Health Policy Commons^™

Getting Started In Evaluation Consulting: Questions To Ask And Answer Along The Way, Judah J. Viola,

Faculty Publications

This PowerPoint presentation includes a four phase approach to considering the main questions you'll need to ask and answer before taking the leap needed to begin working as an independent evaluation consultant.

Massachusetts Senior Legal Assistance Project Needs Evaluation: Current Demand For Legal Services, Alison Gottlieb, Lauren A. Martin, Ellen A. Bruce

Gerontology Institute Publications

The Gerontology Institute at the University of Massachusetts Boston was contracted to conduct a statewide needs assessment for the MSLAP. As agreed upon by the MSLAP Advisory Board, the focus of this assessment was to analyze the demand for services Massachusetts legal service providers have experienced recently as a means to understanding the legal needs of Massachusetts elders (age 60 and older). A second needs assessment was conducted by the Massachusetts Executive Office of Elder Affairs. That needs assessment surveyed home care workers and other elder agency personnel to gauge their assessment of elders’ legal needs in Massachusetts. Read together, …

The Detroit Food System Report 2009-2010, Kameshwari Pothukuchi

Urban Studies and Planning Faculty Research Publications

Assesses the state of the city’s food system, including activities in production, distribution, consumption, waste generation and composting, nutrition and food assistance program participation and innovative food system programs.

Embryonic Stem Cell Research, Michael Phan, Jeniene Hassan

Festival of Communities: UG Symposium (Posters)

Embryonic stem cell research has the potential to regenerate malfunctioning tissues and replace harmful cancer cells. Although it holds the potential to alleviate malicious disabilities and diseases, it raises ethical concerns due to the destruction of a fertilized human embryo. In certain religions (Catholics and Christians), embryonic stem cell research is detested due to the destruction of a human at its early stages of life (embryo). On the other hand, scientists believe that embryonic stem cells can “someday…used to treat human diseases.” (Hansen 879) This analysis on embryonic stem cell research will consider both the supporting and opposing side of …

La Operación Y Estructura De Salud Familiar Comunitaria Intercultural En El Caso De Achocalla, Dominic Strada

Independent Study Project (ISP) Collection

Esta investigación se centra en la nueva política sanitaria del programa Salud Familiar Comunitaria Intercultural, su nueva administración y su aplicación en Bolivia. La Salud Familiar Comunitaria Intercultural es una política de salud social que décadas después del proceso de descentralización del poder ha puesto la responsabilidad sanitaria en manos de las comunidades. Este estudio se centra en las estructuras de Salud Familiar Comunitaria Intercultural desde el nivel municipal, hasta un total de ocho estructuras, en el municipio de Achocalla. Achocalla es un caso interesante ya que es a la vez una localidad urbana, por formar parte de los suburbios …

Economic Circumstances And Support For Universal Health Care, Daniel Cotter

Political Science Theses and Capstones

There have been many differing opinions over the new health care bill passed in 2010. My research is aimed at finding what factors play a role in forming an opinion on the new health care bill. Specifically looking at the economic and demographic circumstances of citizens of the United States and how it has affected their opinions on the health care bill. I use data gathered from the Pew Research Center and ran crosstabs on various different variables including opinions on the current economy, demographic characteristics, as well as opinions on the current health care plan. I anticipate finding that …

Pay-For-Performance Reimbursement In Health Care: Chasing Cost Control And Increased Quality Through "New And Improved" Payment Incentives, Rick Mayes, Jessica Walradt

Political Science Faculty Publications

Pay-for-performance (P4P) reimbursement has become a popular and growing form of health care payment built on the belief that payment incentives strongly affect medical providers' behavior. By paying more to those providers who are deemed to deliver better care, the goal is to increase quality and, hopefully restrain cost growth. This article provides a brief explanation of: (1) how previous P4P plans in the U.S. have fared, along with their special relationship to primary care, and (2) how England's experience with P4P and newer versions of these kinds of plans being pursued in places such as Massachusetts might provide valuable …

The Way It Was In Health Policy, And Probably Will Be: Learning Lessons By Rashi Fein (Book Review), Rick Mayes

