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The Role Of The Opioid Crisis In Elder Abuse, Kimberly I. Snow Mhsa, Jennifer Pratt, Stuart Bratesman Mpp Nov 2020

The Role Of The Opioid Crisis In Elder Abuse, Kimberly I. Snow Mhsa, Jennifer Pratt, Stuart Bratesman Mpp

Disability & Aging

As the opioid crisis has deepened over the past twenty years, its effect on individuals and families, including older adults, has grown. To find out how the opioid crisis might be impacting elder abuse, neglect, and exploitation in Maine, we conducted a mixed methods analysis of 2015-2018 Maine Adult Protective Services (APS) investigations to determine: 1) Did opioid-related investigations increase over time? 2) Do investigations involving opioid misuse or abuse differ from investigations that don’t involve opioids? 3) What themes or features of cases involving opioid misuse or abuse by clients and/or perpetrators emerge from the data?

Key ...


Opioid Overdoses Among High-Risk Medicaid Members: Healthcare Cost, Service Utilization, And Risk Factor Analysis, Judith A. Savageau, Melissa Brindisi, Faye Miller, Laura A. Sefton, Adam Stoler, Margaret Harvey, Dana Bernson Jul 2020

Opioid Overdoses Among High-Risk Medicaid Members: Healthcare Cost, Service Utilization, And Risk Factor Analysis, Judith A. Savageau, Melissa Brindisi, Faye Miller, Laura A. Sefton, Adam Stoler, Margaret Harvey, Dana Bernson

Commonwealth Medicine Publications

Research Objective: Identify risk factors associated with opioid overdoses among three high-risk populations of Medicaid members related to cost and service utilization.

Study Design: Repeated cross-sectional study using five years of Massachusetts Medicaid (MassHealth) claims and state agency data.

Population Studied: MassHealth members aged 11-64 years considered to be high-risk (homeless, unstably housed, and/or criminal justice-involved) and in need of support services, especially those with extensive behavioral health (BH) needs. These three populations were identified as being particularly vulnerable to non-fatal and/or fatal opioid overdoses.

Principal Findings: MassHealth members who were both justice-involved and unstably housed were at ...


What Do We Know About Health Insurance Choice?, Megan Mccarthy-Alfano Jun 2020

What Do We Know About Health Insurance Choice?, Megan Mccarthy-Alfano

Issue Briefs

No abstract provided.


Association Between Racial Discrimination And Health‐Related Quality Of Life And The Impact Of Social Relationships, Sze Yan Liu, Genevieve Bergeron, Nneka Lundy De La Cruz, L. Hannah Gould, Amber Levanon Seligson May 2020

Association Between Racial Discrimination And Health‐Related Quality Of Life And The Impact Of Social Relationships, Sze Yan Liu, Genevieve Bergeron, Nneka Lundy De La Cruz, L. Hannah Gould, Amber Levanon Seligson

Department of Public Health Scholarship and Creative Works

Purpose: Interpersonal racial discrimination is associated with poor health. Social relationships may moderate the impact of discrimination and represent modifiable behaviors that can be targeted by public health interventions. We described citywide associations between self-reported racial discrimination and health-related quality of life among the overall New York City (NYC) adult residential population and by four main race/ethnicity groups and explored whether social relationships moderated health effects of discrimination.

Methods: We analyzed cross-sectional survey data from 2335 adults weighted to be representative of the NYC population. We measured exposures to lifetime interpersonal racial discrimination in nine domains using a modifed ...


Advancing The Implementation And Sustainment Of Medication Assisted Treatment For Opioid Use Disorders In Prisons And Jails, Warren J. Ferguson, Joan Johnston, Jennifer G. Clarke, Peter J. Koutoujian, Kathleen Maurer, Colleen Gallagher, Julie White, Dyana Nickl, Faye S. Taxman Dec 2019

Advancing The Implementation And Sustainment Of Medication Assisted Treatment For Opioid Use Disorders In Prisons And Jails, Warren J. Ferguson, Joan Johnston, Jennifer G. Clarke, Peter J. Koutoujian, Kathleen Maurer, Colleen Gallagher, Julie White, Dyana Nickl, Faye S. Taxman

Open Access Publications by UMMS Authors

BACKGROUND: Opioid use disorder (OUD) is among the most prevalent medical condition experienced by incarcerated persons, yet medication assisted therapy (MAT) is uncommon. Four jail and prison systems partnered with researchers to document their adoption of MAT for incarcerated individuals with opioid use disorders (OUD) using their established treatment protocols. Employing the EPIS (Exploration, Planning, Implementation, and Sustainment) framework, programs report on systematic efforts to expand screening, treatment and provide linkage to community-based care upon release.

