Open Access. Powered by Scholars. Published by Universities.®

Health Services Research Commons™

Open Access. Powered by Scholars. Published by Universities.®

Law

Institution
Keyword
Publication Year
Publication
Publication Type
File Type

Articles 271 - 300 of 348

Full-Text Articles in Health Services Research

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 …

Go to article

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 …

Go to article

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.

Go to article

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.

Go to article

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.

Go to article

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.

Go to article

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.

Go to article

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.

Go to article

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.

Go to article

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 …

Go to article

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.

Go to article

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 …

Go to article

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 …

Go to article

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.

Go to article

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.

Go to article

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 …

Go to article

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 …

Go to article

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.

Go to article

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.

Go to article

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 …

Go to article

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 …

Go to article

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.

Go to article

Hcfa's Outpatient Pps: Finally Ready To Roll?, Karen Matherlee Jun 2000

Hcfa's Outpatient Pps: Finally Ready To Roll?, Karen Matherlee

National Health Policy Forum

This issue brief centers on hospital outpatient department services, scheduled to be on a prospective payment system (PPS) July 1, 2000, 17 years after enactment of legislation mandating PPS for hospital inpatient services. It looks at the challenges to providers and patients, including coding and other process issues, redistribution of payments, and changes in beneficiary co-payments.

Go to article

Using Schip To Subsidize Employment-Based Coverage: How Far Can This Strategy Go?, Karl Polzer Jun 2000

Using Schip To Subsidize Employment-Based Coverage: How Far Can This Strategy Go?, Karl Polzer

National Health Policy Forum

This background paper examines and analyzes early efforts by states to subsidize employment-based health insurance under the State Children's Health Insurance Program (SCHIP), which offers states a more generous funding rate than under Medicaid. As the Health Care Financing Administration prepares to issue regulations governing SCHIP, the paper summarizes complaints by state officials that federal rules governing how job-based coverage might be subsidized under the program are overly complex and rigid. After interviewing officials at the federal level and in six states as well as a variety of researchers and policy experts, the author considered whether and to what extent …

Go to article

Pharmaceutical Marketplace Dynamics, Robin J. Strongin May 2000

Pharmaceutical Marketplace Dynamics, Robin J. Strongin

National Health Policy Forum

This issue brief provides a profile of the pharmaceutical industry and explores topics such as competition, generics, intellectual property, research and development, pricing, and distribution. It also discusses government programs such as the Department of Veterans' Affairs federal supply schedule and Medicaid rebates.

Go to article

Reinventing Medicaid: Hoosier Healthwise And Children's Health Insurance In Indiana, Judith D. Moore, Lisa Sprague Apr 2000

Reinventing Medicaid: Hoosier Healthwise And Children's Health Insurance In Indiana, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This site visit explored the factors that have made Indiana so successful in enrolling children in its Medicaid and SCHIP plans under the brand name Hoosier Healthwise. Site visitors met with legislators and state officials to gain understanding of the genesis and development of Hoosier Healthwise and its aggressive outreach component. A panel of representatives from partner organizations engaged in enrolling children provided further insight into this process. The site visit participants traveled to observe enrollment and operations in both urban (Marion) and rural (Clay) county offices. They also met with health care executives at hospitals, clinics, and neighborhood health …

Go to article

Dispelling The Myths And Stigma Of Mental Illness: The Surgeon General's Report On Mental Health, Richard Hegner Apr 2000

Dispelling The Myths And Stigma Of Mental Illness: The Surgeon General's Report On Mental Health, Richard Hegner

National Health Policy Forum

This paper summarizes the key findings of "Mental Health: A Report of the Surgeon General," which was released on December 13, 1999, by U.S. Surgeon General David Satcher. Topics include the significance of mental illness, the effectiveness of diagnosis and treatment, the widespread lack of treatment, access problems and their causes, the significance of stigma, and the prevention of mental illness.

Go to article

Site Visit To Seattle — University Of Washington Academic Medical Center, Karen Matherlee Apr 2000

Site Visit To Seattle — University Of Washington Academic Medical Center, Karen Matherlee

National Health Policy Forum

The event was part of a series of three site visits leading to an April 27–28, 2000, conference in Annapolis, Maryland, on hospital-based health care systems in transition after enactment of the Balanced Budget Act of 1997 (BBA) and the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA). The site visit focused on the challenges the University of Washington (UW) faces in carrying out its three missions of delivery of health services (with emphasis on the safety net), health professions education, and health science and clinical research. It probed the effects of the BBA on these missions …

Go to article

Applying Science To Public Policy: The Context Of The Surgeon General's Report On Mental Health, Richard Hegner Apr 2000

Applying Science To Public Policy: The Context Of The Surgeon General's Report On Mental Health, Richard Hegner

National Health Policy Forum

Intended to provide public policy context for the December 1999 Surgeon General's Report on Mental Health, this background paper discusses the historic skepticism about the efficacy of treatment of mental illness in this country, insurance practices that have discriminated against mental illness and the reasons for them, the disproportionate share of mental health funding provided by government sources such as Medicaid and state general revenues, the role of state and local public government as providers of catastrophic coverage for mental illness, the cascading cost-shifting game in mental health finance, obstacles to needed treatment (including popular attitudes toward mental illness), the …

Go to article

Site Visit To Detroit — Henry Ford Health System, Lisa Sprague Mar 2000

Site Visit To Detroit — Henry Ford Health System, Lisa Sprague

National Health Policy Forum

This event was one in a series of three site visits leading to an April 27–28, 2000, conference in Annapolis, Maryland, on hospital-based health care systems in transition after the enactment of the Balanced Budget Act of 1997 (BBA) and the Medicare, Medicaid, SCHIP Balanced Budget Refinement Act of 1999 (BBRA). The site visit explored the responses of a large integrated system, the Henry Ford Health System, to the BBA and how the BBA has interacted with other changes in the system's local market and state Medicaid program. Panel presentations highlighted financing and information systems, the integration of diversified services, …

Go to article

First Prev Next Last