Digital Commons Network^™

Top Management Team Diversity, Equality, And Innovation: A Multilevel Investigation Of The Health Care Industry, A. Erin Bass

A. Erin Bass

The role of women on top management teams (TMTs) is an increasingly important topic for both academics and practitioners. Despite increased attention to gender diversity on TMTs, there remains limited understanding of how gender diversity influences important outcomes of the firm, such as innovation. To this end, I investigate the relationships between two dimensions of TMT diversity—TMT gender diversity and TMT compensation equality—and firm innovation, and consider how TMT size influences these relationships. Using a unique, multilevel, longitudinal sample of publicly traded firms in the U.S. health care industry, I find TMT size to be a key driver in the …

When Caring Is Work: Home, Health, And The Invisible Workforce: Introduction, Dianne Avery, Martha T. Mccluskey

Dianne Avery

This essay introduces the SUNY Buffalo Law School 2012 James McCormick Mitchell Lecture. The Lecture featured distinguished scholars Hendrik Hartog, Jennifer Klein, and Peggie R. Smith, who each contributed an essay to this volume. These three scholars give a richly detailed picture of home caretakers' struggles to gain visibility and support for their important work. Legal rulings and policy choices have made care workers distinctly vulnerable, treating care services as an expression of love rather than contract (as Hartog describes), or as social rehabilitation for marginal citizens rather than as skilled health care provision (as Klein explains), or as informal …

How Much Of Health Care Antitrust Is Really Antitrust?, Spencer Weber Waller

Spencer Weber Waller

No abstract provided.

Alienage Classifications And The Denial Of Health Care To Dreamers, Fatma E. Marouf

Fatma Marouf

In the Affordable Care Act (“ACA”), passed in 2010, Congress provided that only “lawfully present” individuals could obtain insurance through the Marketplaces established under the Act. Congress left it to the Department of Health and Human Services (“HHS”) to define who is “lawfully present.” Initially, HHS included all individuals with deferred action status, which is an authorized period of stay but not a legal status. After President Obama announced a new policy of Deferred Action for Childhood Arrivals (“DACA”) in June 2012, however, HHS amended its regulation specifically to exclude DACA recipients from the definition of “lawfully present.” The revised …

Maryland's All-Payer Health Care System: A Light At The End Of A Tunnel, Lama Bakhamis, Taeko Matsumoto, Mary Tran, David P. Paul Iii, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

The state of Maryland, in collaboration with the Centers for Medicare & Medicaid Services, developed the first all-payer system model in the Unites States in 1971 and 35 years later in response to financial pressures undertook to modernize this program. The focus of the modernized program was to improve overall per-capita expenditure, quality of care, and the outcome of Marylanders' health. The financial status of Maryland hospitals was declining because of the rate setting of the Health Services Cost Review Commission while hospital admission rates and spending were increasing. This study showed positive change in moving Maryland health care delivery …

Intellectual Property And Public Health – A White Paper, Ryan G. Vacca, Jim Chen, Jay Dratler Jr., Tom Folsom, Timothy Hall, Yaniv Heled, Frank Pasquale, Elizabeth Reilly, Jeff Samuels, Kathy Strandburg, Kara Swanson, Andrew Torrance, Katharine Van Tassel

Katharine Van Tassel

On October 26, 2012, the University of Akron School of Law’s Center for Intellectual Property and Technology hosted its Sixth Annual IP Scholars Forum. In attendance were thirteen legal scholars with expertise and an interest in IP and public health who met to discuss problems and potential solutions at the intersection of these fields. This report summarizes this discussion by describing the problems raised, areas of agreement and disagreement between the participants, suggestions and solutions made by participants and the subsequent evaluations of these suggestions and solutions.

Led by the moderator, participants at the Forum focused generally on three broad …

Improving Tennessee Health Care Providers Understanding Of Neonatal Abstinence Syndrome, Ivy Click, Nicholas E. Hagemeier

Nicholas E. Hagemeier

No abstract provided.

Etsu Didarp Project 1: Health Care Provider Communication And Prescription Drug Abuse And Misuse, Nicholas E. Hagemeier, Fred Tudiver

Nicholas E. Hagemeier

No abstract provided.

Comfort, Complexities, And Confrontation: Health Care Provider Communication And Prescription Drug Abuse And Misuse, Nicholas E. Hagemeier, Fred Tudiver

Nicholas E. Hagemeier

This presentation describes (1) the role of communication in prescription drug abuse prevention and treatment and (2) the outcomes of 5 focus groups conducted in the Appalachian Region.

Prevention Of Illness, Paul Bernstein

Paul Bernstein, MD, JD, FACC

No abstract provided.

