RWJF - Updates: Health 2000

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CLINICAL CARE MANAGEMENT
Helping reduce the gap between what is known about the best ways to care for people with chronic disease and what is actually practiced.
Much of the Clinical Care Management (CCM) Team’s work in 2000 focused on specific chronic conditions. Depression is the fourth leading cause of disability in the United States and accounts for up to $53 billion annually in lost worker productivity and direct medical costs. Yet research has shown that depression frequently goes undetected, and when detected, is often not treated adequately. To address this problem, the Foundation authorized $12 million for a five-year program intended to improve the treatment of depression in primary care settings.
    The CCM Team also continued its work to improve the care of pediatric asthma through a $2.4-million grant to the University of Michigan School of Public Health to improve the training of primary care physicians in the delivery of asthma care. The project includes the development of a tool kit and interactive seminars designed to enhance clinicians’ therapeutic and patient counseling skills.
    The Foundation also supported an effort to implement and evaluate a model of coordinated acute and primary health care and supportive services in managed care settings for Alzheimer’s disease and dementia. The model works to facilitate early identification of people with possible dementia and Alzheimer’s, provide more appropriate acute and primary care, and better coordinate health care and supportive services.
    Of a more exploratory nature, about $1 million was provided to support the Pittsburgh Regional Health Care Initiative, an effort spearheaded by area business, health care, and philanthropic leaders to dramatically improve the quality of care in the region. Initially, the Initiative is attempting to eliminate in-hospital infections and medication errors.
    In the future, the CCM Team plans to continue its efforts to advance care of specific diseases, help patients better manage their care, and advance the ability of health care purchasers to improve their quality.

INSURANCE COVERAGE
Increasing the number of Americans with health insurance.
The year saw a continuation and expansion of our efforts to increase the number of Americans with health insurance. In January, we approved a $26-million strategic communications campaign to support Covering Kids™, our national initiative designed to maximize the participation of eligible children in available coverage programs.
    In another effort related to Covering Kids, the Foundation approved Supporting Families after Welfare Reform: Access to Medicaid, SCHIP, and Food Stamps. The $6.8-million program is intended to help states and large counties solve problems in their eligibility processes that make it difficult for low-income families, particularly those moving from welfare to work, to access and retain Medicaid coverage, the State Children’s Health Insurance Program, or Food Stamps.
    As part of the Team’s work to educate opinion leaders and the public about the problems of the uninsured, we also provided $3.7 million to the Institute of Medicine for a three-year project that will assess the evidence about the health, economic and social consequences of uninsurance for individuals, families, business, the health care system and communities.
    Building on Health Coverage 2000—a successful conference at the beginning of the year that brought together a diverse group of organizations to discuss the issue of the uninsured and look for common ground—the Foundation also supported a series of regional meetings intended to develop local input and continue to raise the profile of the issue.
    We also provided $10 million to the University of Michigan to undertake a research initiative to help the country better understand the relationship between the labor market and health insurance coverage, and the effect of insurance on worker productivity and health.
     The Coverage Team plans to continue its efforts to help eligible children enroll in available coverage programs and to highlight for the nation the problems of people without health insurance.