Health Policy Commons^™

Dementia In Maine: Characteristics, Care, And Cost Across Settings [Chartbook], Julie T. Fralich Mba, Stuart Bratesman Mpp, Louise Olsen, Catherine Mcguire Bs, Tina Gressani, Karen Mauney, Catherine Gunn, Romaine Turyn

Disability & Aging

This report provides a baseline picture of the current use of services by people with and without dementia in Maine.

Measurement, Monitoring, And Evaluation Of State Demonstrations To Integrate Care For Dual Eligible Individuals: Massachusetts Evaluation Design Plan., Julie T. Fralich Mba, Maureen Booth Mrp, Ma, Edith G. Walsh Phd, Angela M. Greene Ms, Mba, Melissa Morley Phd, Wayne Anderson Phd

Disability & Aging

CMS contracted with RTI International to monitor the implementation of all State demonstrations under the Financial Alignment Initiative, and to evaluate their impact on beneficiary experience, quality, utilization, and cost. The evaluation includes an aggregate evaluation and State-specific evaluations. This report describes the State-specific Evaluation Plan for the Massachusetts demonstration as of December 16, 2013. The evaluation activities may be revised if modifications are made to either the Massachusetts demonstration or to the activities described in the Aggregate Evaluation Plan (Walsh et al., 2013). Although this document will not be revised to address all changes that may occur, the annual …

Strengthening Immigrants' Health Access: Current Opportunities, Leighton C. Ku

Health Policy and Management Issue Briefs

This brief summarizes key opportunities helping the nation’s newcomers in gaining health insurance coverage and health access that are possible under the current law. Provisions of the Affordable Care Act (ACA) will help millions of legal immigrants gain access to affordable health insurance coverage. At the same time, however, immigrants will also face new responsibilities. Like citizens, lawfully present immigrants will be responsible for having health insurance coverage or paying a tax penalty, although some are exempt. Rules about immigrants’ access to health insurance benefits are often complicated because they depend on specific immigration categories, as well as eligibility for …

The National Longitudinal Survey Of Public Health Systems: Selected Findings And Applications, Glen P. Mays

Health Management and Policy Presentations

This presentation reviews the National Longitudinal Survey of Public Health Systems and its applicability for monitoring the effects of the Affordable Care Act on public health delivery within the U.S.

The Cost Of Affordable Food, Candice L. Cobuzzi

SURGE

When someone puts a piece of food in front of me, I don’t just see a piece of food.

Instead, I see an innocent cow being cornered by a forklift and slaughtered, its limp, moist tissue hung on a long conveyer belt with hundreds of others.

I see hundreds of chemically-injected chickens packed into a dark barn with no hope of seeing sunlight in their lifetime.

I see immigrants pulled from their houses like criminals, taken away from the lives they’ve spent years building for themselves and their families, working for the same food company that courted them into the …

A Comparative Analysis Of The Relationship Between Employee Perceptions Of An Organizational Leader's Commitment To Safety And Actual Injury Rates In A University Setting, David E. Oliver

Dissertations

The purpose of this study was to explore the correlation between employee perceptions of their supervisor’s commitment to safety (safety climate) and the actual rate of occupational injuries among the same employees. The study also aimed to examine the relationship between the employee perceptions of their supervisor’s leadership practices and the supervisor’s safety climate rating. In addition, this study examined the potential influence of employee demographic factors on their responses to survey questions. This research study sought to answer three primary questions: (1) Does a significant correlation exist between employee perceptions of his supervisor’s commitment to the health and safety …

Advancing Southern Nevada’S Regional Priorities: Overview Of The 77th Session Of The Nevada Legislature, David F. Damore

Brookings Mountain West Publications

On January 10, 2013 the elected leadership of Southern Nevada met to discuss the region’s governance, K--‐12, higher education, infrastructure, economic development, and health care needs. From that bipartisan discussion emerged policy priorities for the 77^th Session of the Nevada Legislature. This report examines the degree to which the region’s elected senators and assembly members advanced these priorities and represented the interests of Southern Nevada in state government.

