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Articles 241 - 270 of 514
Full-Text Articles in Health and Medical Administration
Long-Term Services And Supports (Ltss): Arlington County's Integrated Approach, Carol O'Shaughnessy, Lisa Sprague
Long-Term Services And Supports (Ltss): Arlington County's Integrated Approach, Carol O'Shaughnessy, Lisa Sprague
National Health Policy Forum
The National Health Policy Forum sponsored a local site visit looking at community-based aging programs and long-term services and supports (LTSS) in Arlington County, Virginia. Arlington County human services are integrated under an umbrella agency in the Department of Human Services (DHS) which administers multiple programs for the elderly and people with disabilities. These include the Older Americans Act services, Medicaid LTSS, transportation services, a nursing case management program, and mental health services for those living in nursing homes and assisted living facilities. Arlington County integrates its aging and disability programs under the auspices of an Administration on Aging-funded Aging …
Recent Proposals To Limit Medigap Coverage And Modify Medicare Cost Sharing, Kathryn Linehan
Recent Proposals To Limit Medigap Coverage And Modify Medicare Cost Sharing, Kathryn Linehan
National Health Policy Forum
As policymakers look for savings from the Medicare program, some have proposed eliminating or discouraging “first-dollar coverage” available through privately purchased Medigap policies. Medigap coverage, which beneficiaries obtain to protect themselves from Medicare’s cost-sharing requirements and its lack of a cap on out-of-pocket spending, may discourage the judicious use of medical services by reducing or eliminating beneficiary cost sharing. It is estimated that eliminating such coverage, which has been shown to be associated with higher Medicare spending, and requiring some cost sharing would encourage beneficiaries to reduce their service use and thus reduce program spending. However, eliminating first-dollar coverage could …
Older Americans Act Of 1965: Programs And Funding, Carol O'Shaughnessy
Older Americans Act Of 1965: Programs And Funding, Carol O'Shaughnessy
National Health Policy Forum
This document offers a basic description of the Older Americans Act of 1965. The Act is considered the major vehicle for promoting the delivery of social services to the aging population. The Act's seven titles and multiple programs are described, along with a chart showing fiscal year 2012 federal appropriations.
Accountable Care Organizations In The Affordable Care Act, Frank Pasquale
Accountable Care Organizations In The Affordable Care Act, Frank Pasquale
Faculty Scholarship
No abstract provided.
The Aging Services Network: Serving A Vulnerable And Growing Elderly Population In Tough Economic Times, Carol O'Shaughnessy
The Aging Services Network: Serving A Vulnerable And Growing Elderly Population In Tough Economic Times, Carol O'Shaughnessy
National Health Policy Forum
In 1965, Congress enacted the Older Americans Act, establishing a federal agency and state agencies to address the social services needs of the aging population. The mission of the Older Americans Act is broad: to help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly. In successive amendments, the Act created area agencies on aging and a host of social support programs. The "aging services network," broadly described, refers to the agencies, programs, and activities that are sponsored by the Older Americans Act. The Act’s funding for services …
Individual And Small-Group Market Health Insurance Rate Review And Disclosure: State And Federal Roles After Ppaca, Kathryn Linehan
Individual And Small-Group Market Health Insurance Rate Review And Disclosure: State And Federal Roles After Ppaca, Kathryn Linehan
National Health Policy Forum
Oversight of private insurance, including health insurance, is primarily a state responsibility. Each state establishes its own laws and regulations regarding insurer activities, including premium increases for the insurance products within its purview. The authority that state regulators have to review and deny requests for premium changes varies from state to state, as do the amount of resources available to state insurance departments for reviewing premium changes. In some markets where insurers have proposed or implemented steep increases, such changes have received considerable attention from the press, state regulators, and policymakers. The Patient Protection and Affordable Care Act (PPACA) requires …
Aligning Graduate Medical Education With Public Policy, Rob Cunningham
Aligning Graduate Medical Education With Public Policy, Rob Cunningham
National Health Policy Forum
In late May–early June 2011, the Forum sponsored a site visit to Denver, Colorado, to observe innovative efforts to improve the health of Coloradans and reduce the cost of health care. The three-day agenda was designed to convey the breadth and interconnectedness of the efforts underway in Denver and to highlight both successes and challenges. The exploration concentrated on how three themes of national interest are unfolding in Denver: building and sustaining a robust and effective safety net in an evolving health care market; improving the health of people and their communities to prevent and reduce the need for health …
