Medicine and Health Sciences Commons^™

What's Happening: September, 2007, Maine Medical Center

What's Happening

No abstract provided.

Medicare's Use Of Risk Adjustment, Gerald F. Kominski

National Health Policy Forum

Medicare accounts for expected differences in resource needs of patients or health plan enrollees by risk-adjusting the payments it makes to health care facilities, such as hospitals, skilled nursing facilities, and home health agencies, and the premiums it pays to health plans. Risk adjustment is intended to ensure that payments or premiums are adequate for patients or plan enrollees who require more resources than average in order to protect beneficiary access as well as the financial condition of the provider or plan. At the same time, risk adjustment lowers payments or premiums for beneficiaries who are expected to use fewer …

Medicaid And State Budgets: Clearing Storm, Foggy Forecast, Courtney Burke

National Health Policy Forum

This issue brief examines the recent history and trends in state budgets and considers how those trends have influenced the role of the Medicaid program. The paper offers several indicators for predicting the future of states’ fiscal standing, cautioning that, although the “stormy” period from 2001 to 2003 is over, states face many challenges in the near future. This issue brief also poses several questions regarding the appropriate roles of state and federal governments in administering the Medicaid program. These questions become particularly important as the population ages and states increasingly take the lead in developing solutions for covering the …

Community-Based Long-Term Care: Wisconsin Stays Ahead, Judith D. Moore, Carol O'Shaughnessy, Lisa Sprague

National Health Policy Forum

This report describes a site visit to Wisconsin in August 2007 that focused on the use of home and community-based services, both public and private, to delay or avoid the need for institutional care. Wisconsin was chosen because it has long been a leader among states in developing such services for the elderly and persons with disabilities. At the time of the visit, a managed long-term care program, Family Care, was operating on a pilot basis in five counties. The Partnership Program, a four-site demonstration integrating acute and long-term care for the dual eligible population (both frail elderly and younger …

Shrinking Inpatient Psychiatric Capacity: Cause For Celebration Or Concern?, Eileen Salinsky, Christopher Loftis

National Health Policy Forum

This issue brief examines reported capacity constraints in inpatient psychiatric services and describes how these services fit within the continuum of care for mental health treatment. The paper summarizes the type and range of acute care services used to intervene in mental health crises, including both traditional hospital-based services and alternative crisis interventions, such as mobile response teams. It reviews historical trends in the supply of inpatient psychiatric beds and explores the anticipated influence of prospective payment for inpatient psychiatric services under Medicare. The paper also considers other forces that may affect the need for and supply of acute mental …

What's Happening: August, 2007, Maine Medical Center

What's Happening

No abstract provided.

Health Information Technology Adoption Among Health Centers: A Digital Divide In The Making?, Adil Moiduddin, Daniel S. Gaylin

National Health Policy Forum

This background paper describes the current status of efforts to implement health information technology in community health centers. It summarizes the benefits experienced by health centers that have pioneered the use of information technology and examines the challenges that have hindered wider adoption. The paper identifies a range of policy options that have been considered to promote broader use of information technology by health centers.

A Relationship Between Us Healthcare Worker Smallpox Vaccination Rates In 2003 And Presidential Election Results In 2004, F. Matthew Mihelic, David G. Schultz Jr., Melinda R. Mihelic

Faculty Publications

A statistical relationship exists between state per capita smallpox vaccination rates of healthcare workers in 2003 and state presidential election results in 2004. The potential implications of political influence on national biosecurity decision making are discussed.

What's Happening: July, 2007, Maine Medical Center

What's Happening

No abstract provided.

Virtual Community Health Promotion, Richard Crespo

Family and Community Health

The “wiki” and open-source phenomena are transforming the way knowledge is generated and shared around the world. The word wiki is from the Hawaiian term wiki-wiki, which means to do something quickly (1). The term became prominent because of the online encyclopedia Wikipedia (www.wikipedia.org), which now has more than 2 million articles contributed by tens of thousands of people. People in so many fields are using Internet communities that the term wiki has come to refer to an online group that collectively works on a project. In the business world, the wiki concept is called wikinomics (1). Even U.S. spy …

Implementing Lean Six Sigma Methodologies In The Radiology Department Of A Hospital Healthcare System, Jamie Workman-Germann, Heather (Woodward) Hagg

RCHE Publications

Increased focus is being placed on the quality of care provided by Hospitals and Healthcare Systems around the country. Caught in the middle between tightening govenment standards, stricter compliance guidelines for insurance companies, and the basic mission to serve those in need with quality and compassion, hospitals are searching for ways to improve their processes and services for the benefit of all. CT (Computed Tomography - CAT Scan) and MRI (Magnetic Resonance Imaging) services in the hospital radiology departments are revenue generating areas. The reimbursement rates for these services are very high, the scan times (especially in CT) are relatively …

Factors Associated With Integrating Self-Management Support Into Primary Care, Richard Crespo, Molly Shrewsberry

Family and Community Health

Purpose

The purpose of this article is to expand the understanding of self-management support by describing factors that contribute to implementing a comprehensive self-management program in primary care.

