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Articles 421 - 450 of 514

Full-Text Articles in Health and Medical Administration

Managed Care: As Good As It Gets? (Los Angeles), Lisa Sprague Jan 2002

Managed Care: As Good As It Gets? (Los Angeles), Lisa Sprague

National Health Policy Forum

This site visit was a return trip to southern California to examine the state of managed care. Between the Forum's last visit (in late 1998) and this one, the marketplace underwent considerable change, including significant movement away from global capitation, the collapse of physician practice management firms, and the development of new insurance products. Site visitors were briefed on managed care trends in the state, and panel discussions focused on issues related to physician group solvency, employer and consumer expectations, managed care regulation, and plan and provider strategies for surviving and prospering in the difficult southern California market. Site visitors …

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Meeting Employees' Information Needs In An Evolving Health Care Marketplace, Lise Rybowski Nov 2001

Meeting Employees' Information Needs In An Evolving Health Care Marketplace, Lise Rybowski

National Health Policy Forum

This background paper explores the role of information in an evolving health care marketplace. It notes that, in a softening economy, many employers seeking relief from escalating health care expenses shift costs onto employees. Some try to make their retreat more palatable by offering employees both more options for how and where they receive health care and more control over how and where the money is spent. This paper discusses the changes that are likely to occur over the next decade in the ways that people make decisions about health plans and providers, the implications for consumers' information needs, and …

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The Disappearing State Surpluses: How Come, How Long, And How Will They Affect Social Service Programs?, Randy Desonia Oct 2001

The Disappearing State Surpluses: How Come, How Long, And How Will They Affect Social Service Programs?, Randy Desonia

National Health Policy Forum

This issue brief focuses on the impact of budget shortfalls being experienced by many states after several years of strong revenue growth. It describes the structure and sources of state revenues and spending and the causes of the shortfall. It also summarizes the fiscal trends and federal policies that could result in significant budget shortfalls in the future.

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Primary Care Case Management: Lessons For Medicare?, Lisa Sprague Oct 2001

Primary Care Case Management: Lessons For Medicare?, Lisa Sprague

National Health Policy Forum

This issue brief looks at primary care case management (PCCM) as a tool that states have used to manage the delivery of care to their Medicaid populations, an alternative to contracting with commercial managed care plans. (States had found PCCM a flexible means of advancing state policy goals, including quality improvement, disease management, and coverage of special-needs populations.) The issue brief considers provider and beneficiary perspectives on PCCM as well as state agency objectives and accomplishments. Finally, it raises the question of adapting the PCCM model for Medicare.

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Emergency Preparedness From A Health Perspective: Preparing For Bioterrorism At The Federal, State, And Local Levels, Robin J. Strongin Oct 2001

Emergency Preparedness From A Health Perspective: Preparing For Bioterrorism At The Federal, State, And Local Levels, Robin J. Strongin

National Health Policy Forum

Despite the good intentions prior to and in the aftermath of the terrorist attacks of September 11, 2001, the existence of significant gaps in the country's preparedness became increasingly clear in the weeks that followed. This background paper provides an overview of the state of bioterrorism preparedness at all levels of government, identifying both the gaps and the steps being taken to close them. A series of reference materials, including a suggested reading list and Web site addresses, are listed at the end of the paper.

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Health Insurance Family Style: Public Approaches To Reaching The Uninsured, Jennifer Ryan Sep 2001

Health Insurance Family Style: Public Approaches To Reaching The Uninsured, Jennifer Ryan

National Health Policy Forum

This issue brief explores existing and potential opportunities to further expand the availability of health coverage for the uninsured and the underinsured, given downturns in the economy and the resulting state budget shortfalls. It also considers the implications of the Health Insurance Flexibility and Accountability (HIFA) initiative announced in August 2001 by the Centers for Medicare and Medicaid Services. Finally, the issue brief describes legislative options for health care reform being debated in Washington, including tax credit incentives, employer-based coverage subsidies and the potential for additional federal funding for public coverage expansions through Medicaid and the State Children's Health Insurance …

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Mission Possible? Maintaining The Safety Net In Urban And Rural Colorado, Karen Matherlee Aug 2001

Mission Possible? Maintaining The Safety Net In Urban And Rural Colorado, Karen Matherlee

National Health Policy Forum

This site visit examined urban safety-net concerns in Denver and rural safety-net issues in three communities in the eastern part of Colorado. The Denver segment featured Denver Health, an integrated health system that provides a continuum of services to diverse vulnerable populations. It explored delivery and financing issues for the system itself and in relation to payers, providers, and consumers (particularly through Community Voices) in its catchment area. The eastern Colorado segment focused on delivery and financing issues in Rocky Ford (community health center/migrant health services concerns), Limon (certified rural health center topics), and Hugo (critical-access hospital matters). The visit …

