Health Policy Commons^™

A Primer For 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. To ensure that providers behave appropriately, the federal and state governments have established an extensive set of regulations that nursing homes must comply with if they are to be reimbursed for patients insured by Medicaid. Consumers exert considerable influence here by focusing on regulations and enforcement of non-compliance.

States also seek to align providers’ interests with those of other interested parties through controls and incentives built into state reimbursement systems, including with respect to facility cost and quality, access to care, payment equity, service capacity, and budgetary …

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

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. State governments 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.

Often, participation in the process of developing Medicaid payment policy is limited to state agency officials and providers of care and, occasionally, union representatives and state legislative staff. Invited less frequently to reimbursement policy discussions are consumer representatives. Lack of consumer involvement in the development of state rate setting systems has the potential to result in the …

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 …

“La Percepción Social De Vih/Sida En Chile Y Sus Efectos”, Philip Krause

Independent Study Project (ISP) Collection

Research Question—How does the social perception of HIV/AIDs in Chile affect the country’s prevention and treatment programs?

Background-- This paper investigated the social perception of HIV/AIDs in Chile through the opinions of experts who work closely to the issue, including regional and national political professionals, medical professionals on HIV/AIDs treatment teams in hospitals, and leaders of social organizations that had a relationship to HIV/AIDs representation and prevention. The professionals were also asked how they believed this perception affected the efforts of the Chilean government and national organizations in prevention and management of the HIV/AIDs epidemic in Chile. An …

Autism In Kenya: A Social, Educational And Political Perspective, Ariana Riccio

Independent Study Project (ISP) Collection

Autism is a widely misunderstood developmental disability that is generally diagnosed in early childhood and has been the recent subject of much media and medical attention in developed nations worldwide. While there has been a noted improvement in diagnostic and therapeutic options for children and their families in developing nations, the attention placed on disability, particularly on autism, is considered underdeveloped and inadequate. This paper will attempt to address the current framework surrounding autism in the area of Nairobi, Kenya and discuss the social attitudes, diagnostic practices, educational opportunities, and government intervention programs available in the area. Given the lack …

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, …

Who’S Pandemic Influenza Preparedness Framework: A Milestone In Global Governance For Health, Lawrence O. Gostin, David P. Fidler

Georgetown Law Faculty Publications and Other Works

In May 2008, the World Health Organization (WHO) adopted the Pandemic Influenza Preparedness Framework for the Sharing of Influenza Viruses and Access to Vaccines and Other Benefits (PIP Framework). The PIP Framework’s adoption ended years of difficult negotiations, which began after Indonesia refused to share samples of avian influenza A (H5N1) with WHO in late 2006. Indonesia justified its actions on the need to create more equitable access for developing countries to benefits, such as vaccines and antivirals, derived from research and development on shared influenza virus samples. The global health community feared that failure to share influenza virus samples …

Healers And Researchers: Towards A More Balanced Relationship, Gracie Tewkesbury

Independent Study Project (ISP) Collection

In my seminar paper, I discussed the benefits for both parties of collaboration between traditional healers and modern scientific researchers. If research is done on the medicinal effects of plants, these cures can be used more safely and effectively by members of the community. This relationship is greatly beneficial in theory, but the reality is less than ideal. Researchers, especially foreign ones, depreciate and exploit the knowledge of healers, and as a result, healers are often distrustful and unwilling to collaborate. The relationship between healers and researchers potentially holds the cures to countless diseases and can contribute directly to greater …

The Politics Of Health Outcomes And Income Inequality: A Time Series Cross-Sectional Analysis Of County-Level Mortality Rates In The United States, Timothy H. Callaghan

Honors Scholar Theses

: Health inequalities are pervasive in the United States today. Despite social epidemiologists frequently citing political and economic factors for this variance, political science has largely ignored these issues. Given this gap in the literature and the importance of the issue, more research is clearly needed to better understand the political and economic causes and implications of these health disparities. This study analyzes the topic in depth, examining how income inequality, which is believed to be a key factor in explaining health inequalities, is related to mortality rates at the county level. Examining aggregate data from all US counties from …

Finger Lickin’ Good: An Analytical Investigation Into The Urban Diet, Jennifer T.R. Tomlinson

Master of Liberal Studies Theses

In this analysis, the origins, customs and implications of fast-food culture will be explored with important focus on the customs of fast-food urban eating. Research indicates that lower-income urban areas are more likely to consume fast-food. The high consumption of fast-food subsequently results in the development of social and economical implications, which include health implications, economic dilemmas, a disconnection between consumers and their consumption and issues of social classification. This analysis also explores the customs of fast-food culture of Pine Hills, Florida with added emphasis on Pine Hills’ cultural uniqueness.

