Medicine and Health Sciences Commons^™

Got Junk? The Federal Role In Regulating “Competitive” Foods, Eileen Salinsky

National Health Policy Forum

A wide variety of food and beverage items are available in schools in addition to the school meals provided through the National School Lunch Program and School Breakfast Program. A long-standing source of controversy, the need for stronger federal restrictions on foods that compete with school meals is again under debate. This issue brief examines the availability and consumption of competitive foods, explores the regulation of these foods at the federal level, considers trends in state and local restrictions, and summarizes perceived barriers to improving the nutritional quality of competitive food options.

No Free Lunch? Current Challenges Facing The National School Lunch And School Breakfast Programs, Eileen Salinsky

National Health Policy Forum

This background paper describes important characteristics of the National School Lunch Program and the School Breakfast Program, reviews U.S. Department of Agriculture rules regarding the nutritional content of school meals, and examines compliance with current nutrition standards. It also considers the dietary status and obesity risk of meal program participants, discusses proposed improvements to nutritional standards and meal requirements, and highlights key legislative issues.

The Role Of Ombudsmen In Assuring Quality For Residents Of Long-Term Care Facilities: Straining To Make Ends Meet, Carol O'Shaughnessy

National Health Policy Forum

Assuring quality of care for residents in long-term care facilities has been a serious and continuing concern of policymakers for decades. The Older Americans Act’s long-term care ombudsman program is a consumer advocacy model intended to improve quality of care by helping the 2.5 million residents of almost 67,000 nursing and other residential care facilities resolve complaints about their care and protect their rights. Despite broad recognition of its value in assisting residents and its efforts to complement federal and state oversight of long-term care facilities, some observers are concerned about the program’s ability to meet its legislative mandates. Limited …

No Powerpoint? Whatever Loys Your Krathong ..., Kimberly D. Acquaviva

National Collaborative on Aging Faculty Publications

The author discusses her experiences teaching a workshop on writing for publication to medicine, nursing and public health faculty in Thailand, without using PowerPoint.

State Medicaid Coverage Of Perinatal Services: Summary Of State Survey Findings, Usha Ranji, Alina Salganicoff, Alexandra M. Stewart, Marisa A Cox, Lauren Doamekpor

Health Policy and Management Faculty Publications

No abstract provided.

Helping Immigrant And Refugee Students Succeed: It's Not Just What Happens In The Classroom, Eileen Kugler, Olga Acosta Price

Center for Health and Health Care in Schools

No abstract provided.

Information Interface - Volume 37, Issue 4 - November/December 2009, George Washington University, Himmelfarb Health Sciences Library

Information Interface (1976 - 2009)

News and information about Himmelfarb Health Sciences Library of interest to users. Includes articles on the PubMed redesign, 2010 Journal Collection, and mobile resources.

Using Primary Care To Bend The Cost Curve: The Potential Impact Of Health Center Expansion In Senate Reforms, Leighton C. Ku, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This analysis of reforms being considered in the United States Senate reaches conclusions similar to those of our prior analyses of reforms being considered in the House of Representatives. The combination of expanded health insurance coverage and investments in the expansion of community health centers can produce substantial long-term savings both for the overall health care system and for the federal government. Our analysis of the Senate provisions from the HELP and Finance Committees estimates $369 billion in total medical savings, including $105 billion in federal Medicaid savings. The Senate provisions produce larger savings because they authorize larger funding increases …

Estimating The Economic Gains For States As A Result Of Medicaid Coverage Expansions For Adults, Peter Shin, Leighton C. Ku, D. Richard Mauery, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This policy research brief examines the Medicaid eligibility expansions under the pending legislative proposals, including the House Tri-Committee bill, the Senate Health, Education, Labor and Pensions Committee bill and the Senate Finance Committee bill. Using new Census Bureau data, the researchers find that under both the House and Senate Finance Committee proposals, about 9.6 million nonelderly adults would gain Medicaid eligibility by 2014. Furthermore, the federal and state expenditures are less than Medicaid's positive impact on the economy amounting in a return of three dollars in new business activities for every dollar of state Medicaid investment. Because Medicaid is designed …