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W-2 In 2001: Wisconsin Works At Welfare Reform, Jennifer Ryan, Randy Desonia Aug 2001

W-2 In 2001: Wisconsin Works At Welfare Reform, Jennifer Ryan, Randy Desonia

National Health Policy Forum

This site visit took federal participants to Wisconsin, widely regarded as one of the pioneers of welfare reform. This site visit focused on Wisconsin Works (W-2), a statewide effort to reduce the state's welfare caseload and send clients to work. In particular, site visitors examined welfare reform policy, service delivery, and financing issues in Milwaukee, at that time the home of 85 percent of W-2 participants. Site visit participants heard from state officials, private-sector representatives, researchers, and advocates on the structure of W-2, its operating policies, and the effects of program implementation on low-income families. They toured a variety of …

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Medicare Coverage: Lessons From The Past, Questions For The Future, Robin J. Strongin Aug 2001

Medicare Coverage: Lessons From The Past, Questions For The Future, Robin J. Strongin

National Health Policy Forum

This paper describes the Medicare coverage process for emerging technologies and the ways it has changed over time. Issues addressed include both the national coverage process and local medical review policies, which account for 90 percent of the coverage determinations. The paper also includes a discussion of the relationship between the coverage process and technology assessment, payment systems and the ongoing debate over coverage criteria and levels of evidence.

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Income Support Policy And The U.S. Child Support System, Jane Koppelman Jul 2001

Income Support Policy And The U.S. Child Support System, Jane Koppelman

National Health Policy Forum

This paper examines the economic profile of custodial and noncustodial parents and the status of the federal/state child support enforcement system. It discusses the reasons for the historically low rate of child support collection; the prospects for new computerized systems to improve the rates of both paternities established and payments collected; ways the system can sustain funding; and the extent to which child support payments can improve the well-being of low-income families.

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Pharmacy Benefit Managers: A Model For Medicare?, Veronica V. Goff Jul 2001

Pharmacy Benefit Managers: A Model For Medicare?, Veronica V. Goff

National Health Policy Forum

This issue brief uses large-employer experiences with pharmacy benefit managers (PBMs) to shed light on their potential as Medicare outpatient drug benefit administrators. PBM management techniques are discussed, as well as employer perspectives on PBM strengths and weaknesses and lessons learned. Considerations for Medicare policy are also examined. The brief built on a previous NHPF issue brief entitled The ABCs of PBMs.

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Federal And State Perspectives On Gme Reform, Karen Matherlee Jun 2001

Federal And State Perspectives On Gme Reform, Karen Matherlee

National Health Policy Forum

This issue brief examines financial support of graduate medical education (GME), a standard budget item in the federal Medicare program and in some state Medicaid programs. It looks at objections to the way in which GME dollars are distributed, especially in terms of variations in Medicare GME payments across states. It explores various reform proposals that are circulating to address this and other GME problems and the odds for major reform.

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Nurse Workforce: Condition Critical, Wakina Scott Jun 2001

Nurse Workforce: Condition Critical, Wakina Scott

National Health Policy Forum

This issue brief provides an overview of the current nursing shortage. It discusses the multiple factors that make this shortage in the nurse workforce different from earlier ones. It also examines steps taken by nursing schools, the health care industry, the federal government, and states to address this issue.

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Youth Violence Prevention: How Does The Health Care Sector Respond?, Anthony S. Raden Jun 2001

Youth Violence Prevention: How Does The Health Care Sector Respond?, Anthony S. Raden

National Health Policy Forum

This background paper examines the health care sector's response to the complex problems associated with youth violence, identifies the unique challenges health professionals face in dealing with young victims and perpetrators of violence, and raises questions about the ability of health professionals in various types of practice settings to assume a more proactive role in preventing youth violence.

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To Retain Or Destroy--That Is The Health Care Records Question, Christine L. Glover Jun 2001

To Retain Or Destroy--That Is The Health Care Records Question, Christine L. Glover

West Virginia Law Review

No abstract provided.

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State-Based Pharmaceutical Assistance Programs: Temporary Fix Or Lessons For Medicare?, Robin J. Strongin Apr 2001

State-Based Pharmaceutical Assistance Programs: Temporary Fix Or Lessons For Medicare?, Robin J. Strongin

National Health Policy Forum

By early 2001, more than one-half of the states had established some type of pharmaceutical assistance programs for the elderly. This issue brief considers specific program parameters, such as eligibility criteria, cost-sharing arrangements, program administration, and marketing and outreach. It also considers programs in the broader context of a future Medicare outpatient prescription drug benefit.