RESULTS: All four systems were engaged with implementation of MAT at the outset of the study. Thus, findings focus more on uptake and penetration ...


Best Practices For Member Outreach And Engagement: How Effective Acos Build Understanding And Respect, Jessica Carpenter, Jocelyn Gordon Jun 2019

Best Practices For Member Outreach And Engagement: How Effective Acos Build Understanding And Respect, Jessica Carpenter, Jocelyn Gordon

Commonwealth Medicine Publications

Targeted strategies and sustained efforts at member outreach and engagement are helping Accountable Care Organizations (ACOs) and their Community Partners (CPs) achieve their shared goals for delivering patient-centered care. The most successful organizations focus on activities designed to create a stronger connection with their members, building trust and a better understanding of individuals’ characteristics and care needs. Positive results of these efforts include successful person-centered care planning, improved compliance with care plans and prescriptions, and implementation of recommended lifestyle changes — changes that help support independent living, reduce medical costs and complications, and drive improvements in member satisfaction.


University Of Massachusetts Medical School Report To Minnesota Department Of Human Services Health And Incarceration Project, Katharine London, Jeremy Tourish Jun 2019

University Of Massachusetts Medical School Report To Minnesota Department Of Human Services Health And Incarceration Project, Katharine London, Jeremy Tourish

Commonwealth Medicine Publications

On behalf of the Minnesota Department of Health Services, Health Law & Policy experts from our Public and Private Health Solutions group completed a literature review of successful efforts to improve the health of previously incarcerated individuals. In addition, our experts conducted five focus groups to obtain recommendations from experienced professionals who work directly with previously incarcerated individuals regarding interventions likely to improve the health of this unique population.

This study came about at the direction of Minnesota Legislature. They were interested in developing a methodology for paying higher rates to health care providers who provide services to high cost and ...


The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd May 2019

The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd

Disability & Aging

This study sought to determine the Medicare and Medicaid costs experienced by dual eligible older adults in Maine for whom Maine Adult Protective Services (APS) substantiated allegations of elder financial exploitation and to compare them to those of Maine’s general older population. The analysis is an important step forward in estimating the medical costs associated with elder abuse.

Elder financial exploitation may result in significant public burden on Medicare and Medicaid, shouldered by taxpayers. Efforts to detect, investigate, prosecute, and mitigate this abuse will benefit not only the victims, but also the financial stewardship of these public programs.


Infants Exposed To Homelessness: Health, Health Care Use, And Health Spending From Birth To Age Six, Robin E. Clark, Linda Weinreb, Julie M. Flahive, Robert W. Seifert May 2019

Infants Exposed To Homelessness: Health, Health Care Use, And Health Spending From Birth To Age Six, Robin E. Clark, Linda Weinreb, Julie M. Flahive, Robert W. Seifert

Commonwealth Medicine Publications

Homeless infants are known to have poor birth outcomes, but the longitudinal impact of homelessness on health, health care use, and health spending during the early years of life has received little attention. Linking Massachusetts emergency shelter enrollment records for the period 2008-15 with Medicaid claims, we compared 5,762 infants who experienced a homeless episode with a group of 5,553 infants matched on sex, race/ethnicity, location, and birth month. Infants born during a period of unstable housing resulting in homelessness had higher rates of low birthweight, respiratory problems, fever, and other common conditions; longer neonatal intensive care ...


