Health Policy Commons^™

Reclaiming Fat, Emilie Debaie

Health Policy & Management Student Scholarship

No abstract provided.

Driving Qi With Research: Findings From Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are increasingly experimenting with quality improvement (QI) strategies designed to enhance the effectiveness and efficiency of their efforts. Does QI work in public health, and if so for whom and under what circumstances? What QI strategies work best for which types of public health process failures, and at what cost? Research underway through the Public Health Practice-Based Research Networks (PBRN) Program is examining these types of questions to build an evidence base for public health QI.

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 …

Postmortems On The Affordable Care Act (Book Review), Rick Mayes

Political Science Faculty Publications

Nearly two years after the Affordable Care Act became law, books are appearing by Washington insiders who detail how the legislation came about. The two reviewed here discuss and dissect topics related to the health reform law from decidedly different points of view.

The Triumph And Tragedy Of Tobacco Control: A Tale Of Nine Nations, Eric A. Feldman, Ronald Bayer

All Faculty Scholarship

The use of law and policy to limit tobacco consumption illustrates one of the greatest triumphs of public health in the late twentieth and early twenty-first centuries, as well as one of its most fundamental failures. Overall decreases in tobacco consumption throughout the developed world represent millions of saved lives and unquantifiable suffering averted. Yet those benefits have not been equally distributed. The poor and the undereducated have enjoyed fewer of the gains. In this review, we build on existing tobacco control scholarship and expand it both conceptually and comparatively. Our focus is the social gradient of smoking both within …

Gender And Race Wage Gaps Attributable To Obesity, Avi Dor, Christine Ferguson, Ellen Tan, Lucas Divine, Jo Palmer

Health Policy and Management Faculty Publications

Currently, two out of three Americans are overweight or obese. In less than 20 years, roughly half of the population will be obese. Furthermore, obesity costs $168.4 billion a year, a number which is projected to increase by $48-66 billion per year. The societal costs of obesity are clear and staggering and the individual costs are equally chilling for most of those who are obese – particularly for Hispanic men and Caucasian and Hispanic women.

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 Science Of Public Health Delivery: Evidence, Uncertainties & Research Needs, Glen P. Mays

Health Management and Policy Presentations

Policy initiatives to reform the nation's health system increasingly recognize the need to incorporate public health and prevention strategies. The nation's delivery system for public health, however, varies widely across states and communities in its structure, authority, and capabilities. This session examines research from the growing field of public health services and systems research to identify directions for improving public health delivery.

Estimating The Value Of Public Health Services & Systems: Evidence, Uncertainties, And Research Needs, Glen P. Mays

Health Management and Policy Presentations

The Affordable Care Act authorized the largest expansion in federal funding for public health services and delivery systems in decades. These provisions, designed to support programs and services that promote health and prevent disease and injury on a population-wide basis, remain controversial because of uncertainties regarding their effectiveness in improving health and constraining medical cost growth. This session examines a series of recent studies to shed light on the health and economic value of spending on public health.

Getting Started In Evaluation Consulting: Questions To Ask And Answer Along The Way, Judah J. Viola,

Faculty Publications

This PowerPoint presentation includes a four phase approach to considering the main questions you'll need to ask and answer before taking the leap needed to begin working as an independent evaluation consultant.

Results From The 2010-11 Readiness For Meaningful Use Of Hit And Patient Centered Medical Home Recognition Survey, Merle Cunningham, Anthony Lara, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This brief describes the status of health centers with respect to Electronic Health Record (EHR) adoption, readiness to meet the health information technology (HIT) meaningful use (MU) standards, and readiness to achieve Patient-Centered Medical Home (PCMH) recognition.

Disparities Research In Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are well positioned within the health system to play key roles in addressing oral health issues on a population-wide basis, However, current evidence reveals wide geographic variation in the delivery of public health interventions for oral health promotion. This session explores the factors contributing to this variation, and it highlights studies underway through the Public Health Practice-Based Research Networks (PBRNs) to produce more and better evidence about public health delivery and impact.

Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota For State Policymakers, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. State governments design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control.

