Digital Commons Network^™

Abortion Provisions In The Senate Managers Amendment, Sara J. Rosenbaum

Health Policy and Management Informal Communications

An assessment on the potential industry effects of the abortion provisions in the Senate Managers Amendment made available on December 18, 2009.

Got Junk? The Federal Role In Regulating “Competitive” Foods, Eileen Salinsky

National Health Policy Forum

A wide variety of food and beverage items are available in schools in addition to the school meals provided through the National School Lunch Program and School Breakfast Program. A long-standing source of controversy, the need for stronger federal restrictions on foods that compete with school meals is again under debate. This issue brief examines the availability and consumption of competitive foods, explores the regulation of these foods at the federal level, considers trends in state and local restrictions, and summarizes perceived barriers to improving the nutritional quality of competitive food options.

No Free Lunch? Current Challenges Facing The National School Lunch And School Breakfast Programs, Eileen Salinsky

National Health Policy Forum

This background paper describes important characteristics of the National School Lunch Program and the School Breakfast Program, reviews U.S. Department of Agriculture rules regarding the nutritional content of school meals, and examines compliance with current nutrition standards. It also considers the dietary status and obesity risk of meal program participants, discusses proposed improvements to nutritional standards and meal requirements, and highlights key legislative issues.

The Role Of Ombudsmen In Assuring Quality For Residents Of Long-Term Care Facilities: Straining To Make Ends Meet, Carol O'Shaughnessy

National Health Policy Forum

Assuring quality of care for residents in long-term care facilities has been a serious and continuing concern of policymakers for decades. The Older Americans Act’s long-term care ombudsman program is a consumer advocacy model intended to improve quality of care by helping the 2.5 million residents of almost 67,000 nursing and other residential care facilities resolve complaints about their care and protect their rights. Despite broad recognition of its value in assisting residents and its efforts to complement federal and state oversight of long-term care facilities, some observers are concerned about the program’s ability to meet its legislative mandates. Limited …

Challenges In Language Services: Identifying And Responding To Patients' Needs, Marsha Regenstein, Holly Mead, Kathryn E. Muessig, Jennifer Huang

Health Policy and Management Faculty Publications

Objective: Identify characteristics of hospitalbased language services (LS), and describe practices of identifying patients with limited English proficiency (LEP) and interpreter training.

Participants: Seventy-one hospitals applied to participate in a national initiative. Applicants were non-federal, acute care hospitals with substantial LEP populations, at least 10,000 discharges, and in-person interpreters.

Methods: Descriptive statistics were generated on language, collection of language data, LEP volume and service utilization, staffing and training requirements and organizational structure. The relationship between admissions and encounters was analyzed.

Results Ninety percent of hospitals collect primary language data. Spanish is the most common language (93% of hospitals). …

Leveling The Field--Ensuring Equity Through National Health Care Reform, Bruce Siegel, Lea Nolan

Health Policy and Management Faculty Publications

Members of minority groups have higher rates of disease, poorer health, and more limited access to care than their white counterparts. They account for half of the uninsured population and 58% of the low-income uninsured population. Even when they have coverage, minority patients are at risk for receiving lower-quality medical and surgical care than white patients. The factors underlying these inequities are complex and go far beyond the health care system,but any meaningful reform must, at a minimum, confront disparities in care. Health care reform provides a unique opportunity to reversea legacy of inequality in health and health care. This …

Racial/Ethnic Disparities In Access To Care Among Children: How Does Medicaid Do In Closing The Gaps?, Marsha Lillie-Blanton, Julia Paradise, Megan Thomas, Paul D. Jacobs, Bianca Dijulio

Health Policy and Management Faculty Publications

While Medicaid and the Children's Health Insurance Program (CHIP) have become increasingly important sources of health coverage for low-income children in all racial and ethnic groups, the program plays an especially large role for children of color, who are more likely than white children to be low-income. In 2007, Medicaid and CHIP covered nearly one in five white children, but roughly two in five African American and Hispanic children.

