Social and Behavioral Sciences Commons^™

Healthcare Reform And Medical Data Security And Privacy, Patricia Mactaggart, Stephanie Fiore

Health Policy and Management Faculty Publications

U.S. health care delivery and administration have undergone transformations that create an expansive demand for health information technology. The concepts put forth in health care reform are reliant on an evolving health information technology infrastructure and the successes of both are dependent on consumer/patient "trust". Every action is interdependent. Each decision is a balance between ease of use, privacy and security concerns of consumers/patients, practicality, costs and political will. The goal is finding the best balance within an appropriate legal framework at the state and federal level so the pieces fit into one complete picture when implemented.

A "Broader Regulatory Scheme"-- The Constitutionality Of Health Care Reform, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

The fundamental goal of the ACA is no less than the preservation of the U.S. health care system. In a country that depends on health insurance to finance care, preservation cannot happen without a comprehensive regulatory scheme that reaches from coast to coast and sets the minimum rules of market entry and operation for health insurers. The glide path to this new system is long and complex, but the law's end point is clear and visionary, and its constitutionality--at least in this first round--is incontrovertible.

Medical Schools In Sub-Saharan Africa, Fitzhugh Mullan, Seble Frehywot, Francis Omaswa, Eric Buch, Candice Chen, S. Ryan Greysen, Tenagne W. Haile-Mariam, +30 Additional Authors

Health Policy and Management Faculty Publications

Small numbers of graduates from few medical schools, and emigration of graduates to other countries, contribute to low physician presence in sub-Saharan Africa. The Sub-Saharan African Medical School Study examined the challenges, innovations, and emerging trends in medical education in the region. We identifi ed 168 medical schools; of the 146 surveyed, 105 (72%) responded. Findings from the study showed that countries are prioritising medical education scale-up as part of health-system strengthening, and we identifi ed many innovations in premedical preparation, teambased education, and creative use of scarce research support. The study also drew attention to ubiquitous faculty shortages in …

The Affordable Care Act: U.S. Vaccine Policy And Practice, Alexandra M. Stewart, Orriel L. Richardson, Marisa A. Cox, Katherine J. Hayes, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

When fully implemented, the Patient Protection and Affordable Care Act, amended by the Health and Education Reconciliation Act will extend health insurance coverage to 94 percent of Americans while establishing a comprehensive set of strategies to improve care and contain costs. The central provisions of the Act – guaranteed affordable and accessible coverage – take effect January 1, 2014. Important insurance reforms aimed at improving coverage become effective before that date, as do a series of investments aimed at improving the accessibility and quality of health care.

This report has several aims: 1) to examine how the laws address vaccine …

Data Segmentation In Electronic Health Information Exchange: Policy Considerations And Analysis, Melissa M. Goldstein, Alison L. Rein, Melissa M. Heesters, Penelope P. Hughes, Benjamin Williams, Scott A. Weinstein

Health Policy and Management Faculty Publications

The issue of whether and, if so, to what extent patients should have control over the sharing or withholding of their health information represents one of the foremost policy challenges related to electronic health information exchange. It is widely acknowledged that patients' health information should flow where and when it is needed to support the provision of appropriate and high-quality care. Equally significant, however, is the notion that patients want their needs and preferences to be considered in the determination of what information is shared with other parties, for what purposes, and under what conditions. Some patients may prefer to …

A Heavy Burden: The Individual Costs Of Being Overweight And Obese In The United States, Avi Dor, Christine Ferguson, Casey Langwith, Ellen Tan

Health Policy and Management Faculty Publications

More than 60% of the United States population is overweight or obese, and if the current trajectory continues, 50% of the population will be obese by 2030. There is no question that being obese or overweight, is more costly than being of normal weight. Using existing literature, we have detailed the costs incurred due to overweight and obesity that affect working-age adults at the individual level.

Among the items discussed in this review, overweight or obese individuals bear the full burden for some costs, such as the value of lost life, lost wages, gasoline costs, and, when applicable, life insurance. …

U.S. Participation In International Health Treaties, Commitments, Partnerships And Other Agreements, Jennifer Kates, Rebecca L. Katz

Health Policy and Management Faculty Publications

The U.S. government's role in global health is long-standing and multifaceted. While primarily involving directly funding and operating programs in low- and middle-income countries, it also includes participation in international treaties, commitments, partnerships, and other multilateral agreements that address or encompass health. Such agreements serve numerous purposes including establishing political and legal commitments, formalizing international relationships, and coordinating roles and responsibilities in an increasingly complex and globalized and interconnected world. The role of the U.S. in international agreements has gained new attention in the Obama Administration, which has stated an intention to reinvigorate multilateral engagement and international partnerships on health …

Aligning Forces For Quality: Improving Language Services Performance Measures, Marsha Regenstein

Health Policy and Management Faculty Publications

This portion of the Language Services Performance Measures guide provides a brief overview of the information contained within each section of the manual. It is intended for use as a quick reference to assist in the implementation of the Language Services performance measures. The sections of the manual are interrelated and have been designed to be used together.