Often, participation in the process of developing Medicaid payment policy is limited to state agency officials and providers of care and, occasionally, union representatives and state legislative staff. Invited less frequently to reimbursement policy discussions are consumer representatives. Lack of consumer involvement in the development of state rate setting systems has the potential to result in the …

A Primer For Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. To ensure that providers behave appropriately, the federal and state governments have established an extensive set of regulations that nursing homes must comply with if they are to be reimbursed for patients insured by Medicaid. Consumers exert considerable influence here by focusing on regulations and enforcement of non-compliance.

States also seek to align providers’ interests with those of other interested parties through controls and incentives built into state reimbursement systems, including with respect to facility cost and quality, access to care, payment equity, service capacity, and budgetary …

Health Insurance Coverage Dipped Along With The State, U.S. Economy, Ryan Dann, Jason R. Jurjevich

Publications, Reports and Presentations

A brief examination of the effects that economic downturns have on health insurance coverage in Oregon. Reviews statistical information relating to health coverage, and disparities that exist within the state.

A Natural Fit: Collaborations Between Community Health Centers And Family Planning Clinics, Rachel Benson Gold, Marcie Zakheim, Jillanne M. Schulte, Susan F. Wood, Tishra Beeson, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Federally Qualified Health Centers (FQHCs) and family planning clinics funded through Title X of the Public Health Service Act are critical components of the health care safety net in urban and rural medically underserved communities. Although they share the common mission of serving vulnerable and low-income populations, health centers and Title X clinics possess different, but complementary, strengths. The Patient Protection and Affordable Care Act (Affordable Care Act) will expand coverage to an additional 32 million people while leaving 23 million uninsured. Most of the newly insured and the remaining uninsured will be residents of medically-underserved communities, and thus, positioning …

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 …

Effective, Efficient Health Care Reform The United States And Swiss Health Care Systems: A Comparative Analysis What Can The U.S. Learn From The Swiss Experience?, Rebecca Dittrich

Independent Study Project (ISP) Collection

Home to 45 million people without health insurance while still spending 17% of its GDP on health care expenses, the United States has been in need of a massive health care overhaul for quite some time. Some have speculated that the Swiss system may be an ideal model for health care reform, and in fact, many aspects of the newly instated Patient Protection and Affordable Care Act (ACA) do reflect areas of LAMal, Swiss health care law. This paper evaluates the Swiss and United States health care systems (under ACA), their similarities and differences, and the pros and cons of …

“ Gimme Samoa That!”: The Changing Diet In Samoa, Dana Melby

Independent Study Project (ISP) Collection

With globalization and Samoa’s entrance into the global economy imported and processed foods, which are high in fat, sugar, and sodium, are increasingly available for consumption. Diet transition, the change in diet from one high in local and traditional foods to one high in imported processed foods, began in Samoa post-World War II, however, the rate of diet change has increased rapidly in the past three decades. The change in diet has led to increased prevalence of obesity, other risk factors, and non-communicable diseases. Non-communicable diseases (NCDs) include cardiovascular disease (CVD), diabetes, and cancer. This study looks at what factors …

Autism In Kenya: A Social, Educational And Political Perspective, Ariana Riccio

Independent Study Project (ISP) Collection

Autism is a widely misunderstood developmental disability that is generally diagnosed in early childhood and has been the recent subject of much media and medical attention in developed nations worldwide. While there has been a noted improvement in diagnostic and therapeutic options for children and their families in developing nations, the attention placed on disability, particularly on autism, is considered underdeveloped and inadequate. This paper will attempt to address the current framework surrounding autism in the area of Nairobi, Kenya and discuss the social attitudes, diagnostic practices, educational opportunities, and government intervention programs available in the area. Given the lack …

Improving The Population’S Health: The Affordable Care Act And The Importance Of Integration, Lorian E. Hardcastle, Katherine L. Record, Peter D. Jacobson, Lawrence O. Gostin

O'Neill Institute Papers

Heath care and public health are typically conceptualized as separate, albeit overlapping, systems. Health care’s goal is the improvement of individual patient outcomes through the provision of medical services. In contrast, public health is devoted to improving health outcomes in the population as a whole through health promotion and disease prevention. Health care services receive the bulk of funding and political support, while public health is chronically starved of resources. In order to reduce morbidity and mortality, policymakers must shift their attention to public health services and to the improved integration of health care and public health. In other words, …

Mandatory Hpv Vaccination And Political Debate, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Vaccinations are among the most cost-effective and widely used public health interventions, but have provoked popular resistance, with compulsion framed as an unwarranted state interference. When the FDA approved a human papillomavirus (HPV) vaccine in 2006, conservative religious groups strongly opposed a mandate, arguing it would condone pre-marital sex, undermine parental rights, and violate bodily integrity. Yet, Governor Rick Perry signed an executive order in 2007 making Texas the first state to enact a mandate — later revoked by the legislature.

