Health Policy Commons^™

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).

Children And Adults With Long Term Services And Support Needs: Mainecare And Medicare Expenditures And Utilization, State Fiscal Year 2010, Stuart Bratesman Mpp, Julie T. Fralich Mba, Tina Gressani, Eileen Griffin Jd

Disability & Aging

This report is one of a series of reports prepared by the USM Muskie School on MaineCare members who are dually eligible for MaineCare and Medicare Services. An earlier report provided a high level overview of the MaineCare and Medicare use and expenditure patterns for all members who were dually eligible in state fiscal years (SFY) 2008 to 2010. Both reports were prepared as part of the Maine State Profile Tool grant funded by the Centers for Medicare & Medicaid Services. This second report analyzes the characteristics, use and expenditure patterns of sub-populations of long term service users including adults …

Satisfaction Survey Results And Lessons Learned: Maine's Aging & Disability Resource Center (Adrc) Project, Julie T. Fralich Mba, Louise Olsen, Mark Richards Bs, Jennifer Pratt, Taryn Bowe

Disability & Aging

The primary goal of Maine’s Aging and Disability Resource Center (ADRC) Project was to empower consumers to make informed decisions about long-term services and supports and to streamline access to existing services and supports through an integrated system. With funding from the Administration on Aging to strengthen and expand the number of Aging and Disability Resource Centers (ADRCs) in the state, all five of the Area Agencies on Aging were committed to becoming and/or strengthening their capacity to be fully functioning ADRCs.

This report provides a summary of the results of consumer satisfaction surveys that were conducted for three years …

Funding Health-Related Vr Services: The Potential Impact Of The Affordable Care Act On The Use Of Private Health Insurance And Medicaid To Pay For Health-Related Vr Services, Robert Silverstein

All Institute for Community Inclusion Publications

One of the myriad of issues affecting the administration of the vocational rehabilitation (VR) program by State VR agencies under Title I of the Rehabilitation Act is how to maximize access to and use of all available funding sources to pay for VR services and supports for VR applicants and clients. In March 2010, Congress passed and the President signed into law the "Affordable Care Act" (ACA). 1 On June 28, 2012, the United States Supreme Court upheld all of the provisions of the ACA, with the exception of provisions mandating Medicaid expansion. The Supreme Court held that if a …

Town Of Cohasset Senior Center Study, Jan Mutchler, Hayley Gravette, Caitlin Coyle

Gerontology Institute Publications

The Town of Cohasset is considering the construction of a new Senior Center that will provide the opportunity for expanded programming within a dedicated building. In support of planning efforts by the Town of Cohasset, a study was conducted by the Gerontology Institute of the McCormack Graduate School at UMass Boston. The study addresses the need for, and probable utilization of, a new Senior Center, and includes consideration of the recreational, educational and health-related programs that are likely to be offered through the new Center. Results of the study presented in this report respond to three questions: First, what are …

Maine Direct Service Workforce Survey Results 2012 [Chartbook], Julie T. Fralich Mba, Eileen Griffin Jd, Danielle Wescott

Disability & Aging

Direct service workers play a central role in the quality of the long-term services and supports provided to older people and people with disabilities in home and community settings. Nationally, and at the state level, there is a critical need for more information about this workforce in order to inform workforce policy and measure improvements in workforce quality and stability over time. Maine was one of seven states to administer baseline surveys under a grant funded by the U.S. Centers for Medicare and Medicaid Service. Survey questions focused on workforce volume, stability, and compensation, as well as, cultural competence, workforce …

The Power To Block The Affordable Care Act: What Are The Limits?, John D. Kraemer, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Though Supreme Court upheld most parts of the Affordable Care Act (ACA), Congress’ goals in enacting it could still be frustrated by non-implementation. During his campaign for president, Governor Romney promised “to issue Obamacare waivers to all fifty states.” While such blanket waivers would likely violate the Constitution’s Take Care Clause, the ACA does permit other waivers. To be lawful, however, they must meet certain requirements designed to enhance access and lower cost. A president who opposes the ACA might be able to limit its implementation by refusing to issue premium subsidies in federally operated insurance exchanges, and this might …

Medicaid Coverage For Individuals In Jail Pending Disposition: Opportunities For Improved Health And Health Care At Lower Costs, Marsha Regenstein, Jade Christie-Maples

Health Policy and Management Faculty Publications

The Patient Protection and Affordable Care Act (ACA) provides an unprecedented opportunity for millions of poor men and women to obtain insurance coverage to address their substantial acute, chronic, physical and behavioral health care needs. The ACA raises Medicaid eligibility levels to 133 percent of poverty, thereby enabling adults with or without children to qualify for coverage. A substantial percentage of the newly eligible population will be jail-involved individuals – people who have had interactions with the legal system over the course of a year, including as an inmate at a county or city jail. Many of these individuals are …

Coverage Of Medicaid Preventive Services For Adults: A National Review, Sara E. Wilensky, Elizabeth A. Gray

Health Policy and Management Faculty Publications

No abstract provided.

