Study Looks at Effect of Medicare on Previously Uninsured Adults; Perspectives Examine Physician-Efficiency Comparisons, Physician-Performance Programs

• "Health of Previously Uninsured Adults After Acquiring Medicare Coverage," Journal of the American Medical Association: The study evaluates how gaining Medicare coverage affected the health of previously uninsured adults. According to the authors, Medicare coverage improved self-reported health for previously uninsured adults, particularly those with cardiovascular disease or diabetes (McWilliams et al., JAMA, 12/26/07).
  
  
• "Comparing Physicians on Efficiency," New England Journal of Medicine: In the article, Arnold Milstein, chief physician at Mercer Health and Benefits and medical director of the Pacific Business Group on Health, and Thomas Lee, network president for Partners HealthCare in Boston and an associate editor of NEJM, discuss issues surrounding the use of physician-efficiency assessments by consumers and purchasers. According to Milstein and Lee, "Knowledge about physicians' efficiency could be helpful to patients who increasingly struggle to afford premiums, deductible, and coinsurance," and it also could "motivate physicians to lead urgently needed efforts to improve efficiency" (Milstein/Lee, NEJM, 12/26/07).
  
  
• "Is Quality Improvement Improving Quality? A View From the Doctor's Office," New England Journal of Medicine: In the NEJM perspective, Mark Vonnegut -- a pediatrician in Quincy, Mass. -- discusses efforts by the health care industry to evaluate physician care and performance. Vonnegut also examines whether these programs have a positive or negative impact on patients' health. Vonnegut says he suspects that such programs will be more beneficial to insurers than physicians and patients, adding that doctors should work harder to determine whether performance-assessing programs truly improve care before the health care industry changes the way medical care evolves and is delivered (Vonnegut, NEJM, 12/26/07).