Mandatory HPV vaccination reached the heights of presidential politics in a recent Republican debate. Calling the vaccine a "very …

“La Percepción Social De Vih/Sida En Chile Y Sus Efectos”, Philip Krause

Independent Study Project (ISP) Collection

Research Question—How does the social perception of HIV/AIDs in Chile affect the country’s prevention and treatment programs?

Background-- This paper investigated the social perception of HIV/AIDs in Chile through the opinions of experts who work closely to the issue, including regional and national political professionals, medical professionals on HIV/AIDs treatment teams in hospitals, and leaders of social organizations that had a relationship to HIV/AIDs representation and prevention. The professionals were also asked how they believed this perception affected the efforts of the Chilean government and national organizations in prevention and management of the HIV/AIDs epidemic in Chile. An …

Transforming Community Health Centers Into Patient-Centered Medical Homes: The Role Of Payment Reform, Leighton C. Ku, Peter Shin, Emily Jones, Brian K. Bruen

Health Policy and Management Faculty Publications

This report examines how changes in the way federally qualified health centers (FQHCs) are financed could support the transformation of these critical safety-net providers into high performing patient-centered medical homes. Through surveys and interviews, the authors explore the current landscape of health center involvement in medical home initiatives, adoption of medical home standards, and receipt of payment incentives. Based on their findings, the authors make preliminary recommendations to encourage health centers to serve as patient- and community-centered medical homes. These include: establishing recommended standards for patient- and community-centered medical homes that apply to FQHCs; structuring payment incentives to promote medical …

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.

State Insurance Exchanges: An Overview, Sara J. Rosenbaum

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

Community Health Centers And The Economy: Assessing Centers' Role In Immediate Job Creation Efforts, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Federal investment in community health centers not only creates health care access but, based on previous studies, generates an estimated 8:1 return for medically underserved communities while creating thousands of jobs. Since our earlier 2008 economic impact study, Congress has made two major program investments: $2 billion under the American Reinvestment and Recovery Act (ARRA) of 2009; and $11 billion under the Affordable Care Act (ACA). This analysis measures the economic and jobs-creation benefits of this cumulative investment in health centers, as well as the impact of legislation enacted in April, 2011, which reduced the first year of new …

Biosimilars: Costs And Controversies, Ruth Lopert

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

Trends Of Increase In Western Medical Services In Traditional Medicine Hospitals In China, Jay J. Shen, Ying Wang, Fang Lin, Jun Lu, Charles B. Moseley, Mei Sun, Mo Hao

Public Health Faculty Publications

Background:

Compare changes in types of hospital service revenues between traditional Chinese medicine (TCM) hospitals and Western-medicine based general hospitals.

Methods:

97 TCM hospitals and 103 general hospitals were surveyed in years of 2000 and 2004. Six types of medical service revenue between the two types of hospitals were compared overtime. The national statistics from 1999 to 2008 were also used as complementary evidence.

Results:

For TCM hospitals, the percentage of service revenue from Western medicine increased from 44.3% to 47.4% while the percentage of service revenue from TCM declined from 26.4% to 18.8% from 1999 to 2004. Percentages of …

Carol Anne Bond V The United States Of America: How A Woman Scorned Threatened The Chemical Weapons Convention, Anna Muldoon, Sarah Kornblet, Rebecca L. Katz

Health Policy and Management Faculty Publications

The case of Carol Anne Bond v the United States of America stemmed from a domestic dispute when Ms. Bond attempted to retaliate against her best friend by attacking her with chemical agents. What has emerged is a much greater issue--a test of standing on whether a private citizen can challenge the Tenth Amendment. Instead of being prosecuted in state court for assault, Ms. Bond was charged and tried in district court under a federal criminal statute passed as part of implementation of the Chemical Weapons Convention (CWC). Ms. Bond's argument rests on the claim that the statute exceeded the …