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Full-Text Articles in Medicine and Health Sciences
The Economics Of Implementing Population Health Strategies, Glen P. Mays
The Economics Of Implementing Population Health Strategies, Glen P. Mays
Glen Mays
Successful strategies to scale up and spread complex community-level interventions require an understanding of the resources required for implementation, how best to distribute them among supporting institutions, and how resource consumption and distribution varies across settings. This session reviews methods and early findings from the RWJF’s Public Health Delivery and Cost Studies (DACS) Initiative, which includes 12 inter-related studies examining the causes and consequences of variation in the costs of delivering complex community-level prevention strategies across more than 300 community settings in 12 states. Findings from these studies highlight the value of studying the economics of implementation, the measurement and …
Opportunities And Future Directions For The National Health Security Preparedness Index, Glen P. Mays
Opportunities And Future Directions For The National Health Security Preparedness Index, Glen P. Mays
Glen Mays
This presentation examines options and opportunities for future development of the National Health Security Preparedness Index, created through a partnership of national public health and health care organizations led by the U.S. Centers for Disease Control and Prevention (CDC) and the Association of State and Territorial Health Officials (ASTHO).
The Dynamics Of Medicaid & Public Health Spending: Implications For Aca Implementation, Glen P. Mays
The Dynamics Of Medicaid & Public Health Spending: Implications For Aca Implementation, Glen P. Mays
Glen Mays
We estimate the dynamics and interactions of governmental spending on Medicaid and other public health services in all 50 states over a 15 year period. 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.
Aca Implementation In Kentucky: Experiences Of An Expansion State, Glen P. Mays
Aca Implementation In Kentucky: Experiences Of An Expansion State, Glen P. Mays
Glen Mays
Kentucky's implementation of the Affordable Care Act has included early successes with insurance coverage expansion through Medicaid and a state-operated health insurance exchange. Signals of improvements in health care accessibility and delivery of preventive services are evident in the first year after coverage expansions. Challenges associated with political opposition, delivery system transformation, and public health financing remain on the state's policy agenda.
Geographic Variation In The Delivery Of High-Value Public Health Services:Exploring Causes & Consequences, Glen P. Mays
Geographic Variation In The Delivery Of High-Value Public Health Services:Exploring Causes & Consequences, Glen P. Mays
Glen Mays
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 …
Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen Mays
Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen Mays
Glen Mays
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.
Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays
Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays
Glen Mays
This lecture reviews the evidence concerning the institutional and economic characteristics of public health delivery systems and their impact on population health. Emerging findings from these studies suggest promising pathways for transforming the U.S. public health system in ways that strengthen its effectiveness, efficiency and equity in producing health. .
Value And Cost-Effectivess Of Community Health Worker Programs: Implications For Home Care Workers, Glen P. Mays
Value And Cost-Effectivess Of Community Health Worker Programs: Implications For Home Care Workers, Glen P. Mays
Glen Mays
This presentation reviews studies on the health and economic value of strategies to improve the coordination of medical care, public health, and social support services for high-need and high-risk populations. Community health worker (CHW) programs feature prominently in these strategies, particularly for rural and low-resource community settings. Home care workers have the potential to function as CHWs in many settings, and as such present powerful opportunities for scaling up CHW programs that connect medical care, public health, and social services delivery.
Ending Failures, Showing Results, Improving Population Health:Insights From Research & Reform In The U.S., Glen P. Mays
Ending Failures, Showing Results, Improving Population Health:Insights From Research & Reform In The U.S., Glen P. Mays
Glen Mays
A growing body of empirical research supports the value of aligning the delivery systems for public health, medical care, and social services for populations with shared needs and risk factors. This presentation reviews selected studies from the field of public health services & systems research (PHSSR) in the U.S. that suggest pathways for achieving greater system alignment in the Canadian context.
How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays
How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays
Glen Mays
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 Improveu.S. Public Health Delivery, Glen P. Mays
Tougher Than Rocket Science, Or Just Messier? Using Research To Improveu.S. Public Health Delivery, Glen P. Mays
Glen Mays
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.
Implementation Of The Affordable Care Act: Kentucky Round I Field Network Study Results, Julia Costich, Glen P. Mays
Implementation Of The Affordable Care Act: Kentucky Round I Field Network Study Results, Julia Costich, Glen P. Mays
Glen Mays
This multi-state field study uses a large interdisciplinary network of policy and services researchers to examine and compare the implementation of the Affordable Care Act (ACA) in states across the US. This first field report for Kentucky examines key design and decision-making factors for the ACA's coverage expansion components.
How Will Public Health And Primary Care Come Together In Massachusetts?
How Will Public Health And Primary Care Come Together In Massachusetts?
Javier Crespo
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 …