Rocky Mountain Highs And Lows: Efforts To Improve Health And Reduce Costs In Denver, Michele J. Orza, Jessamyn Taylor
Rocky Mountain Highs And Lows: Efforts To Improve Health And Reduce Costs In Denver, Michele J. Orza, Jessamyn Taylor
National Health Policy Forum
In late May–early June 2011, the Forum sponsored a site visit to Denver, Colorado, to observe innovative efforts to improve the health of Coloradans and reduce the cost of health care. The three-day agenda was designed to convey the breadth and interconnectedness of the efforts underway in Denver and to highlight both successes and challenges. The exploration concentrated on how three themes of national interest are unfolding in Denver: building and sustaining a robust and effective safety net in an evolving health care market; improving the health of people and their communities to prevent and reduce the need for health …
Home, But Not Alone: Evidence-Based Maternal, Infant, And Early Childhood Home Visitation, Eileen Salinsky
Home, But Not Alone: Evidence-Based Maternal, Infant, And Early Childhood Home Visitation, Eileen Salinsky
National Health Policy Forum
Home visitation services for young and expectant families have the potential to improve child and parent outcomes in a broad variety of ways, but the effectiveness of home visits may depend on the nature, frequency, and duration of these services. The Patient Protection and Affordable Care Act of 2010 (PPACA) created a new federal funding stream to promote the development and implementation of evidence-based home visiting programs. This issue brief provides an overview of the newly established Maternal, Infant, and Early Childhood Home Visiting program, describes existing approaches to home visitation, and discusses the implications of federal funding for state …
Conflict Management Education In Medicine: Considerations For Curriculum Designers, Jeffery Kaufman
Conflict Management Education In Medicine: Considerations For Curriculum Designers, Jeffery Kaufman
Online Journal for Workforce Education and Development
It is important to address conflict in the medical field for a variety of reasons ranging from reducing turnover to increasing the quality of care received by patients. One way to assist with the management of medical conflict is by teaching resolution techniques to medical personnel. There is an opportunity for conflict management curriculum to address many of the issues facing physicians, administrators, staff and patients, however, it is also necessary for those developing that curriculum to understand the nature of the environment and appropriate conflict management tools to be used in that environment as part of the design process. …
The Hospitalist: Better Value In Inpatient Care?, Lisa Sprague
The Hospitalist: Better Value In Inpatient Care?, Lisa Sprague
National Health Policy Forum
From perhaps a few hundred practitioners in 1996 to an estimated 30,000 today, the discipline called hospital medicine has shown remarkably rapid growth. It represents a fundamental separation of the inpatient and outpatient components of internal and family medicine. The split has implications for the quality and efficiency of care delivery, the outlook for the physician workforce, and the development of new models such as accountable care organizations (ACOs).
Medicare's Bundling Pilot: Including Post-Acute Care Services, Laura A. Dummit
Medicare's Bundling Pilot: Including Post-Acute Care Services, Laura A. Dummit
National Health Policy Forum
Fee-for-service Medicare, in which a separate payment is made for each service, rewards health care providers for delivering more services, but not necessarily coordinating those services over time or across settings. To help address these concerns, the Patient Protection and Affordable Care Act of 2010 requires Medicare to experiment with making a bundled payment for a hospitalization plus post-acute care, that is, the recuperative or rehabilitative care following a hospital discharge. This bundled payment approach is intended to promote more efficient care across the acute/post-acute episode because the entity that receives the payment has financial incentives to keep episode costs …
Nyc Budget Cuts: A Counter-Productive Method To Effective Government-Nonprofit Contracting Relationships?, Anna-Kay Sinclair
Nyc Budget Cuts: A Counter-Productive Method To Effective Government-Nonprofit Contracting Relationships?, Anna-Kay Sinclair
Wilson Center for Social Entrepreneurship
This study examines the relationship between New York City budget cuts and the expenditure of human service nonprofits specifically involved in the government contracting relationship. With a focus on the Department for the Aging (DFTA), I examine nonprofits that provide a variety of services to the aging population on behalf of the DFTA. Correlations and regressions are presented examining the relationship between DFTA budget and nonprofit spending. The results of my analysis do not indicate a positive relationship between these two variables.
Perspective: Massachusetts' Health Care Reform And Emergency Department Utilization, Christopher Chen, Gabriel Scheffler, Amitabh Chandra
Perspective: Massachusetts' Health Care Reform And Emergency Department Utilization, Christopher Chen, Gabriel Scheffler, Amitabh Chandra
Articles
No abstract provided.