"Homelike" Characteristics Of Maine's Residential Services: A Survey Of Maine's Residential Service Settings (2010), Julie T. Fralich Mba, Eileen Griffin Jd, Catherine Mcguire Bs

Disability & Aging

To better understand the nature of the residential facilities serving more than 19 percent of Maine’s Long Term Services and Supports (LTSS) population, the Maine Department of Health and Human Services commissioned the Muskie School to conduct a survey of residential facilities as part of its update to Maine’s LTSS profile. The goal of the Maine Residential Settings Characteristics Survey, conducted between July and September 2010, was to measure the "homelike" characteristics of residential settings.

The survey sample comprised a total of 636 facilities which included all licensed residential care facilities or private non-medical licensed institutions. The survey response rate …

Members Dually Eligible For Mainecare And Medicare Benefits: Mainecare And Medicare Expenditures And Utilization, State Fiscal Year 2010., Catherine Mcguire Bs, Tina Gressani, Stuart Bratesman Mpp, Julie T. Fralich Mba, Eileen Griffin Jd

Disability & Aging

This report is one of a series of reports prepared by the USM Muskie School on MaineCare members who are dually eligible for MaineCare and Medicare Services. This first report provides a high level overview of the MaineCare and Medicare use and expenditure patterns for all members who were dually eligible in state fiscal years (SFY) 2008-2010. This report provides baseline data on the characteristics of Medicare-MaineCare members who are dually eligible, the distribution of expenditures across categories of service for MaineCare and Medicare, and the cost of care for people with select chronic conditions. The report includes information on …

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 …

Health Care Reform And Women's Insurance Coverage For Breast And Cervical Cancer Screening, Alice R. Levy, Brian K. Bruen, Leighton C. Ku

Health Policy and Management Faculty Publications

INTRODUCTION:

The Patient Protection and Affordable Care Act of 2010 (ACA) will increase insurance coverage for US citizens and for breast and cervical cancer screening through insurance expansions and regulatory changes. The primary objective of this study was to estimate the number of low-income women who would gain health insurance after implementation of the ACA and thus be able to obtain cancer screening. A secondary objective was to estimate the size and characteristics of the uninsured low-income population and the number of women who would still need National Breast and Cervical Cancer Early Detection Program (NBCCEDP) services.

METHODS:

We used …

Reducing Unlawful Prescription Drug Promotion: Is The Public Health Being Served By An Enforcement Approach That Focuses On Punishment?, Vicki W. Girard

Georgetown Law Faculty Publications and Other Works

Despite the imposition of increasingly substantial fines and recently successful efforts to impose individual liability on corporate executives under the Park doctrine, punishing pharmaceutical companies and their executives for unlawful promotional activities has not been as successful in achieving compliance with the Federal Food, Drug, and Cosmetic Act (FD&C Act) as the protection of the public health demands. Over the past decade, the Food and Drug Administration (FDA) and the Department of Justice (DOJ) have shifted their focus from correction and compliance to a more punitive model when it comes to allegedly unlawful promotion of pharmaceuticals. The shift initially focused …

Twenty Counties In Nebraska Have Uninsured Rate Over 20 Percen, Melanie Kiper

Archived Publications

The U.S. Census Bureau recently released 2010 estimates of health insurance coverage for each of the nation’s roughly 3,140 counties.

Small Area Health Insurance Estimates (SAHIE; http://www.census.gov/did/www/sahie/index.html) are the only source for single-year estimates of health insurance coverage status for every county in the nation. These estimates are available by sex, age groups, race and Hispanic origin (for states only), and income-to-poverty ratios.