Political Science Faculty Publications

Learning Lessons by Rashi Fein is an enjoyable memoir from a scholar and policy adviser unlike any other. Fein’s influential involvement in health care policy dates back to John F. Kennedy’s administration, and his career as a leading health economist paralleled the significant growth in the political influence of health economists following the enactment of Medicare and Medicaid in 1965. Now an emeritus professor of the economics of medicine at Harvard Medical School, Fein writes here about the lessons he learned in medicine, economics, and public policy. His view of the policy process, as a way of coming to …

Finding The Right Fit: Unique Challenges Faced By Health Ngos In The Health System Of Lamu District, Lauren Hartel

Independent Study Project (ISP) Collection

This study examines how nongovernmental organizations and community-based organizations in Lamu District interact with the governmentally structured health care system at the district level. This is done through participatory observation, interviews and removed observation of NGOs, CBOs and government officials. From these observations, this study then identifies major challenges faced by health NGOs that inhibit them from performing to the best of their ability, and at times even compromise the health of the people they are trying to help. The results of this study show that in Lamu District, the most relevant challenges are continuity of care, dissemination of information, …

A Step Towards Realization Of The Twenty-Seventh Right?: A Preliminary Analysis Of The Proposed National Health Insurance For South Africa, Kelsey Fraser

Independent Study Project (ISP) Collection

As part of a three-week social analysis study, the African National Congress’ (ANC) proposal for a National Health Insurance (NHI) scheme was examined. Legal commitments in Section 27 of the Constitution and Section 3 of the National Health Act oblige the South African government to work progressively towards realization of the right to healthcare. The latest push for NHI can be interpreted as an attempt to broaden realization of this right.

Information on the NHI proposal was obtained primarily from documents released by the ANC and was supplemented by written analysis found through Internet research. A partial understanding of public …

How To Help Your Community Recover From Disaster: A Manual For Planning And Action, Judah J. Viola,, Society For Community Research & Action Task Force For Disaster, Community Readiness, And Recovery

Faculty Publications

No abstract provided.

Poverty, Vulnerability, And Provision Of Healthcare In Afghanistan, Jean-Francois Trani, Parul Bakhshi, Ayan A. Noor, Dominque Lopez, Ashraf Mashkoor

Brown School Faculty Publications

This paper presents findings on conditions of healthcare delivery in Afghanistan. There is an ongoing debate about barriers to healthcare in low-income as well as fragile states. In 2002, the Government of Afghanistan established a Basic Package of Health Services (BPHS), contracting primary healthcare delivery to non-state providers. The priority was to give access to the most vulnerable groups: women, children, disabled persons, and the poorest households. In 2005, we conducted a nationwide survey, and using a logistic regression model, investigated provider choice. We also measured associations between perceived availability and usefulness of healthcare providers. Our results indicate that the …

Performance Measures And Pilot Evaluation Of Georgia’S Medical Assistance Program For Population Below The Poverty Line, Tamar Chitashvili

Muskie School Capstones and Dissertations

In recent years the Georgian health care system has been undergoing fundamental reforms aimed at improving the population’s health status by increasing financial and geographic access to high-quality health care. To address limited financial access to health services of the poor, and protect them from catastrophic expenditures associated with illnesses and improve equity, the government restructured the centralized, financially and administratively unsustainable social security system, with a liberal welfare system focusing on providing a safety net for the poor.

Children At Risk In The Child Welfare System: Collaborations To Promote School Readiness - Final Report, Helen Ward Jd, Julie Atkins Ma, Patricia Morris, Sun Young Yoon

Children, Youth, & Families

This study examines the degree to which key players in the child welfare, early intervention/preschool special education (EI/Preschool SPED) and early care and education (ECE) systems (e.g. Head Start, preschool, child care centers, family child care homes) collaborate to meet the developmental needs of children ages 0 to 5 who are involved in the child welfare system. This research includes an analysis of data from the National Survey of Child and Adolescent Wellbeing (NSCAW) as well as a case study in Colorado involving interviews with key stakeholders and statewide surveys of caseworkers and foster parents.

