Health Policy Commons^™

Vital Statistics: The State Of The Public Health Pbrn Program, Glen P. Mays

Health Management and Policy Presentations

The Robert Wood Johnson Foundation's Public Health PBRN Program has continued to expand during the 2013 program year with new networks, new research projects, and expanded translation and dissemination initiatives. The program plays an increasingly powerful role in helping to transform the U.S. public health enterprise into a rapid-learning system for health improvement.

Testing Integrated Primary Care And Public Health Models For Prevention Delivery, Glen P. Mays

Health Management and Policy Presentations

Improving the delivery of evidence-tested prevention interventions to populations at greatest risk requires strong coordination between primary care providers and public health organizations. This presentation reviews current research on models for integrated delivery of primary care and public health services, and identifies emerging research needs and opportunities. Of particular interest are the roles that practice-based research networks (PBRNs) can play in building this evidence.

Public Health Roi: Evidence, Experience And Remaining Questions, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health and prevention strategies holds considerable potential for improving health outcomes and constraining costs across the U.S. health system. Unfortunately, lingering certainties about the costs required to expand public health delivery systems and about the health and economic effects of such expansions has muted private and public support for increased public health expenditures. This lecture examines recent evidence from public health services and systems research studies that examine the health and economic value of public health delivery, and identifies remaining research needs for the field.

Adding Injustice To Injury - Health Perceptions, Plurality, And Power In The Ongoing Bhopal Disaster, Ruth Markwardt

Independent Study Project (ISP) Collection

Standards of health, human rights, and development are typically defined and dictated by policymakers instead of the populations directly affected by so-called development efforts. This paper seeks to contextualize global development efforts by highlighting specific local realities among the community of Bhopal Disaster survivors in Madhya Pradesh, India. As the site of the world’s largest industrial disaster, a disaster which is not over but ongoing, Bhopal represents an important population to highlight as the disaster continues. The Political Ecology of Health model was used to highlight political and environmental influences on community health. Within Political Ecology, this study takes a …

Cost Estimation Methods: Strategies And Examples For Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

This webinar reviews methods for conducting cost studies in public health settings, including strategies for estimating the financial and ecnomic costs of delivering public health services, and analytic approaches to identifying factors that influence delivery costs. These types of studies are of increasing importance to policy and practice stakeholders given the need for evidence about the return-on-investment (ROI) generated through public health delivery.

Accelerating And Expanding Knowledge Transfer In Public Health Settings: Frontiers In Phssr, Glen P. Mays

Health Management and Policy Presentations

Creating a "rapid-learning" system in public health requires mechanisms for the continuous exchange of knowledge and evidence among researchers, practice settings, and policy decision-makers. The open-access platform Frontiers in Public Health Services and Systems Research provides a new mechanism for this exchange.

Building The Science Of Public Health Delivery: Advances In Public Health Services And Systems Research, Glen P. Mays

Health Management and Policy Presentations

Efforts to improve the health and economic performance of the U.S. health system require evidence about how best to deliver public health strategies that protect health and prevent disease and injury on a population-wide basis. The field of public health services and systems research is building a "science of delivery" in public health that complements the evidence-based practice movement in medical care.

Estimating The Health And Economic Effects Of Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

Preventable health conditions account for more than 75% of the $2.7 trillion spent annually on health care in the U.S., yet less than 5% of these expenditures are devoted to public health programs and services that are designed to prevent and control disease and injury rather than to treat the downstream consequences of these conditions. Such limited expenditures in public health may contribute to the higher rates of preventable morbidity, mortality and excess medical costs experienced in the U.S. compared to other high-income countries. In this presentation, I update previous estimates of the health effects and medical cost offsets associated …

Public Health Expenditures, Public Health Delivery Systems, And Population Health, Glen P. Mays

Health Management and Policy Presentations

This seminar examines a series of approaches for estimating the health and economic effects attributable to public health expenditures in the U.S., along with a novel method for estimating economies of scale and scope in the delivery of public health services. The use of instrumental-variables techniques and network analytic methods are described in these research approaches.