As policymakers engaged in health reform consider the merits of public and private approaches to expanding coverage, this report provides an assessment of Medicaid's relative impact on racial and ethnic disparities …

Analysis Of State Medicaid Agency Performance In Relation To Incentivizing The Provision Of H1n1 Immunizations To Eligible Populations, Nancy Lopez, Ross Margulies, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

This analysis examines the extent to which state Medicaid agencies have translated a recent CMS guidance on vaccine coverage into clear information for participating providers clarifying payment for costs associated with the administration of H1N1 vaccines. This clarification may be particularly important in states that do not otherwise cover and pay for recommended immunizations as part of treating adult patients.

Mandatory Vaccination Of Health Care Workers, Alexandra M. Stewart

Health Policy and Management Faculty Publications

New York State’s regulations require health care workers who have direct contact with patients or who may expose patients to disease to be vaccinated against seasonal and H1N1 influenza. Courts must take into account Constitutional guarantees of personal autonomy, freedom of contract, and freedom of religion when reviewing the current lawsuits. These rights, however, have been constrained when they conflict with government measures that are intended to protect the community’s health and safety. Health care workers have a profound effect on patients’ health. Although they have the same rights as all private citizens, it is likely that courts will continue …

An Analysis Of The Implications Of The Stupak/Pitts Amendment For Coverage Of Medically Indicated Abortions, Sara J. Rosenbaum, Lara Cartwright-Smith, Ross Margulies, Susan F. Wood, D. Richard Mauery

Health Policy and Management Faculty Publications

This analysis examines the implications for coverage of medically indicated abortions under the Stupak/Pitts Amendment (Stupak/Pitts) to H.R. 3962, the Affordable Health Care for America Act. In this analysis we focus on the Amendment's implications for the health benefit services industry as a whole. We also consider the Amendment's implications for the growth of a market for public or private supplemental coverage of medically indicated abortions. Finally, we examine the issues that may arise as insurers attempt to implement coverage determinations in which abortion may be a consequence of a condition, rather than the primary basis of treatment.

No Powerpoint? Whatever Loys Your Krathong ..., Kimberly D. Acquaviva

National Collaborative on Aging Faculty Publications

The author discusses her experiences teaching a workshop on writing for publication to medicine, nursing and public health faculty in Thailand, without using PowerPoint.

Analysis Of The Extent To Which State Insurance Laws Mandate Coverage And Payment Of Vaccines And Vaccine Administration Fees During Periods Of Declared Public Health Emergencies, Sara J. Rosenbaum, Nancy Lopez, Ross Margulies

Health Policy and Management Faculty Publications

This analysis examines whether state insurance laws require health insurers, as a condition of doing business, to pay the costs associated with the administration of immunizations during declared public health emergencies. As is the case with the current H1N1 emergency, a public health emergency triggers nationwide distribution of free vaccine. But even when vaccine is distributed free of charge, its administration poses costs to private physicians and charges can be significant. As a result, the Institute of Medicine has identified vaccine administration as a potential financial barrier to care. Most communities have limited numbers of public health workers and professional …

State Medicaid Coverage Of Perinatal Services: Summary Of State Survey Findings, Usha Ranji, Alina Salganicoff, Alexandra M. Stewart, Marisa A Cox, Lauren Doamekpor

Health Policy and Management Faculty Publications

No abstract provided.

Helping Immigrant And Refugee Students Succeed: It's Not Just What Happens In The Classroom, Eileen Kugler, Olga Acosta Price

Center for Health and Health Care in Schools

No abstract provided.

Information Interface - Volume 37, Issue 4 - November/December 2009, George Washington University, Himmelfarb Health Sciences Library

Information Interface (1976 - 2009)

News and information about Himmelfarb Health Sciences Library of interest to users. Includes articles on the PubMed redesign, 2010 Journal Collection, and mobile resources.

