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Articles 1 - 30 of 111
Full-Text Articles in Law
Bridging Silos, Part I: Linkages Among The Di, Ssi, Medicare, And Medicaid Programs, Karen Matherlee
Bridging Silos, Part I: Linkages Among The Di, Ssi, Medicare, And Medicaid Programs, Karen Matherlee
National Health Policy Forum
This paper, the first of two on the general topic of public disability and health benefits, centers on the fundamentals of the Disability Insurance and Supplemental Security Income programs and their relationships with Medicare and Medicaid. In addition to looking at the programs’ definitions, distinctions, and overlaps, it reviews the effects on them of the Ticket to Work and Work Incentives Improvement Act of 1999 and, to a lesser extent, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.
Bridging Silos, Part Ii: Di, Ssi, Medicare, And Medicaid Issues And Initiatives, Karen Matherlee
Bridging Silos, Part Ii: Di, Ssi, Medicare, And Medicaid Issues And Initiatives, Karen Matherlee
National Health Policy Forum
The second of two papers on the general topic of public disability and health benefits, this background paper lays out some key issues confronting the Social Security Disability Insurance, Supplemental Security Income, Medicare, and Medicaid programs. It also discusses major initiatives to address those issues, in light of growing administrative, fiscal, and other problems.
Sailing Schip Through Troubled Waters, Jennifer Ryan
Sailing Schip Through Troubled Waters, Jennifer Ryan
National Health Policy Forum
As the State Children’s Health Insurance Program (SCHIP) enters its sixth year of operation, states have continued their commitment to children’s coverage and to reaching out to the uninsured. This issue brief explores the current status of SCHIP in light of fiscal pressures that have been created by the state budget crisis. It highlights some of the key successes in the program thus far and notes several examples of state initiatives to serve particularly vulnerable populations and collect outcomes data and information about access to care.
Rural Health Care In The Electronic Age (Danville, Pa), Lisa Sprague, Nora Super
Rural Health Care In The Electronic Age (Danville, Pa), Lisa Sprague, Nora Super
National Health Policy Forum
This site visit to the Geisinger Health System in central Pennsylvania explored the use of technology in providing health care to an aging, rural population with a high index of chronic-care needs. The agenda included an in-depth examination of Geisinger’s electronic medical record and its use in various domains of care, including outpatient clinics, disease management, and non-Geisinger medical practices and community hospitals. The program also highlighted specific care management initiatives in the areas of radiology, stroke, and obesity. Geisinger’s advantages as an integrated system dominant in its market, with the resources to invest in technology were weighed in considering …
Managed Care’S Crimea: Medical Necessity, Therapeutic Benefit, And The Goals Of Administrative Process In Health Insurance, William M. Sage
Managed Care’S Crimea: Medical Necessity, Therapeutic Benefit, And The Goals Of Administrative Process In Health Insurance, William M. Sage
Faculty Scholarship
This Essay explores the concept of medical necessity as it has evolved in the judicial and administrative oversight of managed care. The goals of the Essay are to illustrate the range of plausible rationales for establishing administrative procedures to govern medical necessity disputes, and to demonstrate the difficulty of incorporating into those procedures the most important professional and social responsibilities of managed care in today’s health care system. Part I of the Essay explains the ideological and practical significance of medical necessity as managed care has evolved. Part II examines medical necessity as a legal problem, and questions whether current …
Dually Eligible For Medicare And Medicaid: Two For One Or Double Jeopardy?, Jennifer Ryan, Nora Super
Dually Eligible For Medicare And Medicaid: Two For One Or Double Jeopardy?, Jennifer Ryan, Nora Super
National Health Policy Forum