Linkage Politics And The Persistence Of National Policy Autonomy In Emerging Powers: Patents, Profits, And Patients In The Context Of Trips Compliance, Aseema Sinha, Tricia Olsen

CMC Faculty Publications and Research

The Trade Related Intellectual Property Agreement (TRIPS) has had a profound effect on industrialization and innovation, as well as access to medicines in cases of public health crisis such as HIV/AIDS. However, compliance with TRIPS has varied in developing countries, despite heightened international pressure. For instance, Brazil has pursued a coherent approach to its HIV/AIDS health crisis, while India has failed to take care of its HIV patients despite late compliance with the TRIPS agreement and the presence of business firms that produce the generic medicines for HIV/AIDS. This article suggests that divergence in TRIPS compliance is the result of …

A Healthier Bottom Line: Distilling Best Practices In Corporate Wellness, Mark Auriemma, Cfa, Angela Cassidy, Kelly Dougherty, Despina Garalis, Pharmd, Rph, Judith Pelletier, Jennifer Springer

Emerging Leaders Program Team Projects

The Massachusetts Business Roundtable (MBR) collaborated with a team from the Emerging Leaders Program (ELP) from the University of Massachusetts Boston to explore ways to control health care costs. One strategy being implemented by employers to control health care costs is through “wellness programs,” employer-sponsored efforts to improve the health of employees. Members of the Massachusetts Business Roundtable (MBR) and other large employers have had success in reducing their health care costs through the implementation of corporate wellness initiatives. The purpose of this paper is to define what is working in private sector wellness programs to determine whether there is …

Is More Information Always Better? Mandatory Disclosure Regulations In The Prescription Drug Market, Joanna Shepherd

Faculty Articles

This Article proceeds as follows. In Section I, I describe the structure of the PBM industry. I also describe the business model PBMs employ to administer prescription drug coverage and the methods they use to reduce prescription drug spending. In Section II, I discuss mandatory disclosure regulations enacted in several states and at the federal level under the Affordable Care Act. In Section III, I explain why mandatory disclosure regulations are not needed to ensure that health plan sponsors pay a competitive price for PBM services. In Section IV, I discuss the various costs that mandatory disclosure regulations will impose …

Public Health Return On Investment: Making The Case, Glen P. Mays

Health Management and Policy Presentations

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison

Health Management and Policy Presentations

OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health.

METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the availability of 20 …

Supporting Healthy Lives And Vibrant Places: Learning About And Living The Collaborative Leadership Model, Lisa Deangelis, Maureen A. Scully, Andrea Wight

Emerging Leaders Program Team Projects

The 31 fellows in the 2012 UMass Boston Emerging Leaders Program (ELP) worked with community partners to investigate the theme, “Supporting Healthy Lives and Vibrant Places.” They worked in peer self-managed teams, in order to learn collaborative leadership skills first-hand, while engaging with stakeholders and issues where collaboration makes a difference. Their team projects addressed: best practices in corporate wellness initiatives, outreach to support health care access for homeless people, ways to grow awareness of the wide need for affordable housing, ideas for arts-based local economic development, broader funding sources to support innovative research on poverty, and ways to continue …

Reinventing The 21st Century Public Health Workforce: Innovation, Evaluation & Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Compelling opportunities exist for incorporating practice-based research to into the design, implementation, and evaluation of public health workforce training and development programs. Public Health Training Centers (PHTCs) can collaborate with practice-based research networks (PBRNs) to discover and disseminate evidence-based strategies for workforce development.

Valuing Improvements To Coastal Waters Using Choice Experiments: An Application To Revisions Of The Eu Bathing Waters Directive, Stephen Hynes, Dugald Tinch, Nick Hanley

Working Papers

Planned changes to the European Union’s Bathing Waters Directive (2006/7 EC) will force member states to produce improvements in a number of parameters of coastal water quality. This study uses the choice experiment method to estimate the economic benefits attached to such improvements, based on a sample of recreationalists on beaches in Ireland. The analysis indicates that improvements in all of the bathing water related attributes studied result in positive willingness to pay, and also show evidence of scope effects. Using random parameters and latent class modelling techniques, potential heterogeneity in preferences is then investigated and shown to be present …

Making The Case For Public Health: Estimating Roi And Value, Glen P. Mays

Health Management and Policy Presentations

This presentation describes recent progress and new directions for estimating the value of public health strategies and infrastructure.