Parks And Obesity In Rural And Urban Nebraska, Michaela S. Wolf

Department of Environmental Studies: Undergraduate Student Theses

In order to better understand the role community design plays in obesity rates, this project studies a potential relationship between distance of parks from homes and obesity rates in four Nebraska counties. Park use may contribute to important health benefits, such as reducing risk of obesity by increasing physical activity levels. There are limitations to park use, such as crime rates and facility upkeep that are important to understand so that they might be managed and communities can reap greater benefits from their parks, including better fitness. This study examines park distance from homes as a potential limiting factor to …

Exploring Student Perceptions To Explain The Relationship Between Physical Activity And Academic Achievement In Adolescents: A Mixed Methods Study, Megan J. Hylok

College of Education and Human Sciences: Dissertations, Theses, and Student Research

A nationwide survey conducted by the Center for Disease Control in 2007 reported 65% of high school students did not meet the recommendation that youth participate in at least 60 minutes of physical activity most days of the week (CDC, 2008). While research has focused its attention primarily on bodily health, growing evidence supports the benefits of physical activity on brain health (Ratey & Hagerman, 2008). Physical activity is important and many adolescents are not meeting the recommendation, therefore, it is important to explore the adolescent perceptions to understand which factors influence physical activity participation. The significance of this study …

Aids Denialism, Erika Jenel Delos Santos, Roy Llana, Jocelyn Tan

Festival of Communities: UG Symposium (Posters)

AIDS denialism is a growing issue in many parts the world. Through scholarly journal articles, book resources and other research tactics, further understanding how HIV/AIDS denialism is unethical can be distinguished. Discovering that AIDS is most prominent in South Africa explains why denialism is as critical as it is. However, the unethical aspect of AIDS denialism is in effect particularly amongst families. When a South African inhabitant realizes they have AIDS, they feel outcasted by their families due to shame. They fear as though they will be disowned because they have flaws that are unacceptable. These family values are significant …

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 …

Influence Of Sexual Education On Sexual Behavior And Contraceptive Use Among 15 To 19 Year-Olds At Colégio Azevêdo Fernandes In Salvador, Brazil, Julia Still

Independent Study Project (ISP) Collection

Although sexual health education provided by the government through schools has shown positive results, such as those distributed by the Brazilian Ministry of Health, it is not the only source, nor the most implemented source, in which adolescents are exposed to and gain knowledge on the subjects of sexual behavior and sexual health. Just as Article 24 of the Convention on the Rights of the Child details, parents, schools and communities play important roles in the process of sexual education and are required to provide guidance and direction to youth (Pan American Health Organization, 2010). In addition to sexual health …

A Case Study Of Health Interventions And The Caste System: Addressing The Social Determinants Of Health Through Development At Crhp Jamkhed, Laura Kroart

Independent Study Project (ISP) Collection

In the Southeast Asian country of India, the ancient but in some cases still rigidly intact caste system plays a role in determining health status and outcomes for much of its population of over 1.2 billion people.[1] The Comprehensive Rural Health Project, located in Jamkhed in the state of Maharashtra, India, approaches health interventions from a development standpoint, addressing biomedical needs, structural and environmental concerns, and the social and economic determinants of health that impact the lives of over a million villagers in the surrounding area.[2] This independent study project was designed to analyze how the Comprehensive Rural …

Situation Assessment Of The Hiv Response Among Young People In Zambia, Sam Kalibala, Drosin Mulenga

