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Full-Text Articles in Medicine and Health Sciences

Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen P. Mays Nov 2014

Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen P. Mays

Health Management and Policy Presentations

In this paper we estimate the causal impact of state Medicaid enrollment expansions and expenditures on state and local resources allocated to other public health programs and services. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.


Geographic Variation In The Delivery Of High-Value Public Health Services: Exploring Causes & Consequences, Glen P. Mays Nov 2014

Geographic Variation In The Delivery Of High-Value Public Health Services: Exploring Causes & Consequences, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. The Multi-network Practices and Outcomes Variation Examination Study (MPROVE), uses the infrastructure of six Public Health Practice-Based Research Networks (PBRNs) across the U.S. to develop and validate a “starter set” of measures and to analyze geographic variation delivery across diverse public …


How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays Oct 2014

How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays

Health Management and Policy Presentations

Research on the health and economic impact of public health strategies can help newly evolving health care delivery systems focus on upstream health determinants and make evidence-informed decisions about resource allocation across the prevention-treatment spectrum. Examples from research underway in the U.S. have particular relevance for Canada's evolving regional health authorities and their integrated approaches to medical care and public health delivery.


Tougher Than Rocket Science, Or Just Messier? Using Research To Improve U.S. Public Health Delivery, Glen P. Mays Oct 2014

Tougher Than Rocket Science, Or Just Messier? Using Research To Improve U.S. Public Health Delivery, Glen P. Mays

Health Management and Policy Presentations

Advances in the field of public health services & systems research (PHSSR) are incorporating complexity in theory and methods to derive strong inferences about the health and economic effects attributable to public health strategies. Opportunities for comparative international research in Canada and the U.S. promise to strengthen these avenues of inquiry.


Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays Oct 2014

Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays

Health Management and Policy Presentations

Heterogeneity in the mechanisms used for organizing and financing public health strategies creates opportunities for comparative effectiveness research (CER) in public health that examine which organization and financing mechanisms work best, for whom, and under what circumstances. Findings from these types of studies have direct utility in shaping public health policy and practice decisions.


Governmental Public Health And The Economics Of Adaptation To Population Health, Glen P. Mays Oct 2014

Governmental Public Health And The Economics Of Adaptation To Population Health, Glen P. Mays

Health Management and Policy Presentations

Research on the organization and financing of public health strategies offers valuable insight for governmental public health agencies seeking to adapt to a population health improvement perspective under health system reform.


Laboratories And The Value Stream Of Next-Generation Public Health, Glen P. Mays Oct 2014

Laboratories And The Value Stream Of Next-Generation Public Health, Glen P. Mays

Health Management and Policy Presentations

Public health laboratories are the information engines for public health agencies and delivery systems. Measuring the value stream that flows from this information can support objective assessments of the health and economic benefits attributable to laboratory infrastructure and information.


Infectious Diseases, Bert Chapman Jul 2014

Infectious Diseases, Bert Chapman

Libraries Faculty and Staff Scholarship and Research

Provides information about the role of infectious diseases in the early years of U.S. History, with particular emphasis on how they impacted injuries sustained in military conflict.


Does Medicaid Crowd Out Other Public Health Spending? Projecting Aca’S Health & Economic Effects, Glen P. Mays Jun 2014

Does Medicaid Crowd Out Other Public Health Spending? Projecting Aca’S Health & Economic Effects, Glen P. Mays

Health Management and Policy Presentations

Research Objective: Twenty-six states are expanding Medicaid eligibility under the Affordable Care Act (ACA) in 2014, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who newly enroll in Medicaid in response to ACA’s expanded outreach and enrollment incentives. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to …


How Will Public Health And Primary Care Come Together In Massachusetts?, Javier Crespo May 2014

How Will Public Health And Primary Care Come Together In Massachusetts?, Javier Crespo

Public Affairs Capstones Collection

The Patient Protection and Affordable Care Act aims to place public health and prevention practice closer to the clinical care delivery system by mandating basic preventive services and creating a national prevention plan. The Massachusetts health care system has a number of elements that can help foster closer linking of public health practices in the primary care setting. This research set out to examine whether the current healthcare system in Massachusetts will enable public health and primary care integration as intimated upon by the Affordable Care Act. This study will assess the current connection between public health and primary care …


Maximizing Roi: Laboratories And The Value Of Next-Generation Public Health, Glen P. Mays May 2014

Maximizing Roi: Laboratories And The Value Of Next-Generation Public Health, Glen P. Mays

Health Management and Policy Presentations

Laboratories serve as information engines for the public health enterprise, and their importance to population health improvement is likely to grow considerably under U.S. health reform. This session will examine the changing landscape of public health responsibilities within a reforming U.S. health system, and the current and potential roles for public health laboratories in improving the health and economic value of investments in public health. The session examines key changes in the organization, financing, and delivery of public health services that are occurring through innovations to better integrate public health and medical care delivery, and the current and potential roles …


Public Health Services & Systems Research And The Reforming U.S. Health System, Glen P. Mays May 2014

Public Health Services & Systems Research And The Reforming U.S. Health System, Glen P. Mays

Health Management and Policy Presentations

This session reviews progress in the field of public health services & systems research (PHSSR), with a specific focus on findings that can inform the implementation and impact of health reform strategies on the U.S. public health system.


Public Health Services & Systems Research: Taking The Pulse Of The Field, Glen P. Mays Apr 2014

Public Health Services & Systems Research: Taking The Pulse Of The Field, Glen P. Mays

Health Management and Policy Presentations

New research is continuing to reveal pathways for improving health and reducing health disparities at reasonable costs through multi-sector public health strategies.


Creating Learning Systems: Lessons From Public Health Practice-Based Research Networks, Glen P. Mays Apr 2014

Creating Learning Systems: Lessons From Public Health Practice-Based Research Networks, Glen P. Mays

Health Management and Policy Presentations

Practice-based research networks (PBRNs) provide powerful mechanisms for implementing research studies that evaluate the health and economic effects of delivery system innovations. This presentation reviews strategies, emerging findings, and lessons learned from PBRNs and related studies conducted in U.S. public health settings. We give special focus to studies that examine multi-organizational and cross-sectoral strategies for population health improvement.


The Public Health Pbrn Program: A Status Update, Glen P. Mays Apr 2014

The Public Health Pbrn Program: A Status Update, Glen P. Mays

Health Management and Policy Presentations

As of 2014 the Robert Wood Johnson Foundation's Public Health Practice-Based Research Networks Program has engaged more than 1600 U.S. public health agencies in research production and application, generating more than 60 ongoing and completed empirical studies, 70 peer-reviewed publications, and 200 presentations and professional and scientific meetings.


Strengthening The Science Of Public Health Delivery: Complexities In Implementation, Inference & Translation, Glen P. Mays Mar 2014

Strengthening The Science Of Public Health Delivery: Complexities In Implementation, Inference & Translation, Glen P. Mays

Health Management and Policy Presentations

Delivery systems for public health programs and policies are diffuse and heterogeneous across the U.S., reflecting wide variation in the capacity to implement population-level health improvement strategies. This lecture examines strategies for evaluating the causes and consequences of variation in public health delivery across the U.S., with a focus on identifying pathways for improving the health and economic effects of policy and practice.


The Status Of Public Health Services & Systems Research In The Us: Implications For British Columbia, Glen P. Mays Feb 2014

The Status Of Public Health Services & Systems Research In The Us: Implications For British Columbia, Glen P. Mays

Health Management and Policy Presentations

Research on the organization, financing, and delivery of public health services has accelerated in the U.S. in recent years. This applied scholarship has been fueled in part by the changes and natural experiments created by global economic recession and by comprehensive federal and state health reforms. Co-occuring changes in public health organization and financing have occurred in Canada and more specifically in British Columbia, where valuable scholarship on public health delivery is also underway. This presentation reviews the progress and current directions of PHSSR scholarship in the U.S., and identifies opportunities and implications for British Columbia.