A Profile Of Community Health Center Patients: Implications For Policy, Peter Shin, Carmen Alvarez, Jessica Sharac, Sara J. Rosenbaum, Amanda Van Vleet, Julia Paradise, Rachel Garfield

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Community health centers are a key source of comprehensive primary care in medically underserved communities across the country, and their role is expected to grow as health coverage expands under the Affordable Care Act (ACA). To sharpen understanding of the health center patient population, this brief compares it to the overall low-income population, using data from the Health Center Patient Survey and the National Health Interview Survey,respectively. The pre-ACA profile of health center patients that emerges sets the stage for measuring change following implementation of the reform law and can inform health center policy, planning, and assessment moving forward.

How Medicaid Expansions And Future Community Health Center Funding Will Shape Capacity To Meet The Nation's Primary Care Needs, Leighton C. Ku, Julia Zur, Emily Jones, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

A new report by Drs. L. Ku, J. Zur, E. Jones, P. Shin and S. Rosenbaum examines the impact of federal and state policy decisions on community health centers and their ability to continue providing primary care to the nation's poorest residents. The report estimates that under a worst-case scenario the nation's health centers would be forced to contract, leaving an estimated 1 million low-income people without access to health care services by 2020.

Women’S Political Leadership In Boston, Center For Women In Politics And Public Policy, University Of Massachusetts Boston

Publications from the Center for Women in Politics and Public Policy

The center tracks the status of women at all levels of government in the New England states. It also provides dynamic web resources to inform and support public leadership of women of color.

This fact sheet presents information and statistics following the 2013 municipal elections in the City of Boston.

Identifying And Describing The Network Of Health, Education, And Social Service Non-Profit Organizations In Southern Nevada, Shannon M. Monnat, Anna Smedley

Lincy Institute Reports and Briefs

Many of the economic, social, and demographic issues facing southern Nevada are dynamic and interrelated, requiring a coordinated approach on the part of southern Nevada’s non‐profit community. The coordination of services, skills, and talents enables community needs to be addressed in ways that exceed the scope and capacity of any single organization. With the increasing desire of funding organizations to support collaborative efforts, maintaining sustainable connections between southern Nevada’s non‐profit organizations is needed now more than ever before.

This is the first comprehensive study of southern Nevada’s health, education, and social service non‐profit network. Via a web‐based survey of nearly …

Review Of Proposed Plan For New Police And Fire Facilities, Carver, Ma, Edward J. Collins, Jr. Center For Public Management, University Of Massachusetts Boston

Edward J. Collins Center for Public Management Publications

The Edward J. Collins, Jr. Center for Public Management at the University of Massachusetts Boston was hired by the Town of Carver to perform an independent assessment of the Buildings Study Committee’s proposals for the construction/renovation of three new public facilities including a fire station, police station, and elementary school. Specifically, the team from the Center was asked to review: 1) the selected and considered sites for the facilities; and, 2) the funding plan recommended by the Buildings Study Committee.

This analysis has been divided into two components. This, first report presents the Center’s findings as they relate to the …

Assessing The Potential Impact Of The Affordable Care Act On Uninsured Community Health Center Patients: A Nationwide And State-By-State Analysis, Peter Shin, Jessica Sharac, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In this brief, we estimate the number of uninsured community health center (CHC) patients who would gain coverage under the Affordable Care Act using data from the 2009 HRSA Survey of CHC patients and 2011 Uniform Data System. We find that were all states to implement the Affordable Care Act Medicaid expansion, an estimated 5 million uninsured health center patients – or two-thirds of all uninsured patients served by CHCs nationally – would be eligible for coverage. However, over one million uninsured patients – 72% of whom live in southern states – who would have been eligible for coverage will …