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 …

Who Will Care For The Women?, Candace Howes

Economics Faculty Publications

Over 20 million people today, including children, working-age disabled, and elderly persons, require some sort of assistance to live safely. Largely because women live longer than men, well into the ages when the probability of needing care increases, 70 percent of elderly people who need long-term care are women. Furthermore, most long-term care is provided by women, mainly as unpaid care in the home, or as low-paid care in institutions and community settings (Stone & Weiner 2001). The United States faces a severe long-term care crisis because of the nation's inability to plan for the changing demographic balance. The crisis …

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.

Nevada Medicaid And Check Up Programs: Barriers To Enrollment And Utilization, The Nevada Institute For Children’S Research And Policy, Denise Tanata Ashby, Jennifer Waddoups, Tara Phebus

Nevada Institute for Children's Research and Policy Reports

This study offers only a brief look at some of the barriers Nevada children and families face with Medicaid and Nevada Check Up. Strengthening the Medicaid and Nevada Check Up programs is vital to improving children’s health care access and utilization in Nevada. By developing and implementing legislation to improve public health insurance coverage, access, and utilization in Nevada, policymakers can ensure a brighter, happier, and healthier future for Nevada’s children and families.

Communicable Disease And International Security: The Case Of Africa & Hiv/Aids, Amy L Rue

Archived Theses and Dissertations

In this thesis, I will look at how communicable disease fits into the human security discourse particularly with the disease being views as the 'potential threat' and the 'referent object' within the international sphere. The case of Africa will be used to illustrate the impact of HIV/AIDS on international security at country, regional and international levels. Ultimately, I will argue that communicable disease, as a human security issue, is a clear and important international security issue due to its status as a continual "potential threat" within international relations particularly in Africa. The elements that I will use to establish my …

Resuscitating A Healthcare Charity, R Akhileswaran, Seet Ai Mee

Social Space

When government funding policies change, voluntary welfare organisations that depend largely on subsidies to run their services can find their survival at stake. Dr R Akhileswaran and Dr Seet Ai Mee present the case study of HCA Hospice Care.

Assessment Of Maine's Long-Term Care Needs Baseline Report: Demographics And Use Of Long Term Care Services In Maine, Stuart Bratesman Mpp, Julie T. Fralich Mba, Karen Mauney, Catherine Mcguire Bs, Louise Olsen, Jasper Ziller

Disability & Aging

In 2006, the Office of Elder Services requested the assistance of the Muskie School in developing an assessment of long term care service use in Maine. This report provides baseline information on the demographic characteristics, participant characteristics and service use trends for people accessing long term care services in this State.

For purposes of this report, we have excluded people with MR/DD. Long term care services do not include community support services for people with mental illness.

In this report, long term care services include:

• Nursing Facility Services
• Private Non-medical Institutions
• Consumer Directed Attendant Services
• Day Health Services
• Elder and …

Health Care Poverty, Lisa Raiz

The Journal of Sociology & Social Welfare

This paper introduces and describes health care poverty. Underinsurance and its consequences for access to health care are highlighted. Definitions of underinsurance and its prevalence are presented. Groups that experience disproportionate barriers to obtaining medical care are identified. Manifestations of underinsurance are explicated and their relationship to receipt of medical care, such as vaccinations and medications is discussed. A refraining of the health care debate is suggested with emphasis moving from uninsurance to access to health care.

Pursuing Cost Containment In A Pluralistic Payer Environment: From The Aftermath Of Clinton’S Failure At Health Care Reform To The Balanced Budget Act Of 1997, Rick Mayes, Robert E. Hurley

Political Science Faculty Publications

Following a decade in which Medicare operated as the leading ‘change agent’ within the US health care system, the private sector rose to the fore in the mid 1990s. The failure of President Clinton’s attempt at comprehensive, public sector-led reform left managed care as the solution for cost control. And for a period it worked, largely because managed care organizations were able to both squeeze payments to selective networks of medical providers and significantly reduce inpatient hospital stays. There was a lot of ‘fat’ in the nation’s convoluted health care system that could be (and was) eliminated through competitive negotiations …