Will Ending Certain Drug Rebates Lower List Prices And Patient Out-Of-Pocket Costs?, Mckenzie Taylor, Stephanie Tran Apr 2019

Will Ending Certain Drug Rebates Lower List Prices And Patient Out-Of-Pocket Costs?, Mckenzie Taylor, Stephanie Tran

Commonwealth Medicine Publications

Earlier this year, the Department of Health and Human Services (HHS) proposed changes to the current pricing and contracting system for federal health care programs, Medicare Part D and Medicaid.This proposal aligns with the Trump Administration’s blueprint for lowering drug prices which we have written about previously.


The Expanding Role Of Pharmacists: A Positive Shift For Health Care, Ashley Chiara Mar 2019

The Expanding Role Of Pharmacists: A Positive Shift For Health Care, Ashley Chiara

Commonwealth Medicine Publications

When reflecting upon the impactful members of a patient’s healthcare team, much consideration is given to the patient’s nurses, primary care physician and specialists. However, with nearly nine in 10 Americans living within five miles of a community pharmacy, and four in five receiving prescription benefits through a pharmacy benefit manager (PBM), the role of the pharmacist in orchestrating a patient’s care on the front lines is often overlooked.


Payment Reform For Kids, Robert W. Seifert Feb 2019

Payment Reform For Kids, Robert W. Seifert

Commonwealth Medicine Publications

Comprehensive care for children – including greater attention to behavioral health, socio-emotional development, and strong family relationships – may hold the key to lifelong health and well-being. With this premise, a group in Connecticut has just published recommendations for improving pediatric primary care through payment reform.


Integrating A Co-Occurring Disorders Intervention In Drug Courts: An Open Pilot Trial, David A. Smelson, Ian Farquhar, William H. Fisher, Karen Pressman, Debra A. Pinals, Barbara Samek, Mary-Kate Duffy, Leon Sawh Feb 2019

Integrating A Co-Occurring Disorders Intervention In Drug Courts: An Open Pilot Trial, David A. Smelson, Ian Farquhar, William H. Fisher, Karen Pressman, Debra A. Pinals, Barbara Samek, Mary-Kate Duffy, Leon Sawh

Psychiatry Publications

Little research has focused on systematically integrating clinical treatment within existing drug court procedures. This could be particularly useful for clients with substance use disorders, who comprise those on court dockets and often have co-existing mental health issues. This article reports on the preliminary outcomes of integrating MISSION-Criminal Justice (MISSION-CJ), a co-occurring mental health and substance use wraparound intervention, within two Massachusetts drug courts. In this open pilot, clients completed intake and 6-month follow-up assessments. The participants were primarily Caucasian (86%), male (82%), had at least 2 prior arrests, and received outpatient treatment for mental health (54%), alcohol use (51 ...


Lowering Out Of Pocket Drug Costs For Consumers, Mylissa K. Price Jan 2019

Lowering Out Of Pocket Drug Costs For Consumers, Mylissa K. Price

Commonwealth Medicine Publications

Prohibiting gag clauses could help lower consumer out-of-pocket pharmacy costs - if Pharmacy Benefits Managers don't raise prices to make-up the difference. Mylissa Price closes our blog series on President Trump's Blueprint to Lower Drug Costs in this final entry.


Deciphering State Medicaid Programs, Rachel Gershon Jan 2019

Deciphering State Medicaid Programs, Rachel Gershon

Commonwealth Medicine Publications

State Medicaid programs vary substantially from one another. For members, researchers, policymakers, and advocates trying to decipher a state’s Medicaid program, this variation can be a source of frustration, because the details of this variation can be hard to locate.


Will Removing Rebates Really Lower Drug List Prices?, Stephanie Tran Dec 2018

Will Removing Rebates Really Lower Drug List Prices?, Stephanie Tran

Commonwealth Medicine Publications

The Trump Administration Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs calls for incentives to lower drug list prices, including removing rebates. Our clinical consultant Stephanie Tran continues our pharmacy blog series with an assessment of this potential change & its impacts.