Self-Insurance And The Potential Effects Of Health Reform On The Small-Group Market, Kathryn Linehan
Self-Insurance And The Potential Effects Of Health Reform On The Small-Group Market, Kathryn Linehan
National Health Policy Forum
The Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care Education Reconciliation Act of 2010 makes landmark changes to health insurance markets. Individual and small-group insurance plans and markets will see the biggest changes, but PPACA also affects large employer and self-insured plans by imposing rules for benefit design and health plan practices. Over half of workers—most often those in very large firms—are covered by self-insured health plans in which employers (or employee groups) bear all or some of the risk of providing insurance coverage to a defined population of workers and their dependents. As PPACA …
The Elder Justice Act: Addressing Elder Abuse, Neglect, And Exploitation, Carol O'Shaughnessy
The Elder Justice Act: Addressing Elder Abuse, Neglect, And Exploitation, Carol O'Shaughnessy
National Health Policy Forum
Elder abuse, neglect, and exploitation is a social problem that affects older people across all socioeconomic groups and care settings. Although national data on the full extent of the problem are elusive, one study found that 11 percent of older people living in community settings had experienced physical, emotional, or sexual abuse, or potential neglect during one year. Abuse and neglect of residents of nursing facilities and other institutions have been a continuing concern of policymakers and advocates for many years. The Elder Justice Act (EJA), enacted as part of the Patient Protection and Affordable Care Act (PPACA) on March …
Aging And Disability Resource Centers (Adrcs): Federal And State Efforts To Guide Consumers Through The Long-Term Services And Supports Maze, Carol O'Shaughnessy
Aging And Disability Resource Centers (Adrcs): Federal And State Efforts To Guide Consumers Through The Long-Term Services And Supports Maze, Carol O'Shaughnessy
National Health Policy Forum
Since 2003, the U.S. Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS) have made a series of grants to states to develop Aging and Disability Resource Centers (ADRCs). The ADRC program’s purpose is to help people of all ages, disabilities, and income levels more easily access long-term services and supports through single points of entry, make more efficient use of care options, and maximize the services available. Almost $111 million in joint AoA-CMS funding has been devoted to the ADRC initiative since its inception in fiscal year 2003. As of October 2010, 325 ADRC sites …
Premium Assistance: An Update, Cynthia Shirk
Premium Assistance: An Update, Cynthia Shirk
National Health Policy Forum
This background paper explores the use of premium assistance in publicly financed health insurance coverage programs. In Medicaid and the Children’s Health Insurance Program, premium assistance involves using federal and state funds to subsidize premiums for the purchase of private insurance coverage for eligible individuals. This paper reviews the statutory authority for premium assistance, including two new options made available under the Children’s Health Insurance Program Reauthorization Act of 2009. It examines the status of premium assistance programs in the states and offers some insights into how premium assistance programs may fare under the Patient Protection and Affordable Care Act.
The Primary Care Safety Net: Strained, Transitioning, Critical, Jessamyn Taylor
The Primary Care Safety Net: Strained, Transitioning, Critical, Jessamyn Taylor
National Health Policy Forum
This background paper examines the primary care safety net. It describes key primary care safety net providers, including federally qualified health centers, free clinics, local health departments, and safety net hospital outpatient departments and clinics, among others. The paper also explores the changing role of the primary care safety net in a post–health reform marketplace.
High Hopes: Public Health Approaches To Reducing The Need For Health Care, Michele J. Orza
High Hopes: Public Health Approaches To Reducing The Need For Health Care, Michele J. Orza
National Health Policy Forum
Driven in part by a desire to contain health care costs, policymakers are looking beyond medical care for opportunities to reduce the need for expensive services. This paper briefly reviews current public health concepts and strategies for improving health that emphasize nonmedical factors such as behavior, socioeconomic status, and environment. It also provides examples of how these concepts and strategies undergird many of the public health provisions of the Patient Protection and Affordable Care Act, other legislation, and several programs and initiatives. These concepts include prevention, health in all policies, global health, the One Health Initiative, and climate change and …
Governmental Public Health: An Overview Of State And Local Public Health Agencies, Eileen Salinsky
Governmental Public Health: An Overview Of State And Local Public Health Agencies, Eileen Salinsky
National Health Policy Forum
The Patient Protection and Affordable Care Act significantly expands federal support for community prevention and public health. This paper describes the governmental public health infrastructure at both the state and local level in terms of organizational structure, activities, financing, workforce, partnerships, and performance improvement efforts.