The War On Drugs V. The War On Pain: Do Controlled Prescribing Laws Have A Role?, Susanne F. Homant

Dissertations

The illegal use of prescription drugs and the under-treatment of chronic pain are both considered serious public health issues in this country. Strong medicines classified as controlled substances by the DEA are often used to treat chronic pain conditions and are also known to be diverted to non-medical uses, thus a solution to one problem may happen at the expense o f the other. Prescription Monitoring Programs (PMPs) are public policies that are felt by many to address diversion of controlled substances, and are generally welcomed by law enforcement as an excellent tool in the war against drugs. A number …

The Origins Of And Economic Momentum Behind "Pay For Performance" Reimbursement, Rick Mayes

Political Science Faculty Publications

"Pay for performance," a reimbursement method under which some physicians and hospitals are paid more than others for the same services because they have been deemed to deliver better quality care and their patients appear to have better outcomes, is enormously controversial. Disputes invariably arise over how "quality" should (or even can) be measured. Nevertheless, differentiating between medical providers, financially, lies at the heart of this new reimbursement innovation developed by insurance companies and employers. Its two main objectives are: (1) to increase the overall quality of health care that patients receive, and (2) to encourage behavioral change on the …

Update - September 2005, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Just Care: Rationing in a Public Health Crisis
-- Editorial
-- Graduate profiles
-- Jack W. Provonsha Lecture Series: Physician-Assisted Suicide: A Religious Perspective

Compendium Of Quality Indicators: Older Adults, Adults With Physical Disabilities, Adults With Mental Retardation/Autism Living At Home, In The Community Or In Long Term Care Facilities, Julie T. Fralich Mba, Stuart Bratesman Mpp

Disability & Aging

Researchers at the Muskie School of Public Service compiled over 15 tools and surveys. Included in the report are Participant Experience Surveys, Performance Indicators, Experience Surveys, Core Indicators, Consumer Surveys, Behavioral Risk Factors, Outcome Measures, and a variety of Quality Measures. Sample questions and tools are shown in this Compendium of Quality Indicators

Access To Housing For Persons With Disabilities: Lessons Learned From Three Demonstration Projects, Cutler, Disability And Aging, Eileen Griffin Jd

Disability & Aging

The Quality Choices for Maine project was conducted from 2001-2004. This report focuses on Access to Services, one part of the three-year RCSC Quality Grant. The specific housing related goal was “to improve access to community housing for people with disabilities of all types.” Project activities were overseen by the Access to Services Technical Assistance Group and a variety of stakeholders. Read the activity summaries, lessons learned and recommendations on how to sustain the work.

Medicare And America's Healthcare System In Transition: From The Death Of Managed Care To The Medicare Modernization Act Of 2003 And Beyond, Rick Mayes

Political Science Faculty Publications

This article traces the transition-in Medicare, specifically, and in the American healthcare system, generally-from the aftermath of the Balanced Budget Act of 1997 to the passage of the Medicare Modernization Act of 2003. During this time, restrictive managed care died under an onslaught of resurgent cost pressures, legislative and legal attacks, and a vehement physician and consumer backlash. The subsequent reversion to more generous (and more expensive) health plans coincided with a recession in 2001 to trigger a return to rapidly escalating healthcare spending and yet another in the Nation's series of healthcare crises. Current trends suggest that future policymakers …

Factors Affecting Treatment Program Development In A Mental Health Facility Serving Prisoners, Ruby Miranda Meriweather

Dissertations

There is a paucity of literature on how treatment programs for mentally ill prisoners are developed. Federal mandates require that services to mentally ill prisoners be comparable to what is offered in the community. Planners, therefore, must find ways to provide treatment programs that produce that outcome.

This research identified the most important factors that affect treatment program development and implementation to aid planners in designing treatment programs for mentally ill prisoners. This qualitative study, based on grounded theory, used a structured interview with 61 mental health staff (psychiatrists, nurses, psychologists, social workers, and activity therapists) across three categories (Administrative, …