Health Policy Commons^™

Saving Money: The Massachusetts Tobacco Cessation Medicaid Benefit: A Policy Paper, Leighton C. Ku, David Zauche, E. Ripley Forbes

Health Policy and Management Faculty Publications

In the United States, about 70% of smokers want to quit and 50% make a quit attempt each year. Unfortunately, only a small percent are successful, due in part to the lack of easy access to tobacco dependence treatments that have been proven effective. In light of the societal costs of tobacco-related illness, government must do everything it can to encourage and enable smokers to quit.

The tobacco use landscape in this country has changed in recent years -- people with lower income and education levels have a much higher probability of smoking. For instance, the smoking rate for those …

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 …

Options For Cdc's Cancer Screening Programs: Implications Of The Affordable Care Act, Leighton C. Ku, Alice R. Levy, Paula M. Lantz, Rachelle Pierre-Mathieu

Health Policy and Management Faculty Publications

Screening to promote early detection of cancer is a fundamental tool in preventive medicine and public health that facilitates earlier treatment and reductions in cancer mortality. Systematic reviews of the research demonstrate that early detection and treatment for breast and cervical cancers can reduce cancer-related mortality. One of the most important barriers to women being screened is the lack of health insurance coverage. The Centers for Disease Control and Prevention (CDC) administers two programs designed to increase screening, particularly among low-income and vulnerable populations: the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Colorectal Cancer Control Program …

The Essential Health Benefits Provisions Of The Affordable Care Act: Implications For People With Disabilities, Sara J. Rosenbaum, Joel B. Teitelbaum, Katherine J. Hayes

Health Policy and Management Faculty Publications

In establishing minimum coverage standards for health insurance plans, the Affordable Care Act includes an "essential health benefits" statute that directs the U.S. Secretary of Health and Human Services not to make coverage decisions, determine reimbursement rates, establish incentive programs, or design benefits in ways that discriminate against individuals because of their age, disability, or expected length of life. This issue brief examines how this statute will help Americans with disabilities, who currently are subject to discrimination by insurers based on health status and health care need. The authors also discuss the complex issues involved in implementing the essential benefits …

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; …

Medicare Competitive Acquisition: Implications For Persons With Diabetes, Sara J. Rosenbaum, Avi Dor, Brad Finnegan, Emily Jones

Health Policy and Management Faculty Publications

Nearly one in five Medicare beneficiaries has diabetes and these patients face major challenges in managing their health. The high diabetes rate among beneficiaries also means that the Medicare program itself is highly vulnerable to the high costs of uncontrolled diabetes. As a result, great care must be taken when implementing any new cost containment strategy that has the potential to disrupt access to preventive health care. This is particularly in the case of the Medicare Competitive Acquisition Program for Durable Medical Equipment and Supplies (DMEPOS), because of its potential impact on access to products needed for a basic preventive …

The Heart Of The Matter: The Relationship Between Communities, Cardiovascular Services, And Racial And Ethnic Gaps In Care, Marsha Regenstein, Holly Mead, Anthony Lara

Health Policy and Management Faculty Publications

Racial and ethnic disparities in cardiovascular care are greatly influenced by market factors and how the health care system is organized. This study examines key health system factors that contribute to disparities in cardiac care among racial and ethnic minorities in the United States. A market assessment, consisting of site visits, interviews, and data collection from key health care providers in 10 communities, was undertaken to identify common characteristics in the health care markets and to explore how these factors may drive disparities in cardiac care.

Managed Care And Medi-Cal Beneficiaries With Disabilities: Assessing Current State Practice In A Changing Federal Policy Environment, Sara J. Rosenbaum, Sara E. Wilensky, Peter Shin, Ramona Whittington

Health Policy and Management Faculty Publications

This analysis, prepared for The California Endowment, is a follow-on report to our earlier work that raised issues to be considered before moving persons with disabilities into compulsory Medicaid managed care plans and reviewed the extent to which California's legal framework addressed the concerns identified. In this report, the George Washington University School of Public Health and Health Services examines how other states have addressed issues that arise in designing, implementing and overseeing compulsory managed care systems for persons with disabilities and serious and chronic health conditions. The experiences of other states that have developed these types of arrangements offer …

Treating Alcoholism As A Chronic Disease, Jeffrey Hon

Health Policy and Management Faculty Publications

Nearly 14 million Americans have serious problems because of their drinking including eight million men and women who suffer from alcoholism, a chronic disease. Alcoholism can be clinically diagnosed and people with the disease typically experience many additional alcohol-related medical complications. Research demonstrates that treatment can save lives, restore families, reduce health care costs, increase productivity in the workplace and make our communities safer.