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Tanf And Work Support Services: On The Job In Greater Philadelphia, Lisa Sprague Apr 2001

Tanf And Work Support Services: On The Job In Greater Philadelphia, Lisa Sprague

National Health Policy Forum

This site visit looked at programs in the greater Philadelphia area to move welfare recipients into employment and support services aimed at keeping them employed. Four years after implementation of the Personal Responsibility and Work Opportunity Reconciliation Act, welfare caseloads were much reduced, but challenges remained. Pennsylvania officials described their plans to assist beneficiaries who would reach their five-year lifetime cash assistance limit beginning in 2002. Site visitors met with state and county assistance office staff, employers, consumer advocates, and employment and training contractors. They participated in discussions of how work support services, such as medical assistance, child care, and …

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Quality In The Making: Perspectives On Programs And Progress, Lisa Sprague Apr 2001

Quality In The Making: Perspectives On Programs And Progress, Lisa Sprague

National Health Policy Forum

This background paper considered the evolution of quality evaluation efforts, tracing their development from early initiatives to keep track of patients after surgery through the various guidelines, surveys, and measurement tools currently in use. It looked at both quality assurance and quality improvement strategies, highlighting the different philosophies that guide them. The paper examined the roles of purchasers, providers, consumers, and governments in furthering a quality agenda. Both regulatory and voluntary approaches were assessed.

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The Health Care Safety Net In A Time Of Fiscal Pressures, Richard Hegner Apr 2001

The Health Care Safety Net In A Time Of Fiscal Pressures, Richard Hegner

National Health Policy Forum

This background paper reviewed the role played by the health care safety net in serving the nation's uninsured, underinsured, and indigent populations as well as those Americans who experience problems in obtaining access to health care. Against the backdrop of the March 2000 Institute of Medicine report, America's Health Care Safety Net: Intact But Endangered, the paper examined the recurrent choice in U.S. health policy between underwriting public insurance and subsidizing direct provision of health care. It recounted a number of reasons for direct federal interest in the safety net — including the important role played by Medicaid, the major …

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Welfare Reform And The Well-Being Of Families: Successes To Date And Challenges Ahead, Jane Koppelman Mar 2001

Welfare Reform And The Well-Being Of Families: Successes To Date And Challenges Ahead, Jane Koppelman

National Health Policy Forum

This issue brief discusses a key issue in evaluating the 1996 Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA): the status of families after the implementation of this landmark welfare reform program. The new block grant program to states to administer the Temporary Assistance to Needy Families(TANF) program has been extremely effective when measured by lower welfare rolls and higher work rates and earnings for recipients. However, an equally important dimension described by the paper is what is known about longer-term effects and the status of people who have left welfare, with special emphasis on how children have …

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Welfare Reform And Substance Abuse: Innovative State Strategies, Ginger P. Parra Mar 2001

Welfare Reform And Substance Abuse: Innovative State Strategies, Ginger P. Parra

National Health Policy Forum

This issue brief highlights key facts about the impact of substance abuse on welfare reform and recipients of Temporary Assistance to Needy Families, or TANF. After outlining some of the data on the incidence of substance abuse as well as its costs and treatment, it concludes by describing innovative state welfare programs attempting to lower barriers to employment and self-sufficiency.

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The Federal-State Medicaid Match: An Ongoing Tug-Of-War Over Practice And Policy, Karen Matherlee Dec 2000

The Federal-State Medicaid Match: An Ongoing Tug-Of-War Over Practice And Policy, Karen Matherlee

National Health Policy Forum

Reviewing Medicaid match issues since the latter 1980s, this issue brief traces ways in which some states have used creative financing to get more Medicaid matching dollars than they otherwise would qualify for from the federal government. It explores the latest mechanism, states' use of so-called intergovernmental transfers of funds (to avoid established upper payment limits) to increase their matches, triggering efforts by the Senate Finance Committee and the federal Medicaid agency to ban such transfers.