Antidepressant-Induced Mania With Concomitant Mood Stabilizer In Patients With Comorbid Substance Abuse And Bipolar Disorder., Daniel Z Lieberman, George Kolodner, Suena H Massey, Kenneth P Williams

Psychiatry and Behavioral Sciences Faculty Publications

Antidepressant use in the treatment of bipolar disorder is controversial due the risks of affective switching and cycle acceleration. Studies of non-comorbid samples suggest that the risk can be mitigated with the use of a concomitant mood stabilizer. However, the majority of patients with bipolar disorder will experience a comorbid substance use disorder and little is known about these individuals because they are typically excluded from clinical trials. Patients entering a substance abuse treatment program who had a history of bipolar disorder were interviewed to evaluate antidepressant-induced affective switching with and without concomitant mood stabilizer. Among 41 comorbid participants, the …

Implementing A Mandated Space Change: The Unexpected Benefits To Library Systems, Kathe Obrig, Lionel Williams, Leah Pellegrino, Jennifer Mcdaniel, George P. Paul

Himmelfarb Library Faculty Posters and Presentations

In September 2008, the Himmelfarb Health Sciences Library received a mandate to convert the second floor to quiet study space. The conversion involved the removal of the 70,000-volume bound journal collection. This poster presentation illustrates the steps taken to complete the collection relocation and describes the unexpected, beneficial results of this space change.

Libguides: A New Platform For Customized Resource Delivery, Alexandra Gomes, Cynthia Kahn

Himmelfarb Library Faculty Posters and Presentations

In fall 2009, the librarians of the Himmelfarb Health Sciences Library launched the initial set of online LibGuides for the School of Public Health and Health Services. This poster presentation describes the planning, completion, and launching of those LibGuides.

Creating And Using An Access Database To Enhance Subject Analysis And Obtain Faculty Input About The Journals Collection, Laura E. Abate, Yvonne Lee, Kathe Obrig, George P. Paul, Lionel Williams, Semhar Yohannes

Himmelfarb Library Faculty Posters and Presentations

Using Microsoft Access, Himmelfarb Health Sciences Library developed a database for all of its title-level journal holdings to assess and enhance its journal collection.

Innovations In Instruction: Use Of Blogs & Clickers To Solicit Real-Time Responses, Laura E. Abate, Alexandra Gomes, Anne Linton

Himmelfarb Library Faculty Posters and Presentations

Seeking to enhance student interactivity and provide real-time feedback in the area of medical informatics, the Himmelfarb Health Sciences Library developed a series of interactive blogs and clickers. This poster presents the methods and results of using blogs and clickers to increase students' interest in the field of medical informatics.

Discovering Library Resources Using Webfeat Express: Selection, Implementation, And Lessons Learned, Elizabeth Palena Hall, Alexandra Gomes, Kathe Obrig, Laura E. Abate, Leah Pellegrino, Jolinda Thompson

Himmelfarb Library Faculty Posters and Presentations

In 2006, Himmelfarb Health Sciences Library developed a task force to seek out a federated searching system. This poster presentation summarizes the process of selection and implementation of the chosen federated searching system, WebFeat Express.

Using Primary Care To Bend The Curve: Estimating The Impact Of A Health Center Expansion On Health Care Costs, Leighton C. Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This research brief, the third in a series examining the link between national health reform proposals and community health centers, estimates the cost savings that would be realized by making important investments in non-profit health centers as an element of national health reform. Key findings include:

Increasing health center capacity by another 20 million patients by 2019 (to 39 million patients) under health reform can be expected to generate an additional $35.6 billion savings in 2019 and $212 billion in additional savings over the 2010-2019 ten-year time period.

