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Full-Text Articles in Social and Behavioral Sciences
An Analysis Of Political And Legal Debates Concerning Medicaid Expansion In Virginia, Rick Mayes, Benjamin Paul
An Analysis Of Political And Legal Debates Concerning Medicaid Expansion In Virginia, Rick Mayes, Benjamin Paul
Political Science Faculty Publications
The Supreme Court’s historic June 2012 ruling regarding the Affordable Care Act (ACA) in National Federation of Independent Business v. Sebelius set the stage for a massive federalism battle over Medicaid expansion in the United States. The original language of the Act was intended to nationalize Medicaid by having every state expand their program’s eligibility to all individuals up to 138% of the federal poverty level. This would have significantly reshaped Medicaid, a joint federal-state health insurance program, into a universal entitlement for all low-income citizens. Currently, Medicaid eligibility varies dramatically from state to state. The Court held that the …
Strategies For Health Care Cost Containment (1980s-Present), Rick Mayes
Strategies For Health Care Cost Containment (1980s-Present), Rick Mayes
Political Science Faculty Publications
The U.S. health care system during the past three decades has been over two interrelated questions: first, who will control the manner in which medical care is paid for, and, second, how much will it cost? Many health care experts believe that Medicare's efforts at cost control, primarily in the form of the program's seminal transition to and continual modification of prospective payment of health care providers, has both triggered and repeatedly intensified the economic restructuring of the U.S. health care system. Medicare is an almost $600 billion public health insurance program for individuals sixty-five years of age and older; …
The Way It Was In Health Policy, And Probably Will Be: Learning Lessons By Rashi Fein (Book Review), Rick Mayes
The Way It Was In Health Policy, And Probably Will Be: Learning Lessons By Rashi Fein (Book Review), Rick Mayes
Political Science Faculty Publications
Learning Lessons by Rashi Fein is an enjoyable memoir from a scholar and policy adviser unlike any other. Fein’s influential involvement in health care policy dates back to John F. Kennedy’s administration, and his career as a leading health economist paralleled the significant growth in the political influence of health economists following the enactment of Medicare and Medicaid in 1965. Now an emeritus professor of the economics of medicine at Harvard Medical School, Fein writes here about the lessons he learned in medicine, economics, and public policy. His view of the policy process, as a way of coming to …
Pursuing Cost Containment In A Pluralistic Payer Environment: From The Aftermath Of Clinton’S Failure At Health Care Reform To The Balanced Budget Act Of 1997, Rick Mayes, Robert E. Hurley
Pursuing Cost Containment In A Pluralistic Payer Environment: From The Aftermath Of Clinton’S Failure At Health Care Reform To The Balanced Budget Act Of 1997, Rick Mayes, Robert E. Hurley
Political Science Faculty Publications
Following a decade in which Medicare operated as the leading ‘change agent’ within the US health care system, the private sector rose to the fore in the mid 1990s. The failure of President Clinton’s attempt at comprehensive, public sector-led reform left managed care as the solution for cost control. And for a period it worked, largely because managed care organizations were able to both squeeze payments to selective networks of medical providers and significantly reduce inpatient hospital stays. There was a lot of ‘fat’ in the nation’s convoluted health care system that could be (and was) eliminated through competitive negotiations …
The Origins Of And Economic Momentum Behind "Pay For Performance" Reimbursement, Rick Mayes
The Origins Of And Economic Momentum Behind "Pay For Performance" Reimbursement, Rick Mayes
Political Science Faculty Publications
"Pay for performance," a reimbursement method under which some physicians and hospitals are paid more than others for the same services because they have been deemed to deliver better quality care and their patients appear to have better outcomes, is enormously controversial. Disputes invariably arise over how "quality" should (or even can) be measured. Nevertheless, differentiating between medical providers, financially, lies at the heart of this new reimbursement innovation developed by insurance companies and employers. Its two main objectives are: (1) to increase the overall quality of health care that patients receive, and (2) to encourage behavioral change on the …