How The Trans Pacific Partnership Agreement Could Undermine Pharmac And Threaten Access To Affordable Medicines And Health Equity In New Zealand, Deborah Gleeson, Ruth Lopert, Papaarangi Reid

Health Policy and Management Faculty Publications

New Zealand's Pharmaceutical Management Agency (PHARMAC) has been highly successful in facilitating affordable access to medicines through a combination of aggressive price negotiations, innovative procurement mechanisms, and careful evaluation of value for money. Recently the US government, through the establishment of a series of bilateral and plurilateral “free” trade agreements, has attempted to constrain the pharmaceutical access programs of other countries in order to promote the interests of the pharmaceutical industry. The Trans Pacific Partnership Agreement (TPPA) represents the latest example; through the TPPA the US is seeking to eliminate therapeutic reference pricing, introduce appeals processes for pharmaceutical companies to …

The Association Between Insurance Status And Cervical Cancer Screening In Community Health Centers: Exploring The Potential Of Electronic Health Records For Population-Level Surveillance, 2008-2010, Stuart Cowburn, Matthew J. Carlson, Jodi A. Lapidus, Jennifer E. Devoe

Sociology Faculty Publications and Presentations

Introduction: Cervical cancer incidence and mortality rates in the United States have decreased 67% over the past 3 decades, a reduction mainly attributed to widespread use of the Papanicolaou (Pap) test for cervical cancer screening. In the general population, receipt of cervical cancer screening is positively associated with having health insurance. Less is known about the role insurance plays among women seeking care in community health centers, where screening services are available regardless of insurance status. The objective of our study was to assess the association between cervical cancer screening and insurance status in Oregon and California community health centers …

Examining The Effectiveness Of The Millennium Villages Project Through The Health And Education Sectors: A Case Study In Ruhiira, Uganda, Meixi Guo

Independent Study Project (ISP) Collection

This study is meant to present the information gathered by the researcher during a 6-wwek practicum with the Millennium Villages Project Ruhiira office. The objective of this study is to examine the effectiveness of this organization by looking at its Health and Education sectors. By studying the interactions between the two, the paper aims to analyze the pros and cons of their interventions. During the course of this study, the researcher also learns about the local people’s view on the Millennium Villages Project as well as the difficulties Millennium has encountered when implementing the project.

The researcher used multiple methods …

La Situación De Las Cataratas En La Ciudad De Buenos Aires: Un Estudio De Caso En El Hospital Ramos Mejía / The Situation Of Cataracts In The City Of Buenos Aires: A Case Study In Ramos Mejía Hospital, Katie Elizabeth Kessler

Independent Study Project (ISP) Collection

Background: When a person has cataracts his or her lens becomes clouded by proteins, causing diminished vision. Though cataracts cause poor vision or in more serious cases blindness, what is special about cataracts is that they are treatable. Surgery replaces the clouded lens with a new artificial lens called an intraocular lens. In Argentina in 2006 only 10% of cataract surgeries were realized in the public sector, and the Ministry of Health of the Nation decided to develop a program called Program Eye Health and the Prevention of Blindness to fight these and other inequities in the realm of visual …

Gender Disparities In Access To Hiv Testing And Antiretroviral Treatment Services, Wyatt Lombard Smith

Independent Study Project (ISP) Collection

Throughout a six-week practicum period at TASO Mulago in Kampala, Uganda and St. Francis Naggalama Hospital in Naggalama, Uganda, the researcher aimed to find methods to increase male engagement in all facets of comprehensive HIV/AIDS care. Women and children generally receive most global attention on the issue of HIV/AIDS in Uganda but men are beginning to demand more attention. Antiretroviral treatment has been critical in allowing countless people to live functionally with HIV but many research projects have hypothesized that delayed access to HIV/AIDS treatment and prevention methods has resulted in men exhibiting higher mortality rates upon initiation of this …

Towards A Framework Convention On Global Health, Lawrence O. Gostin, Eric A. Friedman, Kent Buse, Attiya Waris, Moses Mulumba, Mayowa Joel, Lola Dare, Ames Dhai, Devi Sridhar

Georgetown Law Faculty Publications and Other Works

A global health treaty, a Framework Convention on Global Health (FCGH)–grounded in the right to health, with the central goal of reducing immense domestic and global health inequities–could serve as a robust global governance instrument to underpin the United Nations post-2015 Millennium Development Goals (MDGs). It would ensure for all people the three essential conditions for a healthy life–public health, health care, and the positive social determinants of health–while advancing good governance, responding to drivers of health disadvantages for marginalized populations, elevating health in other legal regimes, and enhancing people's ability to claim their rights.

The legally binding nature of …

Providing Outreach And Enrollment Assistance: Lessons Learned From Community Health Centers In Massachusetts, Julia Paradise, Sara J. Rosenbaum, Peter Shin, Jessica Sharac, Carmen Alvarez, Julia Zur, Leighton Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2006, major health care reform legislation was enacted in Massachusetts. In many ways a prototype for the Affordable Care Act (ACA), the Massachusetts law required nearly all state residents to obtain health insurance, and made insurance accessible and affordable by reforming the health insurance market and providing subsidies for coverage through expansions of Medicaid and CHIP and a new program for low-income adults who are not eligible for Medicaid, known as Commonwealth Care. The law also created the “Connector,” which, like the ACA’s health insurance Marketplaces, is designed to facilitate and simplify access to insurance for individuals, families, and …

Providing Outreach And Enrollment Assistance: Lessons Learned From Community Health Centers In Massachusetts, Julia Paradise, Sara J. Rosenbaum, Peter Shin, Jessica Sharac, Carmen Alvarez, Julia Zur, Leighton C. Ku

Health Policy and Management Faculty Publications

Six years ago, Massachusetts implemented a broad expansion of health coverage to the uninsured population in the state. Understanding that outreach and enrollment assistance would be essential to the success of the expansion, state policymakers provided for public education campaigns, but also for person-to-person, hands-on assistance, especially in communities with large numbers of uninsured people. Community health centers play a central role in this effort. As states and communities gear up to provide outreach and enrollment assistance under the ACA, the experience of the Massachusetts health centers offers lessons that can help inform current efforts to reach and enroll millions …

Racial Disparity In Duration Of Patient Visits To The Emergency Department: Teaching Versus Non-Teaching Hospital, Zeynal Karaca, Herbert S. Wong

Health Policy and Management Faculty Publications

Introduction: The sources of racial disparity in duration of patients’ visits to emergency departments (EDs) have not been documented well enough for policymakers to distinguish patient-related factors from hospital- or area-related factors. This study explores the racial disparity in duration of routine visits to EDs at teaching and non-teaching hospitals.

Methods: We performed retrospective data analyses and multivariate regression analyses to investigate the racial disparity in duration of routine ED visits at teaching and non-teaching hospitals. The Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD) were used in the analyses. The data include 4.3 million routine ED …

The Bipartisan Senate Immigration Bill: Implications For Health Coverage And Health Access, Leighton C. Ku

Health Policy and Management Issue Briefs

No abstract provided.

Racial Disparities In The Use Of Cardiac Revascularization: Does Local Hospital Capacity Matter?, Suhui Li, Arnold Chen, Holly Mead

Health Policy and Management Faculty Publications

Objective

To assess the extent to which the observed racial disparities in cardiac revascularization use can be explained by the variation across counties where patients live, and how the within-county racial disparities is associated with the local hospital capacity.

Data Sources

Administrative data from Pennsylvania Health Care Cost Containment Council (PHC4) between 1995 and 2006.

Study Design

The study sample included 207,570 Medicare patients admitted to hospital for acute myocardial infarction (AMI). We identified the use of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) procedures within three months after the patient’s initial admission for AMI. Multi-level hierarchical …

Triglyceride/Hdl Ratio As A Screening Tool For Predicting Success At Reducing Anti-Diabetic Medications Following Weight Loss., Ghanshyam P. S. Shantha, Anita A. Kumar, Scott Kahan, Pavan K. Irukulla, Lawrence J. Cheskin

Health Policy and Management Faculty Publications

Background and Objectives

Intentional weight loss, by reducing insulin resistance, results in both better glycemic control and decreased need for anti-diabetic medications. However, not everyone who is successful with weight loss is able to reduce anti-diabetic medication use. In this retrospective cohort study, we assessed the predictive accuracy of baseline triglyceride (TGL)/HDL ratio, a marker of insulin resistance, to screen patients for success in reducing anti-diabetic medication use with weight loss.

Methods

Case records of 121 overweight and obese attendees at two outpatient weight management centers were analyzed. The weight loss intervention consisted of a calorie-restricted diet (~1000Kcal/day deficit), a …

Can Consumers Make Affordable Care Affordable? The Value Of Choice Architecture, Eric J. Johnson, Ran Hassin, Tom Baker, Allison T. Bajger, Galen Treuer

All Faculty Scholarship

Starting this October, tens of millions will be choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do …

Factors Influencing Access To Healthcare Services, Melissa Delia

Independent Study Project (ISP) Collection

Following several political upheavals, the country of Madagascar has become one of the poorest countries in the world. This level of poverty affects many aspects of life, especially access to healthcare services. The availability of both allopathic and traditional healthcare to the impoverished citizens of Madagascar was examined through discussions, interviews, and journal articles. It was found that although both the allopathic and traditional medicinal systems do not charge their patients for general consultations and care, there is a high cost for pharmaceutical medications in the allopathic system. These medications are sometimes too expensive for many Malagasy patients to afford. …

Racial Disparities In The Use Of Cardiac Revascularization: Does Local Hospital Capacity Matter?, Suhui Li, Arnold Chen, Katherine H. Mead

Health Policy and Management Faculty Publications

Objective: To assess the extent to which the observed racial disparities in cardiac revascularization use can be explained by the variation across counties where patients live, and how the within-county racial disparities is associated with the local hospital capacity.

Data Sources: Administrative data from Pennsylvania Health Care Cost Containment Council (PHC4) between 1995 and 2006.

Study Design: The study sample included 207,570 Medicare patients admitted to hospital for acute myocardial infarction (AMI). We identified the use of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) procedures within three months after the patient’s initial admission for AMI. Multi-level hierarchical …

The Stigmatization Of Disabilities In Africa And The Developmental Effects, Kelsey Koszela

Independent Study Project (ISP) Collection

Stigmatization still exists in large scale and leads to exclusion and continued poverty and poor standard of life for persons with disabilities, especially for those living in Africa. The main cause of stigmatization in Africa is a lack of education about disabilities and the needs of persons with disabilities. The unknown creates fear in society and exclusion for persons with disabilities, prohibiting them from obtaining decent education, proper health care and having access to jobs and financial support. Since the Convention for the Rights of Disabled Persons (CRPD) in 2006 societal education has been supplemented by implementation of development programs …

Local Public Health In Financial Crises: Common Decision Drivers For Changes In Services Due To Economic Downturn, Gulzar H. Shah

Health Policy and Management Faculty Presentations

We measured the impact of the 2008-2010 economic recession on local health departments (LHDs) across the United States. Between 2008 and 2010, we conducted 3 Web-based, cross-sectional surveys of a nationally representative sample of LHDs to assess cuts to budgets, workforce, and programs. By early 2010, more than half of the LHDs (53%) were experiencing cuts to their core funding. In excess of 23 000 LHDs jobs were lost in 2008-2009. All programmatic areas were affected by cuts, and more than half of protecting the health of the public, such as monitoring health status to identify and solve community health …