This issue brief describes the characteristics of the population of individuals known as “dual eligibles,” who are eligible for health insurance coverage through both Medicare and Medicaid. It also looks at the differences between “full Medicaid” and “supplemental Medicaid” dual eligibles and the ongoing challenges associated with enrollment and eligibility, integration and coordination, and managed care. The paper presents several examples of integrated care programs designed to better serve the dual-eligible population, including the Program of All-Inclusive Care for the Elderly, Evercare, social health maintenance organizations, and state/federal initiatives such as the Wisconsin Partnership Program, Texas STAR+PLUS, and others. Finally, …
Medical Response For Terrorist And Public Health Threats: One Region's Experience (Pittsburgh), Eileen Salinsky, Lisa Sprague
Medical Response For Terrorist And Public Health Threats: One Region's Experience (Pittsburgh), Eileen Salinsky, Lisa Sprague
National Health Policy Forum
This site visit, planned and convened in conjunction with the Agency for Healthcare Research and Quality’s User Liaison Program, examined the efforts underway in the greater Pittsburgh area to develop emergency medical response capabilities for mass causality events. The site visit explored efforts to improve infectious disease surveillance capabilities and looked at the Region 13 collaborative’s development of a regionalized approach to emergency management planning and response. Hospital preparedness activities were also studied, including a discussion of lessons learned from a recent drill to test response to a radiological event and an exploration of conceptual frameworks to guide hospital planning …
Shaping Public Programs Through Medicare, Medicaid, And Schip Waivers: The Fundamentals, Cynthia Shirk
Shaping Public Programs Through Medicare, Medicaid, And Schip Waivers: The Fundamentals, Cynthia Shirk
National Health Policy Forum
This background paper examines the use of research, demonstration, and program waiver authorities to test new approaches to the delivery of and payment for health care services in federally financed health coverage programs such as Medicare, Medicaid, and the State Children’s Health Insurance Program. The paper also looks at the mechanics of waivers as well as their history and political context in shaping public programs. In addition, it explores the ways the changing state-federal relationship and the ever-growing demand for state flexibility have driven waiver policy.
The Medicare Prescription Drug Proposals And Health Insurance Risk, Dawn Gencarelli
The Medicare Prescription Drug Proposals And Health Insurance Risk, Dawn Gencarelli
National Health Policy Forum
In order to facilitate a better understanding of the complex issues raised by Senate and House proposals to establish a prescription drug benefit for Medicare beneficiaries, this paper briefly addresses some fundamentals of the health insurance market, defines key risk-sharing mechanisms, including risk corridors and reinsurance, and identifies the relevant risk provisions in the bills. Other issues related to cost management strategies and program design, which may have an impact on cost and adverse selection, are also discussed.
Tobacco Regulation Review, V.2, No. 2, Sept. 2003
Tobacco Regulation Review, V.2, No. 2, Sept. 2003
Tobacco Regulation Review
No abstract provided.
Wic Reauthorization: Opportunities For Improving The Nutritional Status Of Women, Infants, And Children, Harriette Fox, Margaret Mcmanus, Harry Schmidt
Wic Reauthorization: Opportunities For Improving The Nutritional Status Of Women, Infants, And Children, Harriette Fox, Margaret Mcmanus, Harry Schmidt
National Health Policy Forum
This paper examines the main reform issues affecting the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which is coming up for reauthorization this year. The paper provides background information on the WIC program, including its dramatic growth in participation and funding. It also reviews WIC’s link to health care and its impact on health outcomes. A series of considerations for WIC’s future are raised, including food package and program eligibility changes, nutrition education strategies to reduce obesity, financial risks and health consequences of relying on infant formula rebates, and new opportunities for research and demonstration.