Were the Medicaid prospective payment rate system to be applied to exchange …

Coverage And Payment For Prescription Drugs Under Medicare Part B: A Complex Patchwork, Amanda Cassidy

National Health Policy Forum

As part of the diverse discussions around health care reform, many have looked to refining Medicare payment systems as a way to give health care practitioners and providers greater incentives to deliver care more efficiently, and thus slow health care spending growth. Understanding how Medicare currently pays for Part B services, including drugs covered under Part B, is essential to understanding the potential impact of these types of reforms. Most items and services covered under Part B, including most Part B drugs, are paid individually, which means practitioners and providers generally receive more payments for providing more services. Some reform …

Stimulus Bill Implementation: Expanding Meaningful Use Of Health It, Rob Cunningham

National Health Policy Forum

The American Recovery and Reinvestment Act authorizes an estimated $38 billion in incentives and supports for health information technology (IT) from 2009 to 2019. After years of sluggish health IT adoption, this crisis-driven investment of public funds creates a unique opportunity for rapid diffusion of a technology that is widely expected to improve care, save money, and facilitate transformation of the troubled U.S. health system. Achieving maximal effect from the stimulus funds is nevertheless a difficult challenge. The Recovery Act strengthens the federal government’s leadership role in promoting health IT. But successful adoption and utilization across the health system will …

Health Center Data Warehouses: Opportunities And Challenges For Quality Improvement, A. Seiji Hayashi, Emily Jones, David M. Stevens, Peter Shin, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This Policy Research Brief reports on a pilot effort to leverage the growing presence of health center data warehouses to advance health care quality improvement through data sharing and exchange. This project builds on a partnership between the Michigan Primary Care Association and The George Washington University's Geiger Gibson/RCHN Community Health Foundation Research Collaborative that centers on developing approaches to using existing health center data for quality improvement.

Information Interface - Volume 37, Issue 3 - August/September 2009, George Washington University, Himmelfarb Health Sciences Library

Information Interface (1976 - 2009)

News and information about Himmelfarb Health Sciences Library of interest to users. Includes articles on the second floor renovations, Psychiatry Portal, and customized research guides.

The Medicare Drug Benefit: Update On The Low-Income Subsidy, Mary Ellen Stahlman

National Health Policy Forum

The Medicare drug benefit (Medicare "Part D"), provides federal subsidies to pay premiums and cost sharing for low-income beneficiaries—almost 10 million in 2009. Yet there are several policy issues concerning these low-income beneficiaries under Part D. First, over 2 million individuals who may qualify for the subsidies have not enrolled. Second, in some states, low-income beneficiaries have little choice of plans (while non-low-income beneficiaries have dozens of choices), unless they pay out-of-pocket for premium amounts above what the subsidy covers. And third, millions of those who have enrolled in the benefit face the prospect each year of switching drug plans …

Community Health Centers In Indiana: State Investments And Returns, Avi Dor, Patrick Richard, Ellen Tan, Sara J. Rosenbaum, Peter Shin, Lee Repasch

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Indiana Community Health Centers (I-CHC), including Federally Qualified Health Centers (FQHCs) and State Funded Health Centers (SFHCs), play a vital role in caring for the state's most vulnerable populations. Although their patient base tends to be poorer and experience greater health challenges than the general population, these health centers have generated substantial health care savings while providing high quality, low cost care. In this brief, key findings are presented from a recent study, conducted for the Indiana State Department of Health by GWU faculty and staff that was designed to estimate the cost savings and benefits generated by the state's …

Estimating The Effects Of Health Reform On Health Centers' Capacity To Expand To New Medically Underserved Communities And Populations, Leighton C. Ku, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Nearly 100 million persons reside in urban and rural communities that can be considered medically underserved as a result of inadequate supply of primary care physicians and elevated health risks. A report by the National Association of Community Health Centers and the Robert Graham Center estimated that 60 million people are "medically disenfranchised" and lack access to adequate primary health care because of where they live, even though many have health insurance. This brief assesses the potential effects of national health reform on health centers and on the number of patients they can serve. Because improving primary care access is …

National Health Reform: How Will Medically Underserved Communities Fare?, Sara J. Rosenbaum, Emily Jones, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This brief examines the factors underlying medical underservice. It finds that the number of Americans living in communities at risk for medical underservice is more than double the number of persons who are uninsured. The report notes that even with health insurance reform, these communities and providers that serve them will continue to be affected by elevated numbers of low income uninsured persons, as well as persons who may be seriously under-insured because of poorer health status and lower family income.

