Social and Behavioral Sciences Commons^™

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.

Paying Medicare Private Plans By Competitive Bidding: Not The Same As Costs In Regular Medicare, Brian Biles, Jonah Pozen

Health Policy and Management Faculty Publications

Medicare Advantage plans are now paid $11 billion a year, and $150 billion over 10 years, more than costs in regular fee-for-service (FFS) Medicare. In the past two years there have been discussions about reducing MA payments to the level of 100 percent of average costs in FFS and using the savings to offset the costs of new Federal health initiatives such as health care reform. Earlier this year, OMB proposed "reducing Medicare overpayments to private insurers through competitive payments." Under this proposal, MA plan "payments would be based on an average of plans' bids submitted to Medicare." This issue …

Health Insurance Fraud: An Overview, Sara J. Rosenbaum, Nancy Lopez, Scott Stifler

Health Policy and Management Faculty Publications

In 2007, the U.S. spent nearly $2.3 trillion on health care and public and private insurers processed more than 4 billion health insurance claims. The National Health Care Anti-Fraud Association (NHCAA) has estimated that, conservatively, 3% of all health care spending—or $68 billion—is lost to health care fraud. Other estimates by government and law enforcement agencies place fraud-related losses as high as 10% of annual health care spending; at this rate, the losses in 2007 alone – over $220 billion – would have been enough to cover the uninsured.

This report, funded by the Robert Wood Johnson Foundation, delves into …

Primary Health Care Access Reform: Community Health Centers And The National Health Service Corps, Fitzhugh Mullan

Health Policy and Management Congressional Testimonies

This testimony by Fitzhugh Mullan, M.D., addresses the following issues:

• Improving access to health care in the United States will require modifications in the U.S. health care workforce, the foremost of which will be the construction of a strong primary care base.
• Two-thirds of the U.S. physician workforce practice as specialists and the number of young physicians entering primary care is declining.
• The distribution of health care providers in the U.S. heavily favors urban areas. Metropolitan areas have 2-5 times as many physicians as non-metropolitan areas and economically disadvantaged areas have significant health care access problems.
• Today's physician-to-population ratio is …

An Overview Of Major Health Information Technology, Public Health, Medicaid, And Cobra Provisions Of The American Recovery And Reinvestment Act Of 2009, Sara J. Rosenbaum, Melissa M. Goldstein, Taylor Burke, Phyllis Borzi, Lara Cartwright-Smith

Health Policy and Management Faculty Publications

A detailed side-by-side analysis of the individual components of the American Recovery and Reinvestment Act of 2009 (ARRA), signed into law on February 17, 2009. One of the most sweeping pieces of economic legislation ever enacted, ARRA not only provides hundreds of billions of dollars in new health and health care spending but also makes comprehensive reforms in health law and policy, particularly in the area of health information law, including health information technology (HIT) adoption and health information privacy.

An Overview Of Major Health Provisions Contained In The American Recovery And Reinvestment Act Of 2009, Sara J. Rosenbaum, Lara Cartwright-Smith, Taylor Burke, Phyllis Borzi, Melissa M. Goldstein

Health Policy and Management Issue Briefs

On February 17, 2009, President Barack Obama signed the American Recovery and Reinvestment Act of 2009 (ARRA) into law. One of the most sweeping pieces of economic legislation ever enacted, ARRA not only provides hundreds of billions of dollars in new health and health care spending but also makes comprehensive reforms in health law and policy, particularly in the area of health information law, including health information technology (HIT) adoption and health information privacy.

Health Information Technology In The United States: On The Cusp Of Change, 2009, Sara J. Rosenbaum, Melissa M. Goldstein, Lee Repasch, Catherine M. Desroches, Ashish K. Jha

Health Policy and Management Faculty Publications

In this report we use the data collected for ONCHIT to focus on EHR adoption in the inpatient setting. We report on several important policy issues. These include the rate of adoption of EHRs among U.S. hospitals generally and among safety-net hospitals, changes in both state and federal policy, and the potential of EHRs to change the quality measurement enterprise.