Health Services Administration Commons^™

Increasing Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. States design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control. The incorporation of multiple, sometimes conflicting incentives into state reimbursement systems has resulted in enormously complex and demanding methodologies that inhibit consumer participation in state rating setting decisions. In turn, the lack of consumer involvement has the potential to result in the adoption of reimbursement systems that favor industry and government interests at the expense of issues important …

Driving Qi With Research: Findings From Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are increasingly experimenting with quality improvement (QI) strategies designed to enhance the effectiveness and efficiency of their efforts. Does QI work in public health, and if so for whom and under what circumstances? What QI strategies work best for which types of public health process failures, and at what cost? Research underway through the Public Health Practice-Based Research Networks (PBRN) Program is examining these types of questions to build an evidence base for public health QI.

The Science Of Public Health Delivery: Evidence, Uncertainties & Research Needs, Glen P. Mays

Health Management and Policy Presentations

Policy initiatives to reform the nation's health system increasingly recognize the need to incorporate public health and prevention strategies. The nation's delivery system for public health, however, varies widely across states and communities in its structure, authority, and capabilities. This session examines research from the growing field of public health services and systems research to identify directions for improving public health delivery.

Estimating The Value Of Public Health Services & Systems: Evidence, Uncertainties, And Research Needs, Glen P. Mays

Health Management and Policy Presentations

The Affordable Care Act authorized the largest expansion in federal funding for public health services and delivery systems in decades. These provisions, designed to support programs and services that promote health and prevent disease and injury on a population-wide basis, remain controversial because of uncertainties regarding their effectiveness in improving health and constraining medical cost growth. This session examines a series of recent studies to shed light on the health and economic value of spending on public health.

Disparities Research In Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are well positioned within the health system to play key roles in addressing oral health issues on a population-wide basis, However, current evidence reveals wide geographic variation in the delivery of public health interventions for oral health promotion. This session explores the factors contributing to this variation, and it highlights studies underway through the Public Health Practice-Based Research Networks (PBRNs) to produce more and better evidence about public health delivery and impact.

Effective, Efficient Health Care Reform The United States And Swiss Health Care Systems: A Comparative Analysis What Can The U.S. Learn From The Swiss Experience?, Rebecca Dittrich

Independent Study Project (ISP) Collection

Home to 45 million people without health insurance while still spending 17% of its GDP on health care expenses, the United States has been in need of a massive health care overhaul for quite some time. Some have speculated that the Swiss system may be an ideal model for health care reform, and in fact, many aspects of the newly instated Patient Protection and Affordable Care Act (ACA) do reflect areas of LAMal, Swiss health care law. This paper evaluates the Swiss and United States health care systems (under ACA), their similarities and differences, and the pros and cons of …

Influenza Vaccination Of The Healthcare Workforce: Developing A Model State Law, Alexandra M. Stewart, Marisa A Cox

Health Policy and Management Faculty Publications

No abstract provided.

Making Sense Of Health Care Planning In Ireland; The Street Level Public Organization (Slpo)., Vivienne Byers

Conference Papers

One of the central mechanisms of the Strategic Management Initiative (SMI) (Government of Ireland 1996) is the devolution of accountability and responsibility from the centre to executive agencies. Service planning was introduced in the Irish health care sector as part of this strategic planning ethos. This paper reports on a study that examined both the intent and the consequences of implementing legislatively mandated planning in the Irish health services, in the context of significant organizational change. In an effort to draw broader lessons, a comparison is drawn with the Canadian experience of service planning.

The choice was made to study …

Local Health Departments’ Governance: A Visual Display Using Lhd Shape Files, Gulzar H. Shah Dr., Carolyn J. Leep, Reba Novich

Health Policy & Management: Faculty Presentations (2008-2022)

Analyses conducted for public health systems and services research (PHSSR) frequently include a variable that represents the relationship between state and local health departments (i.e., a governance category) in their analyses, either as an explanatory variable or a control variable. A number of organizations and researchers has categorized states according to governance, but the categorizations have been inconsistent across studies. This lack of agreement regarding governance category has been problematic for PHSSR.