Methods

Four rural health centers in medically underserved areas participated in a study to document the implementation of a self-management program. This program consisted of a social marketing plan and decision-making tools to guide patients in making self-management behavior changes. The stages of change constructs of the transtheoretical model were used to design the social marketing plan. Key informant interviews were conducted at 6-month and 9-month intervals to document the implementation process. …

Trading Places: Real Choice Systems Change Grants And The Movement To Community-Based Long-Term Care Supports, Cynthia Shirk

National Health Policy Forum

The Real Choice Systems Change grant program was created to help states transform their long-term care service systems from ones that rely on institutions to ones that are more community-based. The grants are intended to help states develop the infrastructure needed for seniors and individuals with disabilities to live in integrated community settings. This issue brief provides information about Systems Change grants and the kinds of activities state Medicaid agencies have undertaken to transform their institutionally based systems. In addition, this paper reports on some of the qualitative and quantitative responses to the changes. This brief also raises critical policy …

The Prescription Drug Safety Net: Access To Pharmaceuticals For The Uninsured, Jack Hoadley

National Health Policy Forum

This background paper provides an overview of organized programs that provide access to prescription drug products for uninsured persons, with an emphasis on manufacturer-sponsored pharmacy assistance programs (PAPs) and the federal 340B drug pricing program. It summarizes the chief characteristics of these programs and reviews concerns regarding the reach and efficiency of these efforts. The paper begins with a brief examination of the number of people who lack insurance coverage for prescription drugs and discusses the influence of this gap in coverage on health status. The paper also describes informal mechanisms providers frequently use to help uninsured patients fill their …

What's Happening: May, 2007, Maine Medical Center

What's Happening

No abstract provided.

The Fundamentals Of Health Savings Accounts And High-Deductible Health Plans, Beth Fuchs, Lisa Potetz

National Health Policy Forum

This background paper updates and expands on a previous NHPF document that looked at the fundamentals of health savings accounts (HSAs) and high-deductible health plans (HDHPs), their intellectual and legislative origins, and the ways they work. In addition to updating information on the HDHP/HSA marketplace, this paper presents a description of how the HDHP combined with the HSA works for enrollees. Using a question and-answer format, it then addresses some of the more complicated details of these arrangements, looking first at the HDHPs and then the HSAs. This closer examination suggests some potential policy challenges for lawmakers, the focus of …

What Have You Done For Me Lately? Assessing Hospital Community Benefit, Eileen Salinsky

National Health Policy Forum

This issue brief reviews key aspects of the ongoing policy debate related to not-for-profit hospitals, the advantages they derive from tax exemption, and the benefits they provide to communities served. It provides a historical context for how federal standards for assessing hospitals’ tax-exempt status have evolved and describes recent activities to explore additional policy changes. Legislative and regulatory actions at the state and local level are also examined. Evidence on the performance of not-for-profit hospitals in comparison to their for-profit competitors on measures of cost, quality, and access is summarized, and perspectives on the need to preserve a not-for-profit presence …

Review Of Access And Quality Of Care In Schip Using Standardized National Performance Measures, Terence A. Partridge

National Health Policy Forum

The State Children's Health Insurance Program (SCHIP) has proven to be a critical addition to public coverage programs for low-income children since its inception ten years ago. Tracking the number of children enrolled, however, is only part of the story. This technical paper reviews access and quality for children enrolled in SCHIP by examining information on four primary and preventive care health measures submitted to the Centers for Medicare & Medicaid Services by states in their 2005 annual reports. The paper concludes that the data examined for this paper indicate that children enrolled in SCHIP are receiving not only coverage …

Competition And Collaboration: The Spirit Of St. Louis, Laura A. Dummit, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum sponsored a site visit to St. Louis, Missouri, on April 3-5, 2007, to consider the relationships between hospitals and physicians—and the degree of alignment in their financial, organizational, and policy goals—as a foundation for a new round of discussions on how to reform the health care system. St. Louis offered an interesting venue for these investigations because it is home to two major medical schools, three large hospital systems, and a physician community dominated by small practices. Site visit participants were able to converse with community, business, medical school, hospital, and physician leaders to learn …

Mapping The Literature Of Health Care Management, Mary K. Taylor, Meseret D. Gebremichael, Cassie Wagner

Articles

Objectives: The research provides an overview of the health care management literature and the indexing coverage of core journal literature.