Medicare Physician Fees: The Data Behind The Numbers, Laura A. Dummit
Medicare Physician Fees: The Data Behind The Numbers, Laura A. Dummit
National Health Policy Forum
Medicare’s physician fee schedule distributes nearly $60 billion annually and is a critical determinant of individual physicians’ incomes, beneficiaries' access to health care services, and Medicare spending, as well as the basis for physician fees used by many private payers. The Centers for Medicare & Medicaid Services (CMS) relies on data derived from expert judgment and other sources to update the fee schedule. Although CMS’s methods and data for maintaining the fee schedule have improved over the years, concerns remain about medical specialty society involvement and the lack of an effective ”counterweight” to vested interests in establishing and updating the …
Tapping The Potential Of The Health Care Workforce: Scope-Of-Practice And Payment Policies For Advanced Practice Nurses And Physician Assistants, Robert Cunningham
Tapping The Potential Of The Health Care Workforce: Scope-Of-Practice And Payment Policies For Advanced Practice Nurses And Physician Assistants, Robert Cunningham
National Health Policy Forum
Expanding coverage and increasing delivery of team-based care are likely to entail a growing role in the
health system for advanced practice nurses (APNs), physician assistants (PAs), and other nonphysician clinicians. These professions have already grown rapidly and have increased access to primary and specialty care, especially in rural and other underserved areas. This background paper provides an overview of the role of APNs and PAs. It reviews the primary features of the training and credentialing of these health professions, including the impact of public policies and market forces on their growth and deployment. It describes variations in state scope-of-practice …
Keeping Health Insurance After A Job Loss: Cobra Continuation Coverage And Subsidies, Kathryn Linehan
Keeping Health Insurance After A Job Loss: Cobra Continuation Coverage And Subsidies, Kathryn Linehan
National Health Policy Forum
Many Americans under 65 have health insurance through an employer. Beginning in 1985, a federal law known as COBRA required that eligible workers and their dependents have the option to continue employer-based group health coverage when employment is terminated. Because premiums for COBRA coverage can be very expensive, the 111th Congress included provisions in the American Recovery and Reinvestment Act of 2009 (and subsequent legislation) to temporarily subsidize premiums for those who have lost their jobs since September 2008. This issue brief outlines the eligibility rules for COBRA as well as the current COBRA subsidies. It also discusses the possible …
Health Care Shortage Designations: Hpsa, Mua, And Tbd, Eileen Salinsky
Health Care Shortage Designations: Hpsa, Mua, And Tbd, Eileen Salinsky
National Health Policy Forum
A wide variety of federal programs designed to improve access to health care services rely on specific criteria to designate areas and populations eligible for funding and other types of aid. Two related yet distinct designations, the Health Professional Shortage Area (HPSA) and the Medically Underserved Area (MUA), are most commonly used to identify underserved people or places. This background paper reviews the methodologies currently utilized in these designations, identifies the federal programs that use these designations to allocate resources, describes proposals that have been advanced to consolidate and improve these designations, and discusses key issues and challenges for future …
Heath Care Spending: Why Is Miami An Outlier?, Laura A. Dummit, Mary Ellen Stahlman
Heath Care Spending: Why Is Miami An Outlier?, Laura A. Dummit, Mary Ellen Stahlman
National Health Policy Forum
The National Health Policy Forum’s site visit to Miami focused on the complex factors that drive health care spending and is the latest in a series on the dynamics of health care markets. Miami has long been recognized as having among the highest Medicare per capita spending in the country, along with high rates of uninsured, strong managed care presence, and a history of health care fraud. This colorful health care market brings into stark relief many of the reasons for high and growing health care spending across the country. It also highlights several issues involved in building and maintaining …
Physician Assessment: Measuring Competence And Performance, Lisa Sprague
Physician Assessment: Measuring Competence And Performance, Lisa Sprague
National Health Policy Forum
No abstract provided.
Information And Incentives: Improving The Health Of New York City's Low-Income Population, Kathryn Linehan, Lisa Sprague
Information And Incentives: Improving The Health Of New York City's Low-Income Population, Kathryn Linehan, Lisa Sprague
National Health Policy Forum
The National Health Policy Forum sponsored a site visit to New York City (NYC) in April 2010 to explore health care delivery for Medicaid beneficiaries and the uninsured in New York City’s hospital-dominated market. New York offers real-time examples of government policy and provider initiatives in health information technology (IT) and quality improvement being played out on a large, complex, and dynamic stage with multiple stakeholders. Site visit participants heard from providers and others who discussed efforts to improve the quality of care for low-income New Yorkers through a variety of methods, such as the adoption and use of electronic …
The State Health Insurance Assistance Program (Ship), Carol O'Shaughnessy
The State Health Insurance Assistance Program (Ship), Carol O'Shaughnessy
National Health Policy Forum
The State Health Insurance Assistance Program (SHIP), created by section 4360 of the Omnibus Budget Reconciliation Act (OBRA) of 1990 and administered by the Centers for Medicare & Medicaid Services (CMS), supports grants to states and jurisdictions to provide information, counseling, and assistance to Medicare beneficiaries and their families on Medicare and other health insurance questions. This publication describes the program and presents its funding history.
Oral Health Checkup: Progress In Tough Fiscal Times?, Cynthia Shirk
Oral Health Checkup: Progress In Tough Fiscal Times?, Cynthia Shirk
National Health Policy Forum
Almost ten years after the surgeon general’s report designating dental disease as the “silent epidemic,” the nation continues to struggle with adequate access to and utilization of dental services. This is particularly true for low-income individuals, who experience more than twice the amount of untreated dental disease as their higher-income peers. This issue brief reviews sources of dental coverage for low-income children and adults and the challenges these programs face. It highlights some examples of state Medicaid initiatives to improve access and utilization for children and the progress of these initiatives. Finally, it examines the potential effects of the economy …