The Association of State and Territorial Health Officials (ASTHO) in conjunction with NORC at the University of Chicago and with input from the National Association of County and …

Influenza Vaccination Of The Health Care Workforce: A Literature Review, Alexandra M. Stewart, Marisa A. Cox, Mallory O'Connor

Health Policy and Management Faculty Publications

Since 1981, the Centers for Disease Control and Prevention (CDC) has recommended that all health care workers (HCWs) receive an annual influenza vaccination. The Healthy People objectives aimed for 60% coverage of HCW influenza vaccination by 2010 and 90% coverage by 2020. Although influenza vaccine uptake among HCWs has trended upward over the past several years, the percentage of immunized HCWs has remained approximately 40% between 2004 and 2008.

In order to complete the literature review, researchers identified and analyzed peer reviewed literature, news articles, professional organization position statements, and institutional policies published between 1991 and 2011. In the absence …

Renewing Health Services Management Research: Redrawing The Citizen-Client In Irish Health Care Policy, Vivienne Byers

Conference Papers

Ireland has a history of health policy which is not explicit as to its aims and objectives. In light of this fact, this paper examines the position and direction of the Irish Health Services, five years on from the advent of the setting up of the Health Services Executive (HSE) and the restructuring of the health services. The Irish health system policy is guided by the Health Strategy of 2001; in that there should be equitable distribution of health services focused on the need of the citizen-client, and also by the Primary Care Strategy (2001:7); in that there should be …

Program Evaluation Of A Community-Based Door-Through-Door Medical Escort Service, Lauren A. Martin

Gerontology Institute Publications

This report summarizes the program evaluation findings of a Boston-based organization’s Medical Escort program. This “door-through-door” service strives to provide medical transportation, physical assistance, and emotional support to elders on their way to the doctor’s office, during medical appointments and on the way back home again. By offering added assistance the program attempts to remove environmental barriers associated with access to health care. This evaluation combines previously collected program statistics with surveys (32) from program volunteers and phone interviews (78) with recipients.

Drive Alive: Teen Seat Belt Survey Program, Katie M. Burkett, Steve Davidson, Carol Cotton, James Barlament, Laurel Loftin, James H. Stephens, Martin Dunbar, Ryan Butterfield

Health Policy & Management: Faculty Publications (2006-2018)

Objective: To increase teen seat belt use among drivers at a rural high school by implementing the Drive Alive Pilot Program (DAPP), a theory-driven intervention built on highway safety best practices.

Methods: The first component of the program was 20 observational teen seat belt surveys conducted by volunteer students in a high school parking lot over a 38-month period before and after the month-long intervention. The survey results were published in the newspaper. The second component was the use of incentives, such as gift cards, to promote teen seat belt use. The third component involved disincentives, such as increased police …

Examining The Interrater Reliability Of The Comprehensive Inventory Of Mental Health And Recovery And Rehabilitation Services (Cimhrrs), Robert W. Johnson

Department of Psychology: Dissertations, Theses, and Student Research

This dissertation is one step in the continuing development, evaluation, and validation of the Comprehensive Inventory of Mental Health and Recovery and Rehabilitation Services (CIMHRRS). The CIMHRRS is an instrument to guide comprehensive assessment of programs that provide integrated services to people with serious mental illness (SMI).

The project described in this dissertation evaluated three key aspects of its performance in real world application: practical feasibility, internal consistency and reliability, and ability to distinguish between different programs. Investigators utilized a combination of principles and methods, associated with psychometric scale development, field methods, and program evaluation. Using a structured site review …

Consumer Consent Options For Electronic Health Information Exchange: Policy Considerations And Analysis, Melissa M. Goldstein, Alison L. Rein

Health Policy and Management Faculty Publications

The issue of whether, to what extent, and how individuals should have the ability to exercise control over their health information represents one of the foremost policy challenges related to the electronic exchange of health information. The current landscape of possible consent models is varied, and the factors involved in choosing among them are complex. States and other entities engaged in facilitating the exchange of electronic health information are struggling with a host of challenges, chief among them the establishment of policies and procedures for patient participation in their exchange efforts. While some have adopted policies enabling patients to exercise …