Deteriorating Access To Women's Health Services In Texas: Potential Effects Of The Women's Health Program Affiliate Rule, Leighton C. Ku, Lara Cartwright-Smith, Jessica Sharac, Erika Steinmetz, Julie Lewis, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Based on an earlier study and an in-depth analysis of five market areas, the authors find that Texas' plan to bar Planned Parenthood clinics from participating in the state Women's Health Program (WHP) would leave tens of thousands of women without a source of care, because Planned Parenthood clinics are the dominant WHP providers in those areas and other local family planning clinics lack the capacity to absorb a large number of additional patients.

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 …

Assessment Of Migrant Health And Health Disparities Between Immigrants And Swiss Nationals Living In Switzerland, Gabriela Mujica-Martorell

Independent Study Project (ISP) Collection

Switzerland is one of the most diverse nations within the OECD and boasts one of the highest net migration rates; it also has one of the highest rated health care systems in the world. Nevertheless, it has been shown that health disparities exist between the Swiss migrant and Swiss national populations: migrants are especially more prone to overweight/obesity, dental health problems, various forms of physical pain, and psychological distress. The purpose of this investigation is to evaluate to what extent certain health conditions are a problem to the immigrant and Swiss national populations. The study also will explore some of …

Strategies To Improve Health Coverage And Narrow The Equity Gap In Child Survival, Health, And Nutrition, Mickey Chopra

Aboriginal Policy Research Consortium International (APRCi)

Implementation of innovative strategies to improve coverage of evidence-based interventions, especially in the most marginalised populations, is a key focus of policy makers and planners aiming to improve child survival, health, and nutrition. We present a three-step approach to improvement of the effective coverage of essential interventions. First, we identify four different intervention delivery channels—ie, clinical or curative, outreach, community-based preventive or promotional, and legislative or mass media. Second, we classify which interventions’ deliveries can be improved or changed within their channel or by switching to another channel. Finally, we do a meta-review of both published and unpublished reviews to …

Empowering The Citizen-Consumer: Re-Regulating Consumer Information To Support The Transition To Sustainable And Health Promoting Food Systems In Canada, Rod Macrae, Michelle Szabo, Kalli Anderson, Fiona Louden, Sandi Trillo

Publications and Scholarship

Both health and sustainability are stated public policy objectives in Canada, but food information rules and practices may not be optimal to support their achievement. In the absence of a stated consensus on the purposes of public information about food, the information provided is frequently determined by the marketers of product. No institution or agency has responsibility for determining the overall coherence of consumer food messages relative to these broader social goals of health and sustainability. Individual firms provide information that shows their products to best advantage, which may contradict what is provided about the product by another firm or …

Women’S Political Leadership In Massachusetts, Paige Ransford, Meryl Thomson, Sarah Healey

Publications from the Center for Women in Politics and Public Policy

The Center for Women in Politics and Public Policy (CWPPP) at UMass Boston’s McCormack Graduate School of Policy Studies has been tracking the election of women at the municipal level in Massachusetts since 1996. In 2003, the Project expanded to include all New England states. CWPPP remains the only research center in the United States that regularly tracks women’s political representation at the local level.

Global Health Governance: Analyzing China, India, And Japan As Global Health Aid Donors, Ann Florini, Karthik Nachiappan, Tikki Pang, Christine Pilcavage

Research Collection School of Social Sciences

Development assistance is a significant mechanism by which major countries exercise influence in the global health arena. Of the major Asian powers, Japan has long provided significant funding, while China and India have primarily been recipients but are beginning to increase their funding roles. This article examines the amounts, channels, modes, disease allocations and the geographic focuses of their foreign health aid, and delineates the institutional structures that govern the formulation and implementation of foreign health aid policy in each of these countries, to explore what influence China, India, and Japan have and may develop in the global health arena. …

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.

The Quest For Universal Health Coverage: Achieving Social Protection For All In Mexico, Felicia Marie Knaul, Eduardo GonzáLez-Pier, Octavio GóMez-DantéS, David GarcíA-Junco, HéCtor Arreola-Ornelas, Mariana Barraza-LloréNs, Rosa Sandoval,, Francisco Caballero, Mauricio HernáNdez-Avila, Mercedes Juan, David Kershenobich, Gustavo Nigenda, Enrique Ruelas, Jaime SepúLveda, Roberto Tapia, Guillermo SoberóN, SalomóN Chertorivski, Julio Frenk

Aboriginal Policy Research Consortium International (APRCi)

Mexico is reaching universal health coverage in 2012. A national health insurance programme called Seguro Popular, introduced in 2003, is providing access to a package of comprehensive health services with financial protection for more than 50 million Mexