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Full-Text Articles in Medicine and Health Sciences

Retooling Tax Subsidies For Health Coverage: Old Ideas, New Politics, Karl Polzer Nov 1998

Retooling Tax Subsidies For Health Coverage: Old Ideas, New Politics, Karl Polzer

National Health Policy Forum

This paper describes the tax treatment of health coverage and health care spending and explores the potential impact of recent tax reform proposals. The paper summarizes the criticisms of the current system and analyzes various alternatives including capping the open-ended tax exclusion of health benefits provided by employers and unions, eliminating the exclusion, and establishing a tax credit.


Physician Organizations Assuming Risk: Market And Policy Implications, Sandra Foote, Lisa Sprague Nov 1998

Physician Organizations Assuming Risk: Market And Policy Implications, Sandra Foote, Lisa Sprague

National Health Policy Forum

This issue brief looks at capitation contracting between physician groups and health plans and ways in which financial risk and functional responsibilities may be apportioned. It traces the evolution of capitation contracting in California and the legislative and regulatory issues that have arisen.


Site Visit To Southern California — Plans And Providers: Risk, Accountability, And Staying Power, Lisa Sprague Nov 1998

Site Visit To Southern California — Plans And Providers: Risk, Accountability, And Staying Power, Lisa Sprague

National Health Policy Forum

This site visit was the second of two focused on managed care operations and market dynamics in California, a state notable for high HMO market penetration and intense competition. In southern California, large physician groups and independent practice associations were highly visible and influential. They had assumed significant financial risk and care management responsibility for patients in HMO plans. The result was a distinctly different model of managed care than existed in other regions of the country. The visit included meetings with leaders from physician organizations and managed care organizations in San Diego and Orange counties, as well as an …


Site Visit To Utah And Nevada — Essential Community Health Services On The Frontier, Karen Matherlee, Michael Anzick Oct 1998

Site Visit To Utah And Nevada — Essential Community Health Services On The Frontier, Karen Matherlee, Michael Anzick

National Health Policy Forum

From the opening dinner to the closing summary, this site visit explored the delivery and financing of essential community services for vulnerable populations in the frontier West. A sequel to the Forum's March 30-31, 1998, urban-centered site visit to Philadelphia, Providing Community-Based Primary Care: Nursing Centers, CHCs, and Other Initiatives, the visit spanned 493 miles. It included overview presentations, bus briefings, facility tours, telehealth demonstrations, panel discussions, and wrap-up reviews. Topics included the Utah health marketplace, the demands of emergency preparedness, the development of a patchwork of services along a continuum ranging from preventive care to tertiary referrals and follow-up, …


Mid-Atlantic Ethics Committee Newsletter, Fall-Winter 1998 Oct 1998

Mid-Atlantic Ethics Committee Newsletter, Fall-Winter 1998

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.


The State Children's Health Insurance Program: How Much Latitude Do The States Really Have?, Richard Hegner Oct 1998

The State Children's Health Insurance Program: How Much Latitude Do The States Really Have?, Richard Hegner

National Health Policy Forum

The State Children's Health Insurance Program (CHIP) — a major program to cover low-income, uninsured children — was passed as part of the Balanced Budget Act of 1997. Its passage was part of a trend of a shifting balance of power between the federal and state governments, particularly in the policy areas of health and social welfare. This issue brief explores the degree of freedom afforded the states by CHIP, the factors guiding state decision making and planning, and the factors influencing the states' various decisions about CHIP. It also discusses state options in four basic areas: participation or nonparticipation …


Protecting The Confidentiality Of Health Information, Nora Super Sep 1998

Protecting The Confidentiality Of Health Information, Nora Super

National Health Policy Forum

This issue brief focuses on the legislation aimed at protecting the confidentiality of health information. It provides an overview of legislation being considered in 1998 and focuses on three key issues: controlling access to health information, conducting research, and preempting state laws.


Communicating To Beneficiaries About Medicare+Choice: Opportunities And Pitfalls, Nora Super Jul 1998

Communicating To Beneficiaries About Medicare+Choice: Opportunities And Pitfalls, Nora Super

National Health Policy Forum

This issue brief explores the opportunities and potential pitfalls in communicating to beneficiaries about Medicare+Choice. This issue brief also looks at the difficulties inherent in communicating complex information to a diverse group of older individuals as well as at communications and programmatic challenges related to information overload, marketing concerns, lack of uniform standards, lack of infrastructure, and the vulnerability of various subpopulations.


Medicare Coverage And Technology Diffusion: Past, Present, And Future, Robin J. Strongin Jul 1998

Medicare Coverage And Technology Diffusion: Past, Present, And Future, Robin J. Strongin

National Health Policy Forum

This issue brief provides an overview of the Medicare coverage process. Coverage involves deciding whether or not to pay for a particular service or product. This brief examines Medicare's coverage determination process, which includes technology assessment, payment determination, and the demand for evidence. Options for improving the coverage determination process are reviewed.


Mid-Atlantic Ethics Committee Newsletter, Summer 1998 Jul 1998

Mid-Atlantic Ethics Committee Newsletter, Summer 1998

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.


Erisa Health Plan Denials: Exploring Models For External Review, Karl Polzer Jun 1998

Erisa Health Plan Denials: Exploring Models For External Review, Karl Polzer

National Health Policy Forum

This paper outlines the current process under the Employee Retirement Income and Security Act (ERISA) by which plan participants can appeal a claim denial as well as changes to the claims procedure requirements being considered by the Department of Labor. It describes state legislative activity in this area and summarizes research describing practices currently in place among managed health care organization. The paper also describes two existing models for external review of managed care plan decisions, one used by the Medicare program and another by the state of Florida.


Pain Management And Palliative Care In The Era Of Managed Care: Issues For Health Insurers, Diane E. Hoffmann Jun 1998

Pain Management And Palliative Care In The Era Of Managed Care: Issues For Health Insurers, Diane E. Hoffmann

Faculty Scholarship

No abstract provided.


Site Visit To New Jersey — State And County Experiences With Welfare Reform And Access To Health Care, Michael Anzick, Richard Hegner May 1998

Site Visit To New Jersey — State And County Experiences With Welfare Reform And Access To Health Care, Michael Anzick, Richard Hegner

National Health Policy Forum

This site visit was the second in a series to examine what is occurring at the state and local level with respect to welfare reform, Medicaid, public health, and safety net and other supportive services. During this visit, policymaker discovered how state officials, directors, and front-line staff at urban and suburban county welfare offices are working with clients to move them off the welfare rolls into jobs and providing the support services necessary for job retention; heard from clients about how programmatic changes are affecting them and their families; learned how the role of safety net health care and temporary …


Dual Diagnoses: The Challenge Of Serving People With Concurrent Mental Illness And Substance Abuse Problems, Richard Hegner Apr 1998

Dual Diagnoses: The Challenge Of Serving People With Concurrent Mental Illness And Substance Abuse Problems, Richard Hegner

National Health Policy Forum

This paper describes the prevalence of comorbid mental disorders in the population and discusses what is known about causality and relapse. The relationship between dual diagnosis and homelessness and crime is also discussed. The paper also explores options for improving treatment among the dually diagnosed.


Increasing The Federal Cigarette Tax: A Means Of Reducing Consumption?, Lauren Tran, Richard Hegner Apr 1998

Increasing The Federal Cigarette Tax: A Means Of Reducing Consumption?, Lauren Tran, Richard Hegner

National Health Policy Forum

This issue brief probes the economic issues associated with tobacco and cigarettes. It examines the possible effectiveness of a tax increase as a strategy to reduce cigarette consumption, especially among young people, and the likely ramifications of a tax increase for the tobacco industry.


Mid-Atlantic Ethics Committee Newsletter, Spring 1998 Apr 1998

Mid-Atlantic Ethics Committee Newsletter, Spring 1998

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.


Restructuring The Va Health Care System: Safety Net, Training, And Other Considerations, Barbara Skydell Mar 1998

Restructuring The Va Health Care System: Safety Net, Training, And Other Considerations, Barbara Skydell

National Health Policy Forum

This paper provides an historical overview of the modern Veterans Administration (VA) healthcare system and describes the multiple missions of the VA — patient care, health professions education, research, and medical preparedness. The VA's reform plan, which addresses issues related to decentralization, management and oversight, resource allocation, eligibility reform, and primary/ambulatory care, is also described and discussed. Challenges facing the VA as it transitions to a greater focus on prevention, primary care, and care management are also addressed.


The Federal Employees Health Benefits Program: What Lessons Can It Offer Policymakers?, Karl Polzer Mar 1998

The Federal Employees Health Benefits Program: What Lessons Can It Offer Policymakers?, Karl Polzer

National Health Policy Forum

This paper provides an historical overview of the Federal Employees Health Benefits (FEHB) program and its marketplace dynamics. It also reviews key program features and issues, including payments to health plans, strategies used to mitigate the opportunities for risk selection, and costs.


Site Visit To Philadelphia — Providing Community-Based Primary Care: Nursing Centers, Chcs, And Other Initiatives, Karen Matherlee Mar 1998

Site Visit To Philadelphia — Providing Community-Based Primary Care: Nursing Centers, Chcs, And Other Initiatives, Karen Matherlee

National Health Policy Forum

This site visit provided federal congressional and agency health staff opportunities to visit facilities and engage in discussions on essential community health services. Focused on community-based primary care in a managed care environment, it featured delivery and financing concerns relating to nursing centers, community health centers, public-mission hospitals, and homeless services. In examining the impact of managed care in a rapidly changing health marketplace, it explored the implementation of the Medicaid HealthChoices program in the city as well as access to and delivery of care to persons with neither public nor private insurance. It also looked at the role of …


Site Visit To Northern California — Risk, Accountability, And Staying Power In Next-Generation Managed Care, Lisa Sprague, Sandra Foote Feb 1998

Site Visit To Northern California — Risk, Accountability, And Staying Power In Next-Generation Managed Care, Lisa Sprague, Sandra Foote

National Health Policy Forum

This three-day site visit looked at private health insurance and delivery of care in a market notable for high managed care penetration, relatively low premium costs, and sophisticated provider groups. Federal congressional and regulatory staff heard from health insurance purchasers (both public and private), health plans, hospital systems, and physician groups about the changing relationships and accountabilities in this market and the ways various organizations were positioning themselves to survive the turmoil and emerge the stronger for it. Participants also heard from two county health programs about how competition and realignment in the private market were impacting safety-net services for …


Health Care Quality: From Data To Accountability, Mary Darby Feb 1998

Health Care Quality: From Data To Accountability, Mary Darby

National Health Policy Forum

This paper discussed the evolution of quality measurement and reporting activities as well as efforts to develop accountability for delivering high-quality care. It examined (a) initiatives in the professional arena, such as accreditation and performance measurement by independent accrediting bodies; (b) activities of market proponents, who have preferred to concentrate on making data available to purchasers and consumers that would enable them to choose high- quality plans and providers; and (c) attempts by the public sector to secure quality through regulation and oversight. An exploration of the successes, limitations, overlaps, and gaps in quality assurance initiatives, the paper was published …


Comments On The Second Report Of The Maryland Attorney General's Research Working Group, Franklin G. Miller Jan 1998

Comments On The Second Report Of The Maryland Attorney General's Research Working Group, Franklin G. Miller

Journal of Health Care Law and Policy

No abstract provided.


The National Bioethics Advisory Commission: Bridging The Gaps In Human Subjects Research Protection, James F. Childress Jan 1998

The National Bioethics Advisory Commission: Bridging The Gaps In Human Subjects Research Protection, James F. Childress

Journal of Health Care Law and Policy

No abstract provided.


Issues Raised By Research Using Persons Suffering From Dementia Who Have Impaired Decisional Capacity, Peter V. Rabins Jan 1998

Issues Raised By Research Using Persons Suffering From Dementia Who Have Impaired Decisional Capacity, Peter V. Rabins

Journal of Health Care Law and Policy

No abstract provided.


Regulating Research With Vulnerable Populations: Litigation Gone Awry, John M. Oldham, Stephan Haimowitz, Susan J. Delano Jan 1998

Regulating Research With Vulnerable Populations: Litigation Gone Awry, John M. Oldham, Stephan Haimowitz, Susan J. Delano

Journal of Health Care Law and Policy

No abstract provided.


Announced To Trounced: A Journalist's Comments On The Demise Of The Tobacco Settlement, Adam S. Levy Jan 1998

Announced To Trounced: A Journalist's Comments On The Demise Of The Tobacco Settlement, Adam S. Levy

Journal of Health Care Law and Policy

No abstract provided.


What Should The Law Say About Disclosure Of Genetic Information To Relatives?, Ellen Wright Clayton Jan 1998

What Should The Law Say About Disclosure Of Genetic Information To Relatives?, Ellen Wright Clayton

Journal of Health Care Law and Policy

No abstract provided.


Tobacco Wars: Will The Rule Of Law Survive?, Robert A. Levy Jan 1998

Tobacco Wars: Will The Rule Of Law Survive?, Robert A. Levy

Journal of Health Care Law and Policy

No abstract provided.


Proxy Consent To Participation Of The Decisionally Impaired In Medical Research-Maryland's Policy Initiative, Diane E. Hoffmann, Jack Schwartz Jan 1998

Proxy Consent To Participation Of The Decisionally Impaired In Medical Research-Maryland's Policy Initiative, Diane E. Hoffmann, Jack Schwartz

Journal of Health Care Law and Policy

No abstract provided.


Regulation Of Research On The Decisionally Impaired: History And Gaps In The Current Regulatory System, Jonathan D. Moreno Jan 1998

Regulation Of Research On The Decisionally Impaired: History And Gaps In The Current Regulatory System, Jonathan D. Moreno

Journal of Health Care Law and Policy

No abstract provided.