Describing health insurance expansion as the single most important strategy to alleviate medical underservice, the Brief also identifies a …

Boosting Health Information Technology In Medicaid: The Potential Effect Of The American Recovery And Reinvestment Act, Brad Finnegan, Leighton C. Ku, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The American Recovery and Reinvestment Act of 2009 (ARRA) will invest approximately $49 billion to expedite health information technology (HIT) adoption through Medicare and Medicaid. Our analysis of 2006 NAMCS data found that approximately 15 percent of the practicing office-based physicians in the country would qualify for up to $63,750 over six years in Medicaid financial incentives for HIT adoption. Included within the 45,000 eligible physicians are about 99 percent of all community health center physicians. If all qualifying physicians apply for the Medicaid incentives and receive the maximum level of payments, the federal government would invest more than $2.8 …

A Health Insurance Exchange: Prototypes And Design Issues, Mark Merlis

National Health Policy Forum

Many reform proposals call for the creation of one or more health insurance exchanges, intermediaries that can help individuals or small employers navigate the insurance market. An exchange might be public or private, national, or local. It might serve simply as a clearinghouse for plan information or could play an active role in setting benefit packages, choosing high-quality plans, and negotiating premium rates. This paper begins with a summary of recent experience with insurance exchanges and similar systems. It then reviews basic issues in the design of an exchange.

Underwriting In The Non-Group Health Insurance Market: The Fundamentals, Kathryn Linehan

National Health Policy Forum

Non-group health insurance is coverage that individuals purchase on their own rather than as part of a group. Most states currently permit non-group insurers to underwrite, a process whereby an insurer assesses the health and other characteristics of individuals to determine their likely utilization of health services or risk; insurers then use this assessment to determine whether they will offer coverage and the premium they will charge. Policymakers have identified underwriting and related practices in non-group markets as a target for reform to enable broader access for the currently uninsured. This publication reviews the characteristics of non-group markets and insurers' …

Resilience And Renaissance: Efforts To Rebuild A Healthier New Orleans, Michele J. Orza, Jessamyn Taylor

National Health Policy Forum

The National Health Policy Forum sponsored a site visit to New Orleans, Louisiana, in May 2009 to explore the city's health challenges, which are similar to those faced by other cities but were all greatly exacerbated by Hurricane Katrina and its aftermath. The agenda focused on three themes: primary care and behavioral health services availability and access, public health preparedness, and rebuilding healthier communities. It examined how these themes and others intersect in two distinct communities within New Orleans: the Holy Cross community surrounding the Lower Ninth Ward Center for Sustainable Engagement and Development and the community surrounding the Mary …

Information Interface - Volume 37, Issue 2 - May/June 2009, George Washington University, Himmelfarb Health Sciences Library

Information Interface (1976 - 2009)

News and information about Himmelfarb Health Sciences Library of interest to users. Includes articles on clinical information tools, Healthy DC, and the new GWU Historia Medicinae journal.

The Children's Health Insurance Program (Chip): The Fundamentals, Jennifer Ryan

National Health Policy Forum

This background paper provides a brief overview of the fundamental elements of the Children’s Health Insurance Program (CHIP). CHIP, which served more than 7 million children in federal fiscal year 2008, is a jointly funded federal-state partnership that was originally enacted in 1997 as a complement to the Medicaid program. CHIP is designed to provide health insurance coverage for children in families who earn too much to qualify for Medicaid but cannot afford to purchase private insurance coverage. The program was reauthorized in the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009, which included several changes and additions to …