Community Health Centers: Opportunities And Challenges Of Health Reform, Sara J. Rosenbaum, Peter Shin, Emily Jones, Jennifer Tolbert

Health Policy and Management Faculty Publications

Community Health Centers: Opportunities and Challenges of Health Reform describes the provisions of the new health reform law that affect community health centers, including increased funding designed to expand the number of health centers, health insurance expansions that will significantly reduce the number of health center patients without insurance, and strategies aimed at increasing the primary care workforce. The brief also discusses some of the opportunities and challenges for the health centers, such as the task of recruiting and retaining qualified health professionals, the need to establish networks and referral arrangements and the renewed focus on prevention and public health …

Drive Alive: Teen Seat Belt Survey Program, Katie M. Burkett, Steve Davidson, Carol Cotton, James Barlament, Laurel Loftin, James H. Stephens, Martin Dunbar, Ryan Butterfield

Health Policy and Management Faculty Publications

Objective: To increase teen seat belt use among drivers at a rural high school by implementing the Drive Alive Pilot Program (DAPP), a theory-driven intervention built on highway safety best practices.

Methods: The first component of the program was 20 observational teen seat belt surveys conducted by volunteer students in a high school parking lot over a 38-month period before and after the month-long intervention. The survey results were published in the newspaper. The second component was the use of incentives, such as gift cards, to promote teen seat belt use. The third component involved disincentives, such as increased police …

Buying Health Care, The Individual Mandate, And The Constitution, Sara J. Rosenbaum, Jonathan Gruber

Health Policy and Management Faculty Publications

Three separate cases raising constitutional challenges to the Affordable Care Act (ACA) are now under way, and together they present issues of great legal complexity. Yet although difficult legal questions must be resolved, a pivotal issue is whose version of events will serve as the judicial analytic filter. For reasons related to the very basis of Congress's constitutional power to enact health care reform, the fight is over whether the individual mandate to purchase health insurance (or pay a tax) is about regulating individuals' economic conduct or regulating their noneconomic status. Depending on which characterization of the facts prevails, the …

Coverage Of Obesity Treatment: A State-By-State Analysis Of Medicaid And State Insurance Laws, Jennifer S. Lee, Jennifer L.O. Sheer, Nancy Lopez, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

Objectives. We determined whether state Medicaid programs cover recommended treatments for adult and pediatric obesity and to what extent states regulate the treatment and coverage of obesity by private insurers.

Methods. We conducted a state-by-state document review of Medicaid manuals and private insurance laws and regulations.

Results. Eight state Medicaid programs appear to cover all recommended obesity treatment modalities for adults. Only 10 states appear to reimburse for obesity-related treatment in children. In the small-group insurance market, 35 states expressly allow obesity to be used for rate adjustments, while 10 states do so in the individual market. Two states expressly …

Socioeconomic Indicators That Matter For Population Health, Paula M. Lantz, Andrew Pritchard

Health Policy and Management Faculty Publications

Increasing research and policy attention is being given to how the socioeconomic environment influences health. This article discusses potential indicators or metrics regarding the socioeconomic environment that could play a role in an incentive-based system for population health. Given the state of the research regarding the influence of socioeconomic contextual variables on health outcomes, the state of data and metrics for these variables at the local level, and the potential for program and policy intervention, we recommend a set of metrics related to the socioeconomic composition of a community (including poverty, unemployment, and public assistance rates); educational attainment and achievement; …

The Social Mission Of Medical Education: Ranking The Schools, Fitzhugh Mullan, Candice Chen, Stephen Petterson, Gretchen Kolsky, Michael Spagnola

Health Policy and Management Faculty Publications

The study proposes a new method of ranking medical schools through the creation of a "social mission" score, reflecting that many believe that medical schools should be accountable to society and have a social mission to train physicians to care for the population as a whole, taking into account such issues as whether schools produce physicians who practice primary care, work in underserved areas, and represent the diversity of the population.

Workplace Screening & Brief Intervention: The Big (Brief Intervention Group) Initiative, Eric Goplerud, Tracy Mcpherson

Health Policy and Management Faculty Publications

To realize the full value of their investment in Employee Assistance Program (EAP), employers should attend to the opportunities to drive down health and productivity costs by encouraging their EAPs to engage and treat workers who drink in unhealthy ways. Nationwide, EAPs engage only about one worker in twenty who has a serious alcohol problem. The lost productivity, absenteeism, excess emergency department and hospital use by the other 19 out of 20 workers with alcohol problems who are not treated add $61 billion (or approximately $200 for every man, woman and child in the United States) to the nation's health …

Implementation Of Eaps, Mark Attridge, Patricia Herlihy, Dave Sharar, Tom Amaral, Tracy Mcpherson, Diane Stephenson, Tom Bjornson, Rich Paul, Lisa Teems, Eric Goplerud, Sandra Routledge

Health Policy and Management Faculty Publications

This Research Note describes how to effectively implement employee assistance program services in an organization.

