Commonwealth Fund

In these case studies for The Commonwealth Fund, Dr. Nichols and Tom Emswiler examine high-performing health care systems to see how they achieve better outcomes at lower cost. Both the Hill Physicians Medical Group, an association of physicians in individual practice, and the Baylor Health Care System, a highly integrated delivery system, have successfully standardized care, implemented electronic medical records, and improved clinical outcomes.

The large majority of American families with health insurance obtain their coveragethrough an employer -- whether their own, their spouse's, or a parent's. Indeed, employersponsoredinsurance (ESI), which covers nearly 63 percent of Americans, has served as thefoundation for the U.S. health insurance system for half a century.

Throughout the 1980s and early 1990s, however, the percentage of people with ESI declined. And, while ESI rates appear to have stabilized since 1993 -- largely becauseof a high-employment economy… more