Health Policy Commons^™

Community Health Centers: The Challenge Of Growing To Meet The Need For Primary Care In Medically Underserved Communities, Tishra Beeson, Sara J. Rosenbaum, Jessica Sharac, Peter Shin, Julia Paradise

Health Policy and Management Faculty Publications

This policy brief profiles health centers and the patients they serve, discusses how health centers are funded, and traces the history of health center growth. It closely examines the recent reduction in both federal appropriations and state grants for health centers, state cutbacks in benefits for adult Medicaid beneficiaries, and the anticipated impact of President Obama's FY 2013 request for federal funding for health centers. Finally, it looks ahead to both the challenges and opportunities health centers face as the nation prepares for 2014, when the ACA will be fully implemented.

Quality Incentives For Federally Qualified Health Centers, Rural Health Clinics And Free Clinics: A Report To Congress, Leighton C. Ku, Merle Cunningham, Debora Goetz Goldberg, Julie S. Darnell, Martin Hiller, Peter Shin, Alice R. Levy, Kate Buchanan, Fraser Rothenberg Byrne

Health Policy and Management Faculty Publications

This report to Congress is submitted pursuant to Section 13113(b) of the American Recovery and Reinvestment Act of 2009 (hereafter, the Recovery Act), under Title XIII, also known as the Health Information Technology for Economic and Clinical Health Act or the HITECH Act. The Section requires the Secretary of Health and Human Services to provide a study that examines methods to create efficient reimbursement incentives for improving health care quality in federally qualified health centers, rural health clinics, and free clinics.

The report discusses current initiatives and incentives that apply to these categories of primary care clinics and the current …

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 …

Issues In Health Reform: How Changes In Eligibility May Move Millions Back And Forth Between Medicaid And Insurance Exchanges, Benjamin D. Sommers, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

The Affordable Care Act will extend health insurance coverage by both expanding Medicaid eligibility and offering premium subsidies for the purchase of private health insurance through state health insurance exchanges. But by definition, eligibility for these programs is sensitive to income and can change over time with fluctuating income and changes in family composition. The law specifies no minimum enrollment period, and subsidy levels will also change as income rises and falls. Using national survey data, we estimate that within six months, more than 35 percent of all adults with family incomes below 200 percent of the federal poverty level …

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 …

Emergency Department Operations In Top-Performing Safety-Net Hospitals, Lea Nolan, Marsha Regenstein, Donna Anthony, Bruce Siegel

Health Policy and Management Faculty Publications

This report profiles five safety-net hospitals—Boston Medical Center, Denver Health, Memorial Regional Hospital, Memorial Hospital West, and Virginia Commonwealth University Health System—that made improvements to curb emergency department (ED) crowding, reduce long waits, and lower the number of hours spent on ambulance diversion. Hospitals used a combination of interventions, including: reconfiguring the ED to maximize efficiency; devising a pre-diversion system to alert staff of ED crowding; installing an electronic tracking system; designating staff members to be responsible for tracking patients; and developing meaningful performance metrics. To be successful, such interventions need to take place within a broader improvement strategy that …

Medicaid And Case Management To Promote Healthy Child Development, Sara J. Rosenbaum, Kay Johnson, Emily Jones, Anne R. Markus

Health Policy and Management Faculty Publications

This policy brief presents options for financing and delivering case management services to low-income and special-needs children in Medicaid. The analysis builds on a literature review of case management, a review of the legal underpinnings of Medicaid case management, and consultation with experts in the fields of health care finance and program operations. It aims to inform the policy community about the importance of case management for assuring the health and development of our youngest and most vulnerable children.

Improving Medicaid: Assessment Of District Of Columbia Agencies' Claims Processes And Recommendations For Improvements In Efficiency And Customer Service, George Washington University, School Of Public Health And Health Services, Department Of Health Policy, Health Management Associates

Health Policy and Management Faculty Publications

The District of Columbia Department of Health Care Finance (DHCF), like other state Medicaid agencies, is constantly challenged to improve service delivery and reimbursement for Medicaid services. In the District, several governmental agencies ("Partner Agencies") play an instrumental role in Medicaid – either as a Medicaid provider or in operating a Medicaid program. Today, each Partner Agency may retain its own system and process for claims submission, provider enrollment, and administrative claiming as it relates to Medicaid. For these reasons, the DHCF initiated an assessment of the Medicaid claims processes for Partner Agencies. The purpose of the assessment is to …

Achieving Family Health Literacy: The Case For Insuring Children, Sara J. Rosenbaum, Peter Shin, Barbara Debuono

Health Policy and Management Faculty Publications

One aspect of the SCHIP reauthorization debate that has received more limited attention than it deserves is the relationship between children's health insurance coverage and family health literacy. That is, to what extent is children's health insurance associated with higher health literacy, and to what extent is reduced parental health literacy linked to lower rates of health insurance among children? This association is extremely important, since there is strong evidence of a link between health literacy and the appropriate use of health care. Evidence suggests that when previously uninsured children are covered by health insurance, parents at all income levels …

Walking A Tightrope: The State Of The Safety Net In Ten U.S. Communities, Marsha Regenstein, Lea Nolan, Marcia J. Wilson, Holly Mead, Bruce Siegel

Health Policy and Management Faculty Publications

This report presents the findings from the Urgent Matters safety net assessments and identifies common characteristics, opportunities and challenges for communities that wish to better serve the health care needs of uninsured and underserved individuals. It also illustrates differences across many of the communities, especially in terms of the structure and financing of their safety nets. It is a companion report to the individual safety net assessments and provides an overarching perspective of problems that affect safety nets across the country.