Following The Man On The Clapham Omnibus: Social Science Evidence In Malpractice Litigation, Richard O. Lempert
Following The Man On The Clapham Omnibus: Social Science Evidence In Malpractice Litigation, Richard O. Lempert
Law & Economics Working Papers Archive: 2003-2009
This article responds to proposals to admit statistical evidence from empirical studies of actual health care practices to prove prevailing health practice standards in malpractice litigation by arguing that the case for doing so has numerous weaknesses that advocates of admitting such data commonly ignore. A fundamental concern is that the standard of practice defense co-evolved with prevailing modes of proof and might have been different had proof through experts not allowed for an aspirational as well as an empirical element to reach the jury. The article also argues that generating reliable statistical evidence of standard medical practice can be …
Obesity In America: A Growing Threat, Eileen Salinsky, Wakina Scott
Obesity In America: A Growing Threat, Eileen Salinsky, Wakina Scott
National Health Policy Forum
This background paper seeks to clarify the nature and causes of the obesity epidemic in the United States and provides an overview of the associated economic and health costs. The paper summarizes existing federal programs and policies that address obesity and examines new and emerging policy strategies to battle the bulging American silhouette. Topics explored include population-based prevention, federal food- and nutrition-assistance programs, Medicare and Medicaid payment policies, school health initiatives, and publicly funded biomedical research.
The Geography Of Medicare: Explaining Differences In Payment And Costs, Nora Super
The Geography Of Medicare: Explaining Differences In Payment And Costs, Nora Super
National Health Policy Forum
This issue brief examines the sources of variation in Medicare payment and costs across different geographic areas and different sites of care. It discusses the payment policies that address variation in the cost of providing care, such as input price adjustments and special payments to hospitals. It also considers differences due to beneficiaries’ health status and in physician practice patterns. Finally, it explores policy options to address Medicare geographic variation.
Mid-Atlantic Ethics Committee Newsletter, Summer 2003
Mid-Atlantic Ethics Committee Newsletter, Summer 2003
Mid-Atlantic Ethics Committee Newsletter
No abstract provided.
Understanding The Terrorist Mindset, Randy Borum
Understanding The Terrorist Mindset, Randy Borum
Mental Health Law & Policy Faculty Publications
No abstract provided.
Border Patrol, Carl E. Schneider
Border Patrol, Carl E. Schneider
Articles
Recently, the Supreme Court has encountered cases that concern perhaps our weightiest bioethical issue-how medical care is to be rationed. But this does not mean that the Court must therefore assess the justice of rationing, as many people incited by many journalists now fondly and firmly believe. In explaining why, we begin with a story about how Learned Hand remembered saying one day to Justice Holmes, "Well, sir, goodbye. Do justice!" Holmes turned quite sharply and said: "That is not my job. My job is to play the game according to the rules." If the Court doesn't do justice, what …
Accumulation Of Tissue Factor Into Developing Thrombi In Vivo Is Dependent Upon Microparticle P-Selectin Glycoprotein Ligand 1 And Platelet P-Selectin, Shahrokh Falati, Qingde Liu, Peter Gross, Glenn Merrill-Skoloff, Janet Chou, Erik Vandendries, Alessandro Celi, Kevin Croce, Barbara C. Furie, Bruce Furie
Accumulation Of Tissue Factor Into Developing Thrombi In Vivo Is Dependent Upon Microparticle P-Selectin Glycoprotein Ligand 1 And Platelet P-Selectin, Shahrokh Falati, Qingde Liu, Peter Gross, Glenn Merrill-Skoloff, Janet Chou, Erik Vandendries, Alessandro Celi, Kevin Croce, Barbara C. Furie, Bruce Furie
Articles & Chapters
Using a laser-induced endothelial injury model, we examined thrombus formation in the microcirculation of wild-type and genetically altered mice by real-time in vivo microscopy to analyze this complex physiologic process in a system that includes the vessel wall, the presence of flowing blood, and the absence of anticoagulants. We observe P-selectin expression, tissue factor accumulation, and fibrin generation after platelet localization in the developing thrombus in arterioles of wild-type mice. However, mice lacking P-selectin glycoprotein ligand 1 (PSGL-1) or P-selectin, or wild-type mice infused with blocking P-selectin antibodies, developed platelet thrombi containing minimal tissue factor and fibrin. To explore the …
Statewide Penetration And Standard Costs Of Psychotropic Medications, Mary R. Murrin
Statewide Penetration And Standard Costs Of Psychotropic Medications, Mary R. Murrin
Mental Health Law & Policy Faculty Publications
This study will examine differences in pharmaceutical utilization rates relative to financial risk arrangements of differing insurance plans. During the last four years we have noted consistent differences in utilization of expensive, psychotropic medications between individuals enrolled in Health Maintenance Organizations (HMOs), which are at financial risk for the provision of pharmaceuticals, and the MediPass program in which the state bears the risk of pharmacy expenses. Persons in HMOs had lower levels of utilization.
