employees get convenient, regular check-ups and other routine care. https://lnkd.in/eAhN-SYj

In a study of primary care in 11 wealthy countries, the United States was found to be lagging behind on multiple measures of access to services and coordination of patient care. Primary care providers serve as most people’s first contact with the health care system. The report found that: ?? U.S. adults are least likely to have a primary care home. ?? Access to home visits or after-hours care is lowest in the U.S. ?? Just half of U.S. primary care physicians report adequate coordination with specialists and hospitals. The researchers attribute the deficiencies in the U.S. to decades of chronic underinvestment as well as reimbursement disparities between #primarycare clinicians and specialists. This #PrimaryCareWeek, take a look abroad and consider the ways in which we might being to improve primary care in the U.S.

?? Around the world, primary care stands as the cornerstone of a strong health care system. Despite its pivotal role, it remains undervalued—especially in the United States, where an imbalance favoring specialty care has persisted for too long. Primary care is not just a necessity, it’s a driver of better health care access, improved health outcomes, and significant reductions in hospitalizations and emergency department visits. The U.S. could benefit from a shift towards a more robustly resourced primary care model. It's time to bring primary care to the forefront, ensuring it receives the focus, funding, and recognition it deserves. #PrimaryCareWeek

The U.S. spends a paltry 5-7% of every health care dollar on #primarycare. Over a third of states have responded by taking steps to invest more in primary care, and evidence is emerging that these efforts can improve quality without an additional increase in overall spending. This #PrimaryCareWeek, check out our Health Affairs article to learn what states are doing, common factors related to success, and what additional research is needed. Gary Swan, Mary Jo Condon, Wayne Altman, Russ Phillips, Zirui Song, Sarah Shaffer, MPH, Rik Ganguly

??? How Medical Practices Are Responding to New Incentives to Meet Patients’ Social Needs The Affordable Care Act’s expansion of Medicaid eligibility to more Americans offers a once-in-a generation opportunity for understanding how poverty and other social risk factors shape a patient's health. The expansion enabled states to begin tying information about social risks like food and housing insecurity to the medical records of some 18 million newly insured people. With vastly different levels of investment, both Massachusetts and Minnesota have made strides in bridging the health and social sectors to achieve better health outcomes at lower costs. In our new feature story, Sarah Klein explores the approaches each state has taken and the impact they’ve had so far. Read about the keys to effectively evaluating patients for their needs, why social psychology matters, and the importance of offering well-defined benefits.