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Caring For The Elderly: Oregon's Pioneers (Portland, Oregon), Nora Super, Lisa Sprague Nov 2000

Caring For The Elderly: Oregon's Pioneers (Portland, Oregon), Nora Super, Lisa Sprague

National Health Policy Forum

This site visit looked at the continuum of care for its elderly and disabled citizens in the first state ever to secure Section 1915(c) and (d) waivers under Medicaid to support home- and community-based services. More than three-quarters of Oregon's Medicaid clients now receive care in these settings. Site visitors were briefed on the history and development of long-term care in the state as well as the various care settings available. Panels discussed strategies and partnerships focused on alleviating workforce shortages and highlighted Oregon nurses' authority to delegate certain caregiving tasks to laypeople. Multnomah County staff described county-level activities, especially …

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Emerging Issues In The Use Of Binding Arbitration To Resolve Disputes Between Individuals And Health Plans, Karl Polzer Nov 2000

Emerging Issues In The Use Of Binding Arbitration To Resolve Disputes Between Individuals And Health Plans, Karl Polzer

National Health Policy Forum

After briefly describing the federal legal framework fostering the growth of binding arbitration, this paper identifies controversies surrounding arbitration as well as arguments supporting and opposing its use. The paper describes the use of arbitration among certain types of collectively bargained employee health plans regulated under the Employee Retirement Income Security Act of 1974 (ERISA), by health maintenance organizations (HMOs) in California, and by a large employer operating a self-insured ERISA health plan. Evidence cited by the California Supreme Court that the largest HMO in California operated its mandatory arbitration program in an unfair way is presented, along with the …

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Understanding Medicaid Home And Community Services: A Primer, Gary Smith, Janet O'Keeffe, Letty Carpenter, Pamela Doty, Brian Burnwell, Robert Mollica, Loretta Williams, George Washington University, Center For Health Policy Research Oct 2000

Understanding Medicaid Home And Community Services: A Primer, Gary Smith, Janet O'Keeffe, Letty Carpenter, Pamela Doty, Brian Burnwell, Robert Mollica, Loretta Williams, George Washington University, Center For Health Policy Research

Center for Health Policy Research

No abstract provided.

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Schip In The Formative Years: An Update, Judith D. Moore Sep 2000

Schip In The Formative Years: An Update, Judith D. Moore

National Health Policy Forum

This issue brief examines the status of the State Children's Health Insurance Program (SCHIP) three years after authorizing legislation was enacted. Topics addressed include enrollment and retention of children in new programs, funding allotments and expenditures, evaluation activities planned and underway, the interaction of Medicaid and SCHIP, and problems common across many states.

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Medicare+Choice: Where To From Here?, Nora Super Sep 2000

Medicare+Choice: Where To From Here?, Nora Super

National Health Policy Forum

This issue brief examines Medicare+Choice (M+C) plan participation, benefit coverage, and enrollment and the factors that have contributed to plans' decisions to participate in or withdraw from certain markets. In addition, the issue brief explores what has been happening to M+C enrollees in terms of costs, benefits, and continuity of care. Lastly, the issue brief examines the reasons that alternative plan options — such as preferred provider organizations (PPOs) and provider-sponsored organizations (PSOs) — have not taken hold. Legislative proposals that might affect the future of M+C are also discussed.

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The Asthma Epidemic: Prospects For Controlling An Escalating Public Health Crisis, Richard Hegner Sep 2000

The Asthma Epidemic: Prospects For Controlling An Escalating Public Health Crisis, Richard Hegner

National Health Policy Forum

This background paper examines the dimensions of the recent asthma epidemic and what could be done to contain it. Information about the prevalence and consequences of asthma across demographic groups is presented. Factors that impede the control of asthma are also identified. The paper also examines the possible causes of asthma and the asthma epidemic as well as new theories about the relationship of asthma to overall advances in health care and economic development. It also discusses the economic implications of asthma and possible cost avoidances linked to better asthma management. The paper concludes with discussions of asthma and public …

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Insuring Virginia's Children: Local Outreach And Enrollment (Northern Virginia), Lisa Sprague, Judith D. Moore Aug 2000

Insuring Virginia's Children: Local Outreach And Enrollment (Northern Virginia), Lisa Sprague, Judith D. Moore

National Health Policy Forum

This one-day visit to a nearby jurisdiction was designed to allow participation by federal staff who have been unable to commit the three days required by a typical Forum site visit. Site visitors were given an overview of health care in Virginia and an introduction to the Children's Medical Income Security Program (CMSIP) as well as its proposed replacement, the Family Access to Medical Insurance Security program (FAMIS). A panel representing community organizations and providers shared their experience, touching on provider concerns, coordination of outreach efforts across counties, and assistance for clients after they are enrolled. The group visited the …

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Outpatient Commitment In Mental Health: Is Coercion The Price Of Community Services?, Coimbra Sirica Jul 2000

Outpatient Commitment In Mental Health: Is Coercion The Price Of Community Services?, Coimbra Sirica

National Health Policy Forum

This paper reviews the debate over civil commitment to outpatient settings of people with mental illness who are considered too ill and/or too dangerous to be left on their own in their communities. The choices of two states — Maryland and New York — in dealing with this issue are reviewed. Alternative ways of drawing people into treatment and keeping them there are also discussed.

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