Welfare Reform: Adolescent Girls In Transition: A One-Year Follow-Up Study, Roger A. Boothroyd, Mary I. Armstrong, Angela Gomez, Haynes Diane
Welfare Reform: Adolescent Girls In Transition: A One-Year Follow-Up Study, Roger A. Boothroyd, Mary I. Armstrong, Angela Gomez, Haynes Diane
Mental Health Law & Policy Faculty Publications
The report summarizes the findings from a one-year follow-up study examining the current well-being and predictors of future hopes and aspirations of adolescent girls living in families receiving TANF. This mixed-method study includes two phases. Phase 1 involved face-to-face interviews using various standardized measures with 125 mothers who were receiving TANF in 2002 and their daughters while Phase 2 included in-depth qualitative interviews with a random sample of 20 adolescent girls participating in Phase 1. One year re-interview rates were 92% for Phase 1 interviews and 90% for Phase 2 interviews.
The Effect Of Abortion Legalization On Sexual Behavior: Evidence From Sexually Transmitted Diseases, Jonathan Klick, Thomas Stratmann
The Effect Of Abortion Legalization On Sexual Behavior: Evidence From Sexually Transmitted Diseases, Jonathan Klick, Thomas Stratmann
All Faculty Scholarship
Unwanted pregnancy represents a major cost of sexual activity. When abortion was legalized in a number of states in 1969 and 1970 (and nationally in 1973), this cost was reduced. We predict that abortion legalization generated incentives leading to an increase in sexual activity, accompanied by an increase in sexually transmitted diseases (STDs). Using Centers for Disease Control data on the incidence of gonorrhea and syphilis by state, we test the hypothesis that abortion legalization led to an increase in sexually transmitted diseases. We find that gonorrhea and syphilis incidences are significantly and positively correlated with abortion legalization. Further, we …
Doing It Rite: Exploring A Decade Of Health Coverage Innovation (Rhode Island), Jennifer Ryan, Ginger P. Parra
Doing It Rite: Exploring A Decade Of Health Coverage Innovation (Rhode Island), Jennifer Ryan, Ginger P. Parra
National Health Policy Forum
This site visit to the state of Rhode Island provided an opportunity to experience and understand the decade of health coverage innovation that has resulted in near universal coverage for children. Site visitors had the opportunity to interact with health care providers, state officials, and consumer advocates, as well as other leaders in health care community. The group also visited the Thundermist Health Center in Woonsocket; a school based health clinic at Woonsocket High School; the HELP Lead Safe Center in South Providence; and a local provider, St. Joseph’s Hospital for Specialty Care, that houses several preventive care clinics and …
Disease Management To Population-Based Health: Steps In The Right Direction?, Lisa Sprague
Disease Management To Population-Based Health: Steps In The Right Direction?, Lisa Sprague
National Health Policy Forum
This issue brief reviews the evolution of the disease management model and the ways it relates to care coordination and case management approaches. It also looks at examples of population-based disease management programs operating in both the private and public sectors and reviews the evidence of their success. Finally, the paper considers the policy implications of adapting this model to a Medicare fee-for-service population.