Consumer Financial Protection In Health Care, Erin C. Fuse Brown

Erin C. Fuse Brown

There are inadequate consumer protections from harmful medical billing practices that result in unavoidable, unexpected, and often financially devastating medical bills. The problem stems from the increasing costs shifting to patients in American health care and the inordinate complexity that makes health care transactions nearly impossible for consumers to navigate. A particularly outrageous example is the phenomenon of surprise medical bills, which refers to unanticipated and involuntary out-of-network bills in emergencies or from out-of- network providers at in-network facilities. Other damaging medical billing practices include the opaque and à la carte nature of medical bills, epitomized by added “facility fees,” …

Managed Care, Utilization Review, And Financial Risk Shifting: Compensating Patients For Health Care Cost Containment Injuries, Vernellia R. Randall

Vernellia R. Randall

This Article examines current tort remedies for personal injury claims and explores the problems that arise when these remedies are applied to physicians' actions that are directed by third-party payers. Part II of this Article explores the organization and historical development of managed health care products. Part III considers the past and present uses of the utilization review process and financial risk shifting. Part IV explores the applicability of traditional theories of tort liability to third-party payers, including direct liability of third-party payers who market managed care products. Part V considers the barriers that ERISA presents to compensating patients for …

Superbugs Versus Outsourced Cleaners: Employment Arrangements And The Spread Of Health Care-Associated Infections, Adam Seth Litwin, Ariel C. Avgar, Edmund R. Becker

Adam Seth Litwin

On any given day, about one in 25 hospital patients in the United States has a health care–associated infection (HAI) that the patient contracts as a direct result of his or her treatment. Fortunately, the spread of most HAIs can be halted through proper disinfection of surfaces and equipment. Consequently, cleaners—“environmental services” (EVS) in hospital parlance—must take on the important task of defending hospital patients (as well as staff and the broader community) from the spread of HAIs. Despite the importance of this task, hospitals frequently outsource this function, increasing the likelihood that these workers are under-rewarded, undertrained, and detached …

Did You Hear What I Meant To Say?, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

The author introduces Volume 4, Issue 1 of Journal of Patient-Centered Research and Reviews by acknowledging the importance of communication between patient and caregiver in the clinical setting. Failure to communicate effectively can have a negative impact on a patient's well-being, therefore efforts to improve communication skills among clinicians, researchers and health practice administrators should be undertaken with regularity.

Merger & Acquisition And Capital Expenditure In Health Care: Information Gleaned From Stock Price Variation, Wenjing Ouyang, Peter E. Hilsenrath

Peter E. Hilsenrath

Investment, especially through merger and acquisition (M&A), is a leading topic of concern among health care managers. In addition, the implications of this activity for organization and market concentration are of great interest to policy makers. Using a sample of 2256 firm-year observations in the health care industry during the period from 1985 to 2011, this article provides novel evidence that managers learn from financial markets in making capital expenditure (CAPEX) and M&A investment decisions. Within the industry, managers in the Drugs subsector are most likely to do so, whereas managers in the Medical Equipment and Supplies are least likely …

Demystifying Health Care, Khabir Ahmed

Khabir Ahmed

No abstract provided.

Medicare Fraud, Waste And Abuse, Jamie Bush, Leslie Sandridge, Cierra Treadway, Kimberly Vance, Alberto Coustasse Dr. Ph, Md, Mba

Alberto Coustasse, DrPH, MD, MBA, MPH

In 2014, the U.S. spent approximately $3 trillion on health care. Medicare accounted for $554 billion of these costs and around $60 billion were squandered due to incorrect billing methods, abuse, and fraud. Types of fraud included: kickbacks, up coding, and organized fraudulent crimes. To reduce the financial burden associated with these activities, the U.S. has created various fraud prevention programs. The purpose of this study was to identify methods of Medicare fraud, examine the various programs implemented by the U.S. government to combat fraud and abuse, and determine the effectiveness of these programs. While fraud prevention strategies have proven …

The Academic And Health Policy Conference On Correctional Health: Evaluation Of Its Academic And Scientific Impact, Judith A. Savageau, Warren J. Ferguson, Laura A. Sefton

Judith A. Savageau

Background: There is limited research and research dissemination on the care of detained persons, often due to barriers to conducting research in correctional settings. Additionally, while concerns exist about the quality of care delivered to inmates, only a small number of academic health science centers provide health care services behind bars. To strengthen the field of academic criminal justice health (ACJH), the Academic and Health Policy Conference on Correctional Health (AHPCCH) was launched in 2007. Objective: To assess the merits of the conference as a stimulus to advance the field of ACJH.

Methods: Two hundred ninety-one individuals were identified who …

Hospital Mergers And Economic Efficiency, Roger D. Blair, Christine Piette Durrance, D. Daniel Sokol

D. Daniel Sokol

Consolidation via merger both from hospital-to-hospital mergers and from hospital acquisitions of physician groups is changing the competitive landscape of the provision of health care delivery in the United States. This Article undertakes a legal and economic examination of a recent Ninth Circuit case examining the hospital acquisition of a physician group. This Article explores the Saint Alphonsus Medical Center-Nampa Inc. v. St. Luke’s Health System, Ltd. (St. Luke’s) decision—proposing a type of analysis that the district court and Ninth Circuit should have undertaken and that we hope future courts undertake when analyzing mergers in the …