Conceptions Regarding Children’S Health: An Examination Of Ethnotheories In A Sending And Receiving Community, Maria Rosario De Guzman, Jennifer Deleon, Gloria Gonzalez-Kruger, Rodrigo Cantarero

Department of Child, Youth, and Family Studies: Faculty Publications

Ethnotheories are beliefs that adults hold about children and the factors that impact upon their development. Scholars suggest that “ethnotheories” serve as cultural models that underlie motivations for parenting practices and the way adults organize children’s early experiences. This study examines Mexican adults’ ethnotheories about children’s health in two communities that are linked by transnational migrants and serve as sending and receiving communities for workers. Forty-four Mexican adults in six focus groups discussed well-being issues affecting children in their communities. Qualitative analyses using grounded theory revealed a complex conception of children’s health issues that included physical, psychological, and behavioral components …

The Cost Of Medication Errors In The Emergency Department: Implications For Clinical Pharmacy Practice, Benjamin Bowman

MPA/MPP/MPFM Capstone Projects

Introduction

The main purpose of this capstone project is to provide an objective analysis of the cost of a medication error in the emergency department. The secondary objective of this analysis is to estimate the cost avoidance impact of providing clinical pharmacy services in the emergency department (ED).

Literature review

Previous literature has described the scope of clinical pharmacy services in the ED and has, to some extent, presented economic outcomes analyses of the impact of these services (Cohen et al., 2009; Lada and Delgado, 2007). According to Cohen et al., the current literature is still lacking a formal pharmacoeconomic …

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.

A Community Benefit Reporting Toolkit For Critical Access Hospitals, John A. Gale Ms, Melanie Race Ms

Rural Hospitals (Flex Program)

No abstract provided.

Opportunities For Comparative Research In Public Health Pbrns : A Baseline Analysis Of Local Practice Settings, Glen P. Mays, Sharla A. Smith, Elaine B. Wootten, Sylvia J. Porchia

Health Management and Policy Presentations

This analysis describes the organizational and operational characteristics of local public health agencies participating in an initial cohort of five (5) public health PBRNs in the U.S. We examine variation in practice settings within and between PBRNs; compare practice settings to state and national norms; and identify opportunities for comparative research that can be conducted through PBRNs.

Children's Health Insurance Program: The Dynamics Of Federalism And Health Care Policy, Erik White

Political Science Theses and Capstones

On February 4^th, 2009, President Obama signed into law the reauthorization of the Children Health Insurance Program. The federal government will now spend 30 billion dollars towards the goal of ensuring that more children in the United States are insured. I investigate this particular health care policy and look at the different dynamics that affect the ultimate goal of universal health insurance for children. Because this program allows for state flexibility under broad federal guidelines, one is able to look at individual states, and their particular actions and characteristics, to determine the best approach to insuring the most …

Cross-System Profile Of Maine's Long Term Support System: A New View Of Maine's Long Term Services And Supports And The People Served, Eileen Griffin Jd, Julie T. Fralich Mba, Catherine Mcguire Bs, Louise Olsen, Stuart Bratesman Mpp, Kathy Bubar, Romaine Turyn

Disability & Aging

This document provides a new way of looking at Maine's long term services and supports, with an emphasis on developing a common approach for describing and analyzing long term services and supports across programs. A conscious effort was made to organize this profile around the populations served rather than the programs serving them. For that reason, the profile captures information on all of the services accessed by each population group, not only those services administered by a particular program. This broader view provides important information about the full range of service utilization for each population group.

The Implementation Of The Kentucky Transitions: A Money Follows The Person Demonstration Grant Program, Amie Goodin

MPA/MPP/MPFM Capstone Projects

Kentucky Transitions is a Kentucky Medicaid program that is funded primarily by a grant from the Centers for Medicare and Medicaid Services. The purpose of this program is to transition individuals residing in long-term care facilities back into the community, where they will continue to receive health, social, and other benefits but do so in an approved residential setting. Individuals living in the community may experience higher quality of life and the increased ability to choose how and when they receive services, while Medicaid reaps the projected financial benefit of providing less-expensive community alternatives for care.