Medicaid Prescription Drug Coverage: State Efforts To Control Costs, Dawn Gencarelli
Medicaid Prescription Drug Coverage: State Efforts To Control Costs, Dawn Gencarelli
National Health Policy Forum
This paper provides a brief summary of the Medicaid prescription drug benefit. It explains the mechanisms being used by states to control their prescription drug spending within the Medicaid program. The paper also highlights some of the concerns that have been expressed with these mechanisms and the litigation that has been initiated in several states as a result of these efforts. It takes a closer look at three states with cost containment strategies that have been the focus of increased scrutiny.
Most Favored Nation Clauses, Jonathan Baker, William Kopit, Thomas Overstreet, Robert Mcnair, Jr., Steven Snow
Most Favored Nation Clauses, Jonathan Baker, William Kopit, Thomas Overstreet, Robert Mcnair, Jr., Steven Snow
Presentations
Event descriptionThe Federal Trade Commission and Department of Justice will commence public hearings in Washington, D.C. on February 26, 2003 on the implications of competition law and policy for health care financing and delivery. The hearings will broadly consider the impact of competition law and policy on the cost, quality, and availability of health care, and the incentives for innovation in the field.Specific subjects to be considered include hospital mergers, the significance of non-profit status, vertical integration, quality and efficiencies, the boundaries of the state action and Noerr-Pennington doctrines, monopsony power, the adequacy of existing remedies for anticompetitive conduct, and …
The U.S. Health Workforce: Definitions, Dollars, And Dilemmas, Karen Matherlee
The U.S. Health Workforce: Definitions, Dollars, And Dilemmas, Karen Matherlee
National Health Policy Forum
This background paper provides a comprehensive view of the structure of the health workforce. It explores public and private insurance coverage and payment policies, as well as discretionary grant programs, that govern it. The paper also looks at health workforce concerns: supplies of certain types of physicians, health workforce mix, challenges from complementary and alternative medicine, shortages of nurses and pharmacists (and some other practitioners), maldistribution issues, and lack of diversity in response to demographic changes. It presents proposals that are on the table to reform the health workforce, at a time when it is demanding greater attention from health …
Reauthorizing Head Start: The Future Federal Role In Preschool Programs For The Poor, Jane Koppelman
Reauthorizing Head Start: The Future Federal Role In Preschool Programs For The Poor, Jane Koppelman
National Health Policy Forum
This paper describes the implications of President Bush’s proposal to devolve authority for running the Head Start program to the states and to alter the organization and funding of all government early childhood programs—with the goal of improving the school readiness skills of low-income children. The administration plan to allow states to mix Head Start funds with state-funded preschool money and, if desired, child care monies to create a more uniform early childhood care system with an educational focus raises numerous questions. This paper addresses questions raised by this plan, including the potential quality of these new systems, the extent …
A Matter Of Priority: Transplanting Organs Preferentially To Registered Donors, Adam Kolber
A Matter Of Priority: Transplanting Organs Preferentially To Registered Donors, Adam Kolber
Faculty Scholarship
No abstract provided.
Physician Liability And Managed Care: A Philosophical Perspective, Dionne L. Koller
Physician Liability And Managed Care: A Philosophical Perspective, Dionne L. Koller
All Faculty Scholarship
Despite the emergence of managed health care and the resulting dramatic change in the role of the third-party payer in the physician-patient relationship, the liability standards applied to physicians largely have remained unchanged. This has created a tension between physicians' legal and ethical obligations, and the requirements imposed on the physician by managed health care. Specifically, the issue confronts the physician in the context of malpractice liability. Managed Care Organizations impose a significant amount of control over the way physicians practice medicine, often forcing physicians to ration care. Notwithstanding any beneficial cost savings that might result, this approach subjects the …
Mid-Atlantic Ethics Committee Newsletter, Spring 2003
Mid-Atlantic Ethics Committee Newsletter, Spring 2003
Mid-Atlantic Ethics Committee Newsletter
No abstract provided.