Quality-Enhancing Merger Efficiencies, Roger D. Blair, D. Daniel Sokol

D. Daniel Sokol

The appropriate role of merger efficiencies remains unresolved in US antitrust law and policy. The Patient Protection and Affordable Care Act (ACA) has led to a significant shift in health care delivery. The ACA promises that increased integration and a shift from quantity of performance through increased competition will create a system in which quality will go up and prices will go down. Increasingly, due to the economic trends that respond to the ACA, including considerable consolidation both horizontally and vertically, it is imperative that the antitrust agencies provide an economically sound and administrable legal approach to efficiency enhancing mergers. …

Predicting The Fallout From King V. Burwell - Exchanges And The Aca, Nicholas Bagley, David K. Jones, Timothy Stoltzfus Jost

Timothy S. Jost

The U.S. Supreme Court's surprise announcement on November 7 that it would hear King v. Burwell struck fear in the hearts of supporters of the Affordable Cara Act (ACA). At stake is the legality of an Internal Revenue Service (IRS) rule extending tax credits to the 4.5 million people who bought their health plans in the 34 states that declined to establish their own health insurance exchanges under the ACA. The case hinges on enigmatic statutory language that seems to link the amount of tax credits to a health plan purchased "through an Exchange established by the State." According to …

Allowing Patients To Waive The Right To Sue For Medical Malpractice: A Response To Thaler And Sunstein, Tom Baker, Timothy D. Lytton

Timothy D. Lytton

This essay critically evaluates Richard Thaler and Cass Sunstein’s proposal to allow patients to prospectively waive their rights to bring a malpractice claim, presented in their recent, much acclaimed book, Nudge: Improving Decisions about Health, Wealth and Happiness. We show that the behavioral insights that undergird Nudge do not support the waiver proposal. In addition, we demonstrate that Thaler and Sunstein have not provided a persuasive cost-benefit justification for the proposal. Finally, we argue that their liberty-based defense of waivers rests on misleading analogies and polemical rhetoric that ignore the liberty and other interests served by patients’ tort law rights. …

Medicare Fraud In The United States: Can It Ever Be Stopped?, Chelsea Hill, Alex Hunter, Leslie Johnson, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

The majority of the United States health care fraud has been focused on the major public program, Medicare. The yearly financial loss from Medicare fraud has been estimated at about $54 billion. The purpose of this research study was to explore the current state of Medicare fraud in the United States, identify current policies and laws that foster Medicare fraud, and determine the financial impact of Medicare fraud. The methodology for this study was a literature review. Research was conducted using a scholarly online database search and government Web sites. The number of individuals charged with criminal fraud increased from …

How Obamacare’S Future Rests On A Single Clause, Alan E. Garfield

Alan E Garfield

No abstract provided.

“Early-Bird Special” Indeed!: Why The Tax Anti-Injunction Act Permits The Present Challenges To The Minimum Coverage Provision, Michael C. Dorf, Neil S. Siegel

Michael C. Dorf

In view of the billions of dollars and enormous effort that might otherwise be wasted, the public interest will be best served if the Supreme Court of the United States reaches the merits of the present challenges to the Patient Protection and Affordable Care Act (ACA) during its October 2011 Term. Potentially standing in the way, however, is the federal Tax Anti-Injunction Act (TAIA), which bars any “suit for the purpose of restraining the assessment or collection of any tax.” The dispute to date has mostly turned on the fraught and complex question of whether the ACA’s exaction for being …

The Economic Impact Of Saint Mary's Hauenstein Center On The Greater Grand Rapids Area, George A. Erickcek

George A. Erickcek

No abstract provided.

The Economic Impact Of Health Services In Muskegon County, George A. Erickcek

George A. Erickcek

No abstract provided.

Kentucky State Innovation Model (Sim) Design Grant: Consumer Engagement, Susan Buchino, Monica Wendel, Liza Creel

Susan Buchino

The Messenger Model: Don't Ask, Don't Tell?, Jeffrey L. Harrison

Jeffrey L Harrison

This article makes the case that the messenger model is either tacitly or inadvertently a "don't ask, don't tell" policy when it comes to competitor cooperation. In addition, this article presents an economic framework that explains how such a policy may benefit health care consumers. Finally, it is suggested that the "don't ask, don't tell" policy has created an area of per se legality that precludes an examination designed to distinguish consumer-benefiting practices from those that provide no benefit.

Rate Setting And Disclosure In Continuing Care Retirement Communities (Ccrcs), Seth C. Anderson, Jeffrey E. Michelman, Raymond M. Johnson, Kristi Quick

Jeffrey E Michelman

By 2026, the population of Americans age 65 and older will double to 71.5 million. According to a recent study by Metlife, et al., there are five important issues that impact both current and future retirees: Increased longevity with Americans living longer; Changing economic factors such as increased health care costs; A growing skills shortage in many industries; Different beliefs about work among the aging Baby Boomer generation; and Financial resources available for retirement. All five of these factors affect both the ways seniors plan for retirement and the ways that organizations providing services to seniors must respond. Continuing care …