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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 …
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.
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.
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.
Learning From Networks: Care Transitions, Market Competition, And Community Interventions, Glen P. Mays
Learning From Networks: Care Transitions, Market Competition, And Community Interventions, Glen P. Mays
Glen Mays
Social network analysis methods offer many avenues of inquiry for studying new developments in health policy and health care delivery. The expanding availability of large linkable electronic clinical and administrative data sources allows for novel SNA applications with dependent data structures. Opportunities include the study of delivery patterns within accountable care organizations (ACOs), and other multi-provider networks, price and quality competition within new health insurance exchanges, and population health effects attributable to complex community-level interventions.
Does Medicaid Crowd Out Other Public Health Spending? Projecting Aca’S Health & Economic Effects, Glen P. Mays
Does Medicaid Crowd Out Other Public Health Spending? Projecting Aca’S Health & Economic Effects, Glen P. Mays
Glen Mays
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 …
Public Health Services & Systems Researchand The Reforming U.S. Health System, Glen P. Mays
Public Health Services & Systems Researchand The Reforming U.S. Health System, Glen P. Mays
Glen Mays
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.
Creating Learning Systems: Lessons From Public Health Practice-Based Research Networks, Glen P. Mays
Creating Learning Systems: Lessons From Public Health Practice-Based Research Networks, Glen P. Mays
Glen Mays
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.
Health Reform Implementation: Update And Implications For Kentucky, Glen P. Mays
Health Reform Implementation: Update And Implications For Kentucky, Glen P. Mays
Glen Mays
This talk reviews the progress of health reform implementation in Kentucky with a focus on opportunities for aligning systems for medical care, public health, and social support delivery to improve population health.
Public Health Services & Systems Research Inventory, Ann V. Kelly, Anna G. Hoover, Glen P. Mays
Public Health Services & Systems Research Inventory, Ann V. Kelly, Anna G. Hoover, Glen P. Mays
Glen Mays
This inventory summarizes research projects funded through the Robert Wood Johnson Foundation's Public Health Services & Systems Research (PHSSR) program, including studies supported by the National Coordinating Center for PHSSR, the Public Health Practice-Based Research Networks Program, and the National Network of Public Health Institutes.
Estimating The Costs Of Foundational Public Health Capabilities: A Recommended Methodology, Glen P. Mays
Estimating The Costs Of Foundational Public Health Capabilities: A Recommended Methodology, Glen P. Mays
Glen Mays
The Institute of Medicine’s 2012 report on public health financing recommended the convening of expert panels to identify the components and costs of a “minimum package of public health services” that should be available in every U.S. community. The report recommended that this minimum package include a core set of public health programs that target specific, high-priority preventable health problems and risks, along with a set of “foundational public health capabilities” that are deemed necessary to support the successful implementation of public health programs and policies. In response to this recommendation, the Robert Wood Johnson Foundation, in collaboration with the …
Bibliography Of The Public Health Pbrn Program: 2008-2013., Glen P. Mays
Bibliography Of The Public Health Pbrn Program: 2008-2013., Glen P. Mays
Glen Mays
This report inventories the research products of the Public Health Practice-Based Research Networks (PBRN) Program during its initial six years of development. The Public Health PBRNs comprise state and local public health organizations and university-based research centers that collaborate to study the implementation and impact of novel strategies involving the organization, financing, and delivery of public health strategies. The Robert Wood Johnson Foundation provide primary support for the PBRNs during this initial six-year period.