HIV and AIDS

The main objective of this situational assessment is to compile and synthesize existing recent information on HIV and young people together with the current AIDS response for young people in Zambia—including programs, policies, and key partners—and to document gaps and challenges in the response. The assessment aims to further strengthen this response by all stakeholders including the Government of the Republic of Zambia, the UN, faith-based organizations, civil society organizations, donors, young people, and youth-led organizations. Recommendations include: amending and strengthening laws related to HIV programming for young people and involving them in design and implementation; offering health services, life …

Facilitating Regulatory Approval Of Multipurpose Prevention Technologies For Sexual And Reproductive Health, Martha Brady

HIV and AIDS

This brief describes multipurpose prevention technologies (MPTs) that address women's sexual and reproductive health (SRH) needs, and how to go about facilitating regulatory approval of this technology. It outlines a strategic framework to examine current regulatory guidance, as well a product development pathway to bring MPTs to market.

What Regulatory Guidance Exists For Multipurpose Prevention Technologies (Mpts)? A Review Of Key Guidance Documents And Their Applicability To Mpts, Martha Brady, Heeyoung Park

HIV and AIDS

This brief reviews regulatory guidance documents and how they may apply to multi-purpose technologies (MPTs). It examines guidance documents from the Food and Drug Administration (FDA), the European Medicines Agency (EMA) and the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The brief concludes by anticipating increased interactions with US regulatory agencies in hopes of finding new regulatory pathways that address MPTs specifically.

Hiv Integrated Biological And Behavioural Surveillance Survey (Ibbss) 2010, Federal Ministry Of Health

HIV and AIDS

This report by the Nigerian Federal Ministry of Health highlights the findings of an integrated biological and behavioral surveillance survey (IBBSS) in Nigeria among groups whose behaviors or occupations often place them at higher risk of contracting sexually transmitted infections, including HIV. The main objectives of the study were to assess the knowledge and beliefs of high-risk groups about STI and HIV, determine the prevalence of HIV infection among these groups, and obtain data that will permit identification of trends over time. Since the 2007 IBBSS survey report, a considerable number of interventions have commenced among the study groups.

Scaling Up The Integration Of Tuberculosis Screening Into Reproductive Health Services, Aphia Ii Or Project In Kenya

Reproductive Health

The Population Council’s APHIA II Operations Research and Kenya’s Ministry of Health implemented a pilot project in five facilities across Nairobi Province in 2010 with the aim of improving access to care and treatment for tuberculosis (TB) for women during postnatal care (PNC) services. As tuberculosis persists in Kenya, integration of screening and referrals within postnatal care services will increase case detection and treatment for those infected. Integration of TB screening is likely to be scaled up throughout PNC and maternal and child health services in Kenya. Strong linkages between health services, training, and supervision, and simple provider tools will …

The Need For School-Based Drug Prevention Programs In The Curriculum, Theodore Waldeck

McNair Poster Presentations

Drugs are still a problem facing our children. Studies have proven that prevention programs are beneficial to our children. In fact, one study, states that for every $150 spent per child for a program, $840 is saved in crime and healthcare costs (Caulkins, Chiesa, Pacula, and Paddock, 2002). What would the savings be if we educated our children from kindergarten, all the way through high school, instead of one, or a couple of years? Therefore, this study is to explain the need for implementing school-based drug prevention programs from kindergarten through twelfth grade.

First Generation Of Gender And Hiv Programs: Seeking Clarity And Synergy, Judith Bruce, Nicole Haberland, Amy Joyce, Eva Roca, Tobey Nelson Sapiano

Poverty, Gender, and Youth

In the past decade, there have been expanding resources to address the underlying gender dimensions of HIV. This has been particularly urgent in sub-Saharan Africa as the female-to-male infection ratios in young populations has reached 3 to 1 and sometimes above. The phrase “gender and HIV” has become commonplace yet does not provide any specific guidance as to target audiences, content, or measurable results. It can include everything from microcredit programs for HIV-positive women, to workplace programs seeking to change negative male norms, to efforts to increase respect for diverse sexual and gender identities. This review, conducted by the Population …