Method: Citations from five source journals for the years 2002 through 2004 were studied using the protocols of the Mapping the Literature of Allied Health Project and Mapping the Literature of Nursing Project. The productivity of cited journals was analyzed by applying Bradford's Law of Scattering.

Results: Journals were the most frequently cited format, followed by books. Only 3.2% of the cited journal titles from all 5 source journals generated two-thirds of the cited titles. When only the health care …

What's Happening: April, 2007, Maine Medical Center

What's Happening

No abstract provided.

A Case Study Of School Age Female Minority Athletes Who Became Pregnant, Floyd Jones Phd, Jennifer Y. Mak, Phyllis A. Jones Ed

Management Faculty Research

The purpose of this study is to provide an in-depth understanding of ''What had happened to the urban minority female athletes who became pregnant while playing high school basketball?'' The study wanted to provide a qualitative analysis of rich narrative data collected from questionnaire interviews of two separate groups (one in Pittsburgh, the other in New York City). The findings of this study suggest that in fact urban female African-Americans athletes still received benefits from sports participation.

A Two-Hour Basketball Practice Increases Landing Error Scoring System Scores In Female Collegiate Basketball Players, Caroline Wesley

Undergraduate Theses and Capstone Projects

The high rate of knee injuries in women’s athletics has been well documented in recent years. There are multiple factors which contribute to the increased risk of injury in female athletes, including biomechanics when landing. Fatigue has also been examined as a contributing factor to injury, but few studies have utilized actual sport participation as a fatiguing protocol. No study has used the Landing Error Scoring System (LESS) to examine the changes that may result from fatigue. The objective of our study was to use the LESS to examine the effects of a two-hour basketball practice on the landing biomechanics …

Health Care Price Transparency And Price Competition, Mark Merlis

National Health Policy Forum

Growing numbers of consumers are in health plans that give them incentives to be more cost-conscious. Yet complex pricing systems and limited information may make it hard to choose among providers and treatment options. This report examines steps that insurers and others have taken to make better price information available, possible government measures to further promote price transparency or to simplify price comparisons, and the likely effects on consumer behavior and provider competition.

Fairfax County's Commitment: A Housing And Health Continuum For Seniors, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-day site visit focused on the range of services made available to seniors by Fairfax County, Virginia, including senior centers, adult day health care, and assisted living and independent housing. Services to low-income residents were emphasized. Participants were introduced to the different agencies and funding streams involved and were able to observe how county officials have acted on a stated commitment to help seniors who wish to age in place, staying in the county and in their own homes rather than in a nursing home or other institution. The day included tours of two Fairfax County multiservice sites, in …

Medical Malpractice Reform: A Societal Crisis Or Fear Marketing?, Phil Rutsohn, Andrew Sikula Sr.

Management Faculty Research

This paper explores the primary issues surrounding the malpractice crisis currently facing the healthcare system and asks the question ‘is it truly a crisis or is it an effective marketing campaign waged by interested parties?’ The authors discuss the primary issues presented by both the supporters of tort reform and the opposition to tort reform. As is true for many issues in healthcare, final analysis suggests that tort reform is needed or not needed depends on the analysts' role in the system. The authors argue that the evidence suggests malpractice reform will produce desired results if the goal is to …

What's Happening: March, 2007, Maine Medical Center

What's Happening

No abstract provided.

Adaptation Of Lean Methodologies For Healthcare Applications, Heather (Woodward) Hagg, Deanna Suskovich, Jamie Workman-Germann, Susan Scachitti, Brian Hudson, Joseph Swartz, Chris Vanni

RCHE Publications

Lean and Six Sigma quality concepts and terminology have been applied in the manufacturing arena since the late 1980’s and early 1990’s. It has only been in recent years that healthcare administrators have identified these methods as being adaptable to their organizations so that they may realize organizational improvements for continuing success and delighting customers. Unfortunately, this is not an application that is widely taught in typical Industrial Engineering curriculum and therefore there are few educated professionals coming right out of college that are able to apply these principles to healthcare. There are however, many experienced professionals knowledgeable in the …

What's Happening: February, 2007, Maine Medical Center

What's Happening

No abstract provided.

Inside Unlv, Diane Russell, Shane Bevell, David Ashley, Lori Bachand, Grace Russell, Mamie Peers

Inside UNLV

No abstract provided.