Quantifying The Value Of Public Health Investments, Glen P. Mays

Health Management and Policy Presentations

This session reviews recent findings from a series of studies that estimate the health and economic effects attributable to investments in public health services and delivery systems.

Developing Service Delivery Measures For Studies Of Practice Variation: The Mprove Study, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Consequently, HHS recently used a consensus-based process to develop a framework for improving quality in public health and to identify a set of nine priority areas for improvement. As next steps in operationalizing this framework, measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. This presentation profiles the methodology developed …

Scale And Scope Effects In Public Health Delivery: Estimating Gains From Regionalization, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Current approaches to health system reform under the Affordable Care Act include efforts to enhance the delivery of public health services that promote health and prevent disease and injury on a population-wide basis. The nation’s public health delivery system comprises nearly 3000 local public health agencies that vary widely in size, resources, and capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources and expertise across local jurisdictions to enhance delivery and improve population health. This analysis uses longitudinal observations on a national sample of local public health agencies …

Funding Public Health: A New Iom Report On Investing In A Healthier Future, George Isham, Robert Kaplan, Glen P. Mays

Health Management and Policy Presentations

A new Institute of Medicine report recommends establishing a national target for life expectancy and implementing new mechanisms for financing public health strategies to acheive this target.

Expanding The Evidence Base For Accreditation And Qi: Progress In Practice-Based Research Networks, Glen P. Mays

Health Management and Policy Presentations

Studies that examine the implementation and impact of quality improvement strategies in public health are underway through the Public Health Practice-Based Research Networks.

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

BACKGROUND: Policy strategies for reforming the U.S. health care system to control costs and improve health outcomes include the possibility of expanded support for public health activities that are designed to prevent disease and promote health on a population-wide basis. These activities include efforts to monitor and report on community health status, investigate and control disease outbreaks, educate the public about health risks and prevention strategies, develop and enforce laws and regulations to protect health, and inspect and assure the safety and quality of water, food, air and other resources necessary for health. The Patient Protection and Affordable Care Act …

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

LSU New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

The Science Of Public Health Practice: Using Pbrns For Delivery System Research In Public Health Settings, Glen P. Mays

Health Management and Policy Presentations

PBRN research tests strategies for improving the delivery of services that promote health and prevent disease and injury on a population-wide basis.

What Is The Optimal Subsidy For Exercise? Informing Health Insurance Companies' Fitness Reimbursement Programs, Molly E. Frean

Economics Honors Projects

Health care costs account for 17% of US GDP and many programs and policies seek to reduce these costs. This paper focuses on exercise as preventive care due to its immense physiological benefits. I model the profit-maximizing choice of health insurance companies to subsidize exercise and the utility-maximizing choice of individuals to engage in exercise using a traditional principal-agent framework. I then use principles from behavioral economics and psychology to critique these models and provide further insight into understanding our underconsumption of such preventive services. I end with an evaluation of current programs and suggestions for improvement using empirical findings.

Investing In A Healthier Future: Iom Dissemination Workshop, Glen P. Mays

Health Management and Policy Presentations

This session discusses strategies for implementing new financing strategies and funding mechanisms for public health services.

Patterns Of Interaction In Public Health Research Networks: Insight From Network Analysis, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Studies from the past three decades have found evidence of wide variation in public health practices and policies across states and communities despite an expanding evidence base of efficacious public health strategies, suggesting gaps in implementation and translation processes. Practice-based research networks (PBRNs) are expected to accelerate research participation and translation. This study uses social network analysis methods with twelve Public Health PBRNs to study processes influencing the implementation and translation of research within diverse public health settings.

DATA and METHODS: A cross-sectional network analysis survey was validated and fielded with participants in two cohorts of public health PBRNs …