Though Kentucky Transitions operates …

Medication Therapy Management: Is It Worth Medicare’S Time?, Jennifer White

MPA/MPP/MPFM Capstone Projects

Problem:

Medication Therapy Management (MTM) is a service that a pharmacist can provide to any of their patients, but mostly to those who are either high risk patients for adverse events or those who are new to chronic medication therapy. As Medicare Part D has begun to cover MTM services, more and more pharmacists and other clinicians are becoming providers of MTM.

The intent of MTM is to decrease adverse events and healthcare costs to both the patient and the third party payer. In realizing the benefits of MTM, it is important to assess these outcomes to see if clinical, …

Policy Issues Affecting Maine’S Hospitals, John A. Gale Ms, Jennifer D. Lenardson Mhs

Rural Hospitals (Flex Program)

Legislators and other policymakers will be continually challenged to balance the needs of hospitals for appropriate reimbursement and oversight with supporting their provision of important services to local communities.

Shea/Apic Guideline: Infection Prevention And Control In The Long-Term Care Facility, Philip W. Smith, Gail Bennett, Suzanne Bradley, Paul Drinka, Ebbing Lautenbach, James Marx, Lona Mody, Lindsay Nicolle, Kurt Stevenson

United States Department of Veterans Affairs: Publications

Long-term care facilities (LTCFs) may be defined as institutions that provide health care to people who are unable to manage independently in the community.¹ This care may be chronic care management or short-term rehabilitative services. The term nursing home is defined as a facility licensed with an organized professional staff and inpatient beds that provides continuous nursing and other services to patients who are not in the acute phase of an illness. There is considerable overlap between the 2 terms.

More than 1.5 million residents reside in United States (US) nursing homes. In recent years, the acuity of illness …

Preparing For The Future: An Evaluation Of Alternative Methods For Estimating The Needed Capacity Of Nursing Home Beds In Kentucky, Michelle D. Woods

MPA/MPP/MPFM Capstone Projects

Due to the aging of the generation known as “Baby Boomers”, the nation is expected to witness extraordinary growth in the total population ages 65 and over. Population projections provided by the United States Bureau of the Census suggest that this segment of the population will double in size to 72 million by the year 2030. In order to prepare for the anticipated increase elderly Americans, policy officials have been analyzing the potential effects on the nation’s long-term care system. Although Baby Boomers can expect to live longer than their predecessors, as they age, it is predicted that this generation …

Creating Progam Logic Models: A Toolkit For State Flex Programs, John A. Gale Ms, Andrew F. Coburn Phd, Stephanie Loux Ms

Population Health & Health Policy

A logic modeling toolkit developed by the Flex Monitoring Team is available for use by state Medicare Rural Hospital Flexibility Programs (Flex Programs) in planning for and managing their Flex programs. The use of the Program Logic Model (PLM) Toolkit will provide states with a tool to assist in:

Planning, managing, reporting on, and assessing their Flex Program goals, activities, and accomplishments;

• Developing buy-in among key Flex Program stakeholders;
• Clarifying the underlying program assumptions;
• Identifying and defining measurable outcomes;
• Linking state-level Flex Program strategies and activities to specific and measurable outcomes; and
• Reporting program results to both internal and external …

Designing Employer-Sponsored Mental Health Benefits, Rachel Sethi, Joanne Jee, Lisa Chimento, D. Richard Mauery

Health Policy and Management Faculty Publications

No abstract provided.

Mental Illness And Barriers To Health Care Access, Charlene Powell

MPA/MPP/MPFM Capstone Projects

Statement of Problem

Access to health care in the United States is major concern, despite the fact that the country spends more per capita on health care than any other country. Individuals with mental illness may face greater access problems than the general population.

Research Question

• Does mental illness predict greater difficulties with access to health care?

Methodology

The 2004 National Health Interview Survey (NHIS) was used to examine the barriers to health care among individuals reporting a mental illness diagnosis. Nine questions relating to health access problems were drawn from the survey and combined into an access index. Multivariate …