Paying Medicare Advantage Plans By A Blend-Based System: Where Are The Gains And Losses?, Brian Biles, Jonah Pozen, Grace Arnold

Health Policy and Management Issue Briefs

Medicare Advantage (MA) plans are now paid $11 billion a year and $150 billion over 10 years more than costs in fee-for-service (FFS) Medicare. In the past two years there have been discussions about reducing MA payments to the level of FFS costs and using the savings to offset the costs of new Federal initiatives such as health care reform. These discussions have included a number of options on the specific new approach to pay plans including: average FFS costs in each county; a blend of local county FFS costs and national FFS average costs; and a regional system based …

Health Care Fraud, Sara J. Rosenbaum, Nancy Lopez, Scott Stifler

Health Policy and Management Faculty Publications

Adequate safeguards against health care fraud are essential to the proper functioning of any health care system. This analysis examines health care fraud in the U.S., and its findings underscore the importance to national health reform of comprehensive anti-fraud protections covering both public and private health insurance industry. This analysis, funded by the Robert Wood Johnson Foundation, examines health care fraud in a national policy context.

Using Primary Care To Bend The Cost Curve: The Potential Impact Of Health Center Expansion In Senate Reforms, Leighton C. Ku, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This analysis of reforms being considered in the United States Senate reaches conclusions similar to those of our prior analyses of reforms being considered in the House of Representatives. The combination of expanded health insurance coverage and investments in the expansion of community health centers can produce substantial long-term savings both for the overall health care system and for the federal government. Our analysis of the Senate provisions from the HELP and Finance Committees estimates $369 billion in total medical savings, including $105 billion in federal Medicaid savings. The Senate provisions produce larger savings because they authorize larger funding increases …

Estimating The Economic Gains For States As A Result Of Medicaid Coverage Expansions For Adults, Peter Shin, Leighton C. Ku, D. Richard Mauery, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This policy research brief examines the Medicaid eligibility expansions under the pending legislative proposals, including the House Tri-Committee bill, the Senate Health, Education, Labor and Pensions Committee bill and the Senate Finance Committee bill. Using new Census Bureau data, the researchers find that under both the House and Senate Finance Committee proposals, about 9.6 million nonelderly adults would gain Medicaid eligibility by 2014. Furthermore, the federal and state expenditures are less than Medicaid's positive impact on the economy amounting in a return of three dollars in new business activities for every dollar of state Medicaid investment. Because Medicaid is designed …

Antidepressant-Induced Mania With Concomitant Mood Stabilizer In Patients With Comorbid Substance Abuse And Bipolar Disorder., Daniel Z Lieberman, George Kolodner, Suena H Massey, Kenneth P Williams

Psychiatry and Behavioral Sciences Faculty Publications

Antidepressant use in the treatment of bipolar disorder is controversial due the risks of affective switching and cycle acceleration. Studies of non-comorbid samples suggest that the risk can be mitigated with the use of a concomitant mood stabilizer. However, the majority of patients with bipolar disorder will experience a comorbid substance use disorder and little is known about these individuals because they are typically excluded from clinical trials. Patients entering a substance abuse treatment program who had a history of bipolar disorder were interviewed to evaluate antidepressant-induced affective switching with and without concomitant mood stabilizer. Among 41 comorbid participants, the …

Libguides: A New Platform For Customized Resource Delivery, Alexandra Gomes, Cynthia Kahn

Himmelfarb Library Faculty Posters and Presentations

In fall 2009, the librarians of the Himmelfarb Health Sciences Library launched the initial set of online LibGuides for the School of Public Health and Health Services. This poster presentation describes the planning, completion, and launching of those LibGuides.

Creating And Using An Access Database To Enhance Subject Analysis And Obtain Faculty Input About The Journals Collection, Laura E. Abate, Yvonne Lee, Kathe Obrig, George P. Paul, Lionel Williams, Semhar Yohannes

Himmelfarb Library Faculty Posters and Presentations

Using Microsoft Access, Himmelfarb Health Sciences Library developed a database for all of its title-level journal holdings to assess and enhance its journal collection.

Discovering Library Resources Using Webfeat Express: Selection, Implementation, And Lessons Learned, Elizabeth Palena Hall, Alexandra Gomes, Kathe Obrig, Laura E. Abate, Leah Pellegrino, Jolinda Thompson

Himmelfarb Library Faculty Posters and Presentations

In 2006, Himmelfarb Health Sciences Library developed a task force to seek out a federated searching system. This poster presentation summarizes the process of selection and implementation of the chosen federated searching system, WebFeat Express.