New Aca Waiver Directives Signal Changes For State Health Insurance Marketplaces, Rachel Gershon, Catherine Torri Dec 2018

New Aca Waiver Directives Signal Changes For State Health Insurance Marketplaces, Rachel Gershon, Catherine Torri

Commonwealth Medicine Publications

New Trump Administrations Section 1332 waiver guidance increases state ACA flexibility. Rachel Gershon & Catie Torri discuss what this could mean for health care policy.


Better Negotiations Between Payers And Manufacturers In An Effort To Reduce Drug Prices, Mckenzie Taylor Nov 2018

Better Negotiations Between Payers And Manufacturers In An Effort To Reduce Drug Prices, Mckenzie Taylor

Commonwealth Medicine Publications

Mckenzie Taylor continues our monthly conversation on the strategies presented in The Trump Administration Blueprint to Low Drug Prices and Reduce Out-of-Pocket Costs, discussing the ways new negotiations between payers and manufacturers are helping to reduce drug prices.


How Can Improved Competition Lead To Lower Drug Prices?, Youkavet Samih Oct 2018

How Can Improved Competition Lead To Lower Drug Prices?, Youkavet Samih

Commonwealth Medicine Publications

In this installment of our blog series on "President Trump's Blueprint to Lower Drug Prices and Reduce Out-Of-Pocket Costs," our pharmacy expert Youkavet Samih discusses how creating drug competition drives down prices for consumers.


Hiring Workers With Disabilities Makes Sense Whether The Job Market Is Hot Or Cold, Kathleen A. Petkauskos Oct 2018

Hiring Workers With Disabilities Makes Sense Whether The Job Market Is Hot Or Cold, Kathleen A. Petkauskos

Commonwealth Medicine Publications

The U.S. Department of Labor released its latest report in September, and it was more of the same. Unemployment remained at 3.9 percent, where it has hovered for much of the year, but there was a shift for one key demographic.

After decades of struggle, workers with disabilities are beginning to move the needle, outpacing the employment gains of people without disabilities. In August 2018, the employment-to-population ratio for working-age people with disabilities jumped to 30.2 percent from 29.5 percent the year before. The labor force participation rate for working-age people with disabilities also increased, rising ...


Utilization Management Programs Are Critical For Effective Mltss Programs, Jessica Carpenter Oct 2018

Utilization Management Programs Are Critical For Effective Mltss Programs, Jessica Carpenter

Commonwealth Medicine Publications

When discussing an efficient managed long-term services and supports (LTSS) program, the importance of a utilization management program cannot be overlooked. It’s a way to not only ensure individuals receive the high-quality services they need, but also realize substantial cost savings for payers.


A View Of The Drug Pricing Blueprint, Bonnie C. Greenwood Sep 2018

A View Of The Drug Pricing Blueprint, Bonnie C. Greenwood

Commonwealth Medicine Publications

Drug spend is predicted to experience the fastest annual growth between 2017-2026 compared to other health care goods and services.Contributing factors include increasing unit prices of branded and generic medications, growth of the specialty drug market, and greater numbers of people with access to prescription drug coverage. A recent analysis estimates total drug expenditures in 2016 to be $480 billion when accounting for gross profits of intermediaries in the distribution chain, such as wholesalers, pharmacy benefit managers (PBMs), and pharmacies. Certainly, the complexity of the drug distribution and reimbursement system and lack of pricing transparency can be viewed both ...


Case Files Key To Comprehensive Medical Board Reviews, Jody Simpson Aug 2018

Case Files Key To Comprehensive Medical Board Reviews, Jody Simpson

Commonwealth Medicine Publications

There are many obstacles public retirement systems must overcome to ensure clinically sound medical board recommendations. Complex medical records that describe various conditions and ailmentsmust be compiled and analyzed to make accurate recommendations. There are key elements to inform a successful medical board review, and chief among them is compiling robust, well-documented case files. If you begin the process with incomplete documentation, you run the risk of getting a partial clinical picture of the member. Not having a full clinical picture could make it difficult to achieve a fully-informed decision.


