Health Policy Commons^™

A New State Plan Option To Integrate Care And Financing For Persons Dually Eligible For Medicare And Medicaid, Jane H. Thorpe, Katherine J. Hayes

Health Policy and Management Faculty Publications

As health care costs continue to escalate, Congress, the U.S. Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies, researchers, and policymakers are focusing on identifying new approaches to care delivery and reimbursement for individuals who are dually eligible for both Medicare and Medicaid. Although relatively few in number (9 million), dual eligible beneficiaries are more likely than others to experience poor health, including multiple chronic conditions, functional and cognitive impairments, and a need for continuous care. Sixty-six percent of dual eligibles have three or more chronic conditions; sixty-one percent are …

Promoting The Integration And Coordination Of Safety-Net Health Care Providers Under Health Reform: Key Issues, Leighton C. Ku, Peter Shin, Marsha Regenstein, Holly Mead

Health Policy and Management Faculty Publications

The Affordable Care Act includes several provisions designed to encourage greater coordination and integration among health care providers, including the promotion of accountable care organizations and health homes. While much discussion has focused on how these strategies might be adopted by Medicare and private insurers, little attention has focused on their application among safety-net health care providers. Such providers face particular challenges in coordinating care for their low-income and uninsured patients, and no single approach is likely to meet their diverse needs. Successful efforts will require federal, state, and local financial resources to sustain the safety net and make the …

Presentation Of The 2011-2012 Geiger Gibson Distinguished Visitor In Community Health Policy, Rachel A. Gonzales-Hanson

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

In The Face Of Crisis: The Treatment Action Campaign Fights Government Inertia With Budget Advocacy And Litigation, Neil Overy, International Budget Partnership

International Budget Partnership

At the turn of the millennium the South African government allocated a total of R214 million (US$28.5 million) to the fight against HIV/AIDS, an epidemic that had reached crisis proportions. Less than 10 years later this figure has risen, in inflation-adjusted terms, to R3.96 billion (US$528 million), a real increase of over 1,850 percent. This study looks at how a civil society organization’s ongoing campaigns for treatment access that combined negotiations with the government, mass mobilization of its members (including civil disobedience campaigns), and litigation contributed to this increase.

The full version, short summary, and one page summary of this …

Measuring Primary Care: Theory, Policy, And Practice, Barbara Starfield

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

The Right Care At The Right Time By The Right Professional, Mary Jean Schumann

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

Medicare's Accountable Care Organization Regulations: How Will Medicare Beneficiaries Who Reside In Medically Underserved Communities Fare?, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

On March 31, 2011, the Centers for Medicare and Medicaid Services (CMS) released proposed regulations implementing the Medicare Shared Savings Program (MSSP). The thrust of the MSSP is to promote savings to Medicare as well as the greater clinical integration of health care through incentive payments to accountable care organizations (ACOs) that meet Medicare standards for structure, performance, and health care outcomes. The effort to spur greater clinical integration through the MSSP was part of a broader set of reforms contained in the Affordable Care Act (ACA) whose aim was to improve health care quality and efficiency. Among these reforms …

Medicaid And Access To The Courts, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

The Medicaid program is grounded in a statute that is one of the most complex of all federal laws. An insurer of more than 60 million people — and poised to begin serving 16 million more by 2019 — Medicaid will be reexamined this year, in all its legal complexities, by the U.S. Supreme Court, which has agreed to hear California's appeal in the case Maxwell-Jolly v. Independent Living Center of Southern California. The Court's ruling could fundamentally alter states' accountability to beneficiaries and providers when their official conduct allegedly violates Medicaid's essential federal requirements.

The Role Of Community Health Centers In Addressing The Needs Of Uninsured Low-Income Workers: Implications Of Proposed Federal Funding Reductions, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The severe economic downturn over the past few years has demonstrated the heightened importance of strengthening the health care safety net, particularly for working Americans who may have lost their health insurance coverage or do not have access to employer-sponsored benefits. Both historically and most recently during the current recession, health centers have played a critical role in providing services to the working poor, assuring that they continue to receive timely preventive care that obviates the need for, and minimizes use of, more costly services. We estimate that 1 in 4 low income, uninsured working adults depend on health centers …

The Health Care Access And Cost Consequences Of Reducing Health Center Funding, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

For over four decades, community health centers have served a critical role in providing affordable access to quality care to some of the nation's most vulnerable populations. Health centers have historically enjoyed broad bipartisan support, based on the evidence documenting their high quality care, crucial role in both urban and rural communities, and ability to "bend the cost curve."

On February 20, 2011, the U.S. House of Representatives voted to reduce discretionary health center funding by $1.3 billion in FY 2011 alone. Although the spending bill was rejected by the U.S. Senate on March 10, 2011, final spending measures for …

Who Are The Health Center Patients Who Risk Losing Care Under The House Of Representatives' Proposed Fy 2011 Spending Reductions?, Sara J. Rosenbaum, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

On February 20, 2011, the United States House of Representatives approved more than $61 billion in discretionary spending reductions for the remainder of FY 2011. The legislation includes $1.3 billion in direct spending cuts for community health centers. Using the NACHC patient estimates, we present evidence on the characteristics of patients whose continuing access to health center services is at risk. We arrived at these estimates using data from the Uniform Data System (UDS), the federal reporting system in which all health centers must participate, as well as national estimates from the Medical Expenditure Panel Survey (MEPS), and published reports …