Consumer Consent Options For Electronic Health Information Exchange: Policy Considerations And Analysis, Melissa M. Goldstein, Alison L. Rein

Health Policy and Management Faculty Publications

The issue of whether, to what extent, and how individuals should have the ability to exercise control over their health information represents one of the foremost policy challenges related to the electronic exchange of health information. The current landscape of possible consent models is varied, and the factors involved in choosing among them are complex. States and other entities engaged in facilitating the exchange of electronic health information are struggling with a host of challenges, chief among them the establishment of policies and procedures for patient participation in their exchange efforts. While some have adopted policies enabling patients to exercise …

Accountable Care Organizations: Implications For Antitrust Policy, Taylor Burke, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

This analysis examines accountable care organizations (ACOs) and assesses their implications for antitrust policy. Consideration of the antitrust implications of ACOs is timely. Both the House and Senate health reform measures contemplate the creation of ACOs as a new class of Medicare provider while providing parallel legal authority under Medicaid.

Changing Policy: The Elements For Improving Childhood Asthma Outcomes, Anne R. Markus, Meagan Lyon, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

This report lays out the facts and offers specific policy recommendations for success that could change the face of childhood asthma in America. These recommendations aim to make better use of programs and policies already in place, such as Medicaid and the Children's Health Insurance Program (CHIP), as well as private sector insurance coverage and existing public health programs. The recommendations also underscore the importance of careful research -- scientific, practical, and community-based -- in order to continue to learn what works best and strengthen knowledge for future action. In a reformed health system, these initial efforts are not wasted …

Can States Pick Up The Health Reform Torch?, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

No abstract provided.

The Role Of Medicaid In Promoting Access To High-Quality, High-Value Maternity Care, Anne R. Markus, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

The main purpose of this article is to analyze and describe the role of Medicaid in facilitating access to care for pregnant women and ensuring high-quality maternity care that is affordable. It first summarizes the federal Medicaid requirements regarding eligibility, coverage of benefits, financing, and service delivery, with a special emphasis on existing quality provisions. Then, it discusses current issues and recommends several Medicaid reforms, particularly in the area of quality assessment and improvement. All reforms, including Medicaid reforms, should seek to support the IOM-identified aims. Much of the emphais in Medicaid policy development has been focused on access to …

The Diabetes Primary Prevention Initiative Interventions Focus Area: A Case Study And Recommendations, Deborah S. Porterfield, Laurie Hinnant, David M. Stevens, Ernest Moy, Dppi-Ifa Case Study Group

Health Policy and Management Faculty Publications

Background: In 2005, CDC began the Diabetes Primary Prevention Initiative Interventions Focus Area (DPPI-IFA), which funded fıve state Diabetes Prevention and Control Programs (DPCPs) to translate diabetes primary prevention trials into real-world settings by developing and implementing a framework for state-level diabetes primary prevention.

Purpose: The purpose of this case study, conducted in 2007, was to describe DPPI-IFA implementation, including facilitators and challenges to the initiative. Methods: Case studies of the fıve DPCPs in the DPPI-IFA involving site visits with key informant interviews of state staff and partners and archival record collection.

Results: Partners recruited for DPPI-IFA activities included …

The Health Information Technology Provisions In The American Recovery And Reinvestment Act Of 2009, Taylor Burke

Health Policy and Management Faculty Publications

This installment of Law and the Public’s Health explores the comprehensive reforms contained in the American Recovery and Reinvestment Act of 2009, whose implementation is expected to transform the use of health information technology as part of Medicare, Medicaid, and public health practice.

Can The Deployment Of Community Health Workers For The Delivery Of Hiv Services Represent An Effective And Sustainable Response To Health Workforce Shortages? Results Of A Multicountry Study, Francesca Celletti, Anna Wright, John Palen, Seble Frehywot, Anne R. Markus, Alan E. Greenberg, Rafael Augusto Teixeira De Aguiar, Francisco Campos, Eric Buch, Badara Samb

Health Policy and Management Faculty Publications

In countries severely affected by HIV/AIDS, shortages of health workers present a major obstacle to scaling up HIV services. Adopting a task shifting approach for the deployment of community health workers (CHWs) represents one strategy for rapid expansion of the health workforce. This study aimed to evaluate the contribution of CHWs with a focus on identifying the critical elements of an enabling environment that can ensure they provide quality services in a manner that is sustainable. The method of work included a collection of primary data in five countries: Brazil, Ethiopia, Malawi, Namibia, and Uganda. The findings show that delegation …