Bringing Data Into Focus To Optimize Benefits And Savings For Medicare-Medicaid Members, Jenifer Hartman Aug 2018

Bringing Data Into Focus To Optimize Benefits And Savings For Medicare-Medicaid Members, Jenifer Hartman

Commonwealth Medicine Publications

Dual eligible recipients represent a critical population for state Medicaid programs. To get a better understanding of this unique demographic, MassHealth partnered with UMass Medical School to design data analytics programs around the objective of protecting Medicaid as the payer of last resort.

Over the last three years, these programs achieved over $68 million in new savings by optimizing benefits for dual eligible members. The program also identified and recovered over $21 million in Medicare premium overpayments for Medicaid members with discrepancies in Medicare entitlement and premium charges.

Jenifer Hartman of the Center for Healthcare Financing presented UMass Medical School ...


Managed Long-Term Services And Supports Program Framework: Best Practices, Jessica Carpenter Aug 2018

Managed Long-Term Services And Supports Program Framework: Best Practices, Jessica Carpenter

Commonwealth Medicine Publications

Health plans and accountable care organizations are working with Medicaid programs to transition fee-for-services long-term services and supports (LTSS) to a managed care model known as managed LTSS. With more individuals with disabilities seeking to living in their own homes or in community settings, payers must take proactive steps to ensure individuals receive the right service and in the right setting. This white paper details the actions health plan decision makers should consider while developing a comprehensive managed LTSS program.


Sne-Ptn Attends Cms Transforming Clinical Practice Initiative National Expert Panel 2018, Jay Flanagan Aug 2018

Sne-Ptn Attends Cms Transforming Clinical Practice Initiative National Expert Panel 2018, Jay Flanagan

Commonwealth Medicine Publications

Practice transformation networks from across the country are going public with their successful results on patients and clinical practices. UMass Medical School’s Southern New England Practice Transformation Network (SNE-PTN) was one of the networks sharing its positive outcomes.


The Role Of Health Care In Criminal Justice Reform, Julie White Jul 2018

The Role Of Health Care In Criminal Justice Reform, Julie White

Commonwealth Medicine Publications

Mass incarceration continues to be problem in United States with over 2.2 million people incarcerated, costing approximately $80 billion in taxes annually. As a result of the coalescence of social policy researchers, restorative justice policies, civil rights activists, and economists, there is recognition that incarceration is not a financially sustainable ‘solution’ to crime.


Public Retirement System Medical Board Reviews: Elements Of Success, Jody Simpson Jul 2018

Public Retirement System Medical Board Reviews: Elements Of Success, Jody Simpson

Commonwealth Medicine Publications

Comprehensive evaluations of disability benefit applications is a vital responsibility for public retirement systems. Incomplete or incorrect evaluations can lead to costly mistakes in both financial and human terms. The Disability Evaluation Services team shares an framework for success public retirement systems can use to ensure their Medical Boards receive disability determinations that are complete and clinically sound.


Advancing The Science And Practice Of Health Care For Justice-Involved Individuals, Dyana Nickl Jun 2018

Advancing The Science And Practice Of Health Care For Justice-Involved Individuals, Dyana Nickl

Commonwealth Medicine Publications

Our nation’s correctional population is about 6.6 million including those individuals supervised by probation and/or parole agencies, according to the latest figures from the U.S. Bureau of Justice Statistics. Over two million of those are incarcerated and in the custody of a state or federal prison or local jail. It has been reported time and time again that inmates have greater health needs than those living in the community, including higher rates of Hepatitis C, HIV/AIDS, mental health issues and substance use disorder. There is still much we can improve upon in the way we ...


The Role Of Clinical Guidelines In A Managed Long Term Services & Supports Framework, Jessica Carpenter, Jill Morrow-Gorton Jun 2018

The Role Of Clinical Guidelines In A Managed Long Term Services & Supports Framework, Jessica Carpenter, Jill Morrow-Gorton

Commonwealth Medicine Publications

This presentation describes the managed long-term services and supports (MLTSS) national landscape since 2012 as well as some LTSS utilization trends. A key part of the presentation is our MLTSS best practice framework and the role of LTSS clinical guidelines in that framework. The presentation includes a case study.

Experts from Disability Community Services and the Office of Clinical affairs gave the presentation during a webinar hosted by the Association for Community Affiliated Plans.