National Efforts Toward Fgm-Free Villages In Egypt: The Evidence Of Impact, Ghada Barsoum, Nadia Rifaat, Omaima El-Gibaly, Nihal Elwan, Natalie Forcier

Poverty, Gender, and Youth

This report is a midterm evaluation and documentation of the process and approach of the FGM-Free Village Model implemented in Egypt by the National Council of Childhood and Motherhood with assistance from the Population Council. In a comparison of responses from women and men in intervention groups to those in nonintervention (control) villages, data analysis shows that the program has been successful in changing views and attitudes toward female genital mutilation (FGM). FGM is an entrenched generational practice, and eradicating it in a community requires concerted effort over an extended period of time. This evaluation strongly recommends that efforts be …

Innovative Financing Through Pay-For-Performance For Providers To Improve Quality Of Care In Bangladesh: Transforming Research Into Action, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, Ismat Ara Hena

Reproductive Health

To improve access to and use of facility-based obstetric and newborn care, the Government of Bangladesh is implementing two innovative performance-based financing programs, namely demand-side financing (DSF) and pay-for-performance (P4P). With the purpose of identifying the lessons learned, limitations of the P4P and DSF models, and scopes for cross learning, a two-day workshop was organized in Dhaka. This workshop report, prepared by the Population Council, resulted in several recommendations to modify DSF and P4P schemes. In Bangladesh, the need for continuing performance-based financing programs to meet MDGs and other health indicators is beyond argument, but it is urgently required to …

Increasing Access To Safe Abortion In Rural Maharashtra: Outcomes Of A Comprehensive Abortion Care Model, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Shveta Kalyanwala

Reproductive Health

This assessment of a Comprehensive Abortion Care (CAC) model was conducted by the Population Council on behalf of the Consortium for Safe Abortions in India. The goal of the Consortium is to increase access to legal, safe, and comprehensive abortion services, including post-abortion family planning, in the public health system, and especially among the rural poor. This report describes the CAC model implemented in Aurangabad district, Maharashtra, and examines the extent to which the model improved (a) the availability and quality of abortion services in public sector facilities, and (b) women’s awareness and experiences with regard to abortion services. It …

Expanding Access To Safe Abortion And Post-Abortion Care: Recommendations Of A South Asia Regional Consultation, Population Council

Reproductive Health

A South Asia Regional Consultation, organized by the Population Council with representation from governments and key stakeholders of Bangladesh, India, Nepal, and Pakistan, was held in New Delhi, to discuss ways of expanding women’s access to safe abortion services. The Consultation deliberated on ways of expanding the provider base for safe induced abortion so as to overcome inadequate and inequitable access to safe abortion. They also looked to expand access to services for the management of incomplete abortion and complications of unsafe abortion that persist in the region and, thereby, to reduce morbidity and mortality resulting from unsafe abortion. In …

Introduction Of Medical Abortion In Ghana, Emmanuel Kuffour, Selina F. Esantsi, Placide Tapsoba, Gloria Quansah Asare, Ian Askew

Reproductive Health

To significantly expand women’s access to modern family planning and comprehensive abortion care services a provisional license was awarded to Marie Stopes International-Ghana by the Ghana Food and Drugs Board for the introduction and provision of the first medical abortion regimen (mifepristone and misoprostol) in Ghana. The Population Council conducted this study to document the introduction process; findings from the study will provide much needed evidence to inform policy decisionmaking and the scale-up phase. Overall the study has shown that medical abortion is a viable option for Ghanaian women--an overwhelming number of those who have benefitted from the procedure are …

Community Health Workers Can Effectively Provide Information And Referrals To People Living With Hiv In Their Communities, Population Council

Reproductive Health

A number of studies reported high levels of sexually transmitted infections among people living with HIV (PLHIV). Unfortunately, prevention interventions targeting PLHIV in the community are not common in Kenya, and most PLHIV who are not on ART have limited access to prevention information and risk-reduction counseling. The Population Council’s APHIA II Operations Research Project conducted a research project to address these gaps. This study was conducted in 2010 in collaboration with the International Center for Reproductive Health and the National AIDS and STI Control Programme. The findings show that the intervention had a number of positive outcomes and concludes …