Implementing A Mandated Space Change: The Unexpected Benefits To Library Systems, Kathe Obrig, Lionel Williams, Leah Pellegrino, Jennifer Mcdaniel, George P. Paul

Himmelfarb Library Faculty Posters and Presentations

In September 2008, the Himmelfarb Health Sciences Library received a mandate to convert the second floor to quiet study space. The conversion involved the removal of the 70,000-volume bound journal collection. This poster presentation illustrates the steps taken to complete the collection relocation and describes the unexpected, beneficial results of this space change.

Innovations In Instruction: Use Of Blogs & Clickers To Solicit Real-Time Responses, Laura E. Abate, Alexandra Gomes, Anne Linton

Himmelfarb Library Faculty Posters and Presentations

Seeking to enhance student interactivity and provide real-time feedback in the area of medical informatics, the Himmelfarb Health Sciences Library developed a series of interactive blogs and clickers. This poster presents the methods and results of using blogs and clickers to increase students' interest in the field of medical informatics.

Using Primary Care To Bend The Curve: Estimating The Impact Of A Health Center Expansion On Health Care Costs, Leighton C. Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This research brief, the third in a series examining the link between national health reform proposals and community health centers, estimates the cost savings that would be realized by making important investments in non-profit health centers as an element of national health reform. Key findings include:

Increasing health center capacity by another 20 million patients by 2019 (to 39 million patients) under health reform can be expected to generate an additional $35.6 billion savings in 2019 and $212 billion in additional savings over the 2010-2019 ten-year time period.

Were the Medicaid prospective payment rate system to be applied to exchange …

Talking With Patients: How Hospitals Use Bilingual Clinicians And Staff To Care For Patients With Language Needs, Jennifer Huang, Karen C. Jones, Marsha Regenstein, Christal Ramos

Health Policy and Management Issue Briefs

Improving access to language services in health care settings has become a focal point for health reform and disparities-focused legislation, in recognition of the increasing linguistic and cultural diversity of individuals across the nation. Bilingual staff and clinicians can serve as enormously valuable resources to hospitals and other health care organizations, offering a critical set of skills to interact with individuals who require care in a language other than English. Bilingual clinicians can serve a vital need for hospitals by providing high-quality health care, improving patient safety, and meeting organizational priorities to provide linguistically and culturally appropriate care for patients. …

The Economic Burden Of Health Inequalities In The United States, Thomas A. Laveist, Darrell J. Gaskin, Patrick Richard

Health Policy and Management Faculty Publications

This study, commissioned by the Joint Center for Political and Economic Studies and carried out by leading researchers from Johns Hopkins University and the University of Maryland, provides important insight into how much of a financial burden racial disparities are putting on our health care system and society at large. The researchers examined the direct costs associated with the provision of care to a sicker and more disadvantaged population, as well as the indirect costs of health inequities such as lost productivity, lost wages, absenteeism, family leave, and premature death.

Coverage And Payment For Prescription Drugs Under Medicare Part B: A Complex Patchwork, Amanda Cassidy

National Health Policy Forum

As part of the diverse discussions around health care reform, many have looked to refining Medicare payment systems as a way to give health care practitioners and providers greater incentives to deliver care more efficiently, and thus slow health care spending growth. Understanding how Medicare currently pays for Part B services, including drugs covered under Part B, is essential to understanding the potential impact of these types of reforms. Most items and services covered under Part B, including most Part B drugs, are paid individually, which means practitioners and providers generally receive more payments for providing more services. Some reform …

Stimulus Bill Implementation: Expanding Meaningful Use Of Health It, Rob Cunningham

National Health Policy Forum

The American Recovery and Reinvestment Act authorizes an estimated $38 billion in incentives and supports for health information technology (IT) from 2009 to 2019. After years of sluggish health IT adoption, this crisis-driven investment of public funds creates a unique opportunity for rapid diffusion of a technology that is widely expected to improve care, save money, and facilitate transformation of the troubled U.S. health system. Achieving maximal effect from the stimulus funds is nevertheless a difficult challenge. The Recovery Act strengthens the federal government’s leadership role in promoting health IT. But successful adoption and utilization across the health system will …