Friday, February 18, 2011

Best practices emerge from survey of kids' health care

Recently, the Commonwealth Fund released a scorecard on childrens' health care outcomes that trumpeted major differences in outcomes from state to state. According to the report, "there is a twofold or greater spread between the best and worst states across important indicators of access and affordability, prevention and treatment, and potential to lead healthy lives."

The report also found wide gaps in performance in everything from developmental screening rates to provision of mental health care, hospitalizations because of asthma, prevalence of teen smoking, and mortality rates among infants and children.

It's the sort of report you've read or skimmed through hundreds of times—with the ultimate, unsurprising conclusion that regional differences in U.S. health care are as stark as ever. But tucked beneath the usual headlines were a series of inspiring stories about a diverse collection of states partnering with hospitals and other providers to improve childrens' health care across the spectrum.

Alabama, for instance, got lauded for its 94 percent insurance coverage rate for children, due in part to their status as the first state to adopt an SCHIP program back in 1998—now known as All Kids and to ongoing efforts to keep track of the state's children through information sharing between various state agencies and providers.

And North Carolina earned the highest rates of screening from development and/or behavioral delays, due in part to its decade-old Child Health Assessment and Monitoring Program.

Even in the overall scorecard, which measured performance in several different areas, there was hope for states battling difficult economic environments; the report singled out West Virginia and Tennessee for landing in the top half of overall performance despite high rates of poverty, unemployment and disease.

By the time I was done, I was less interested in the headlines about differences in care than in the case studies of innovations across the country.

In fact, the most valuable insight I got from the report wasn't from a single factoid or policy analysis, but from this simple line, "There is value in learning from best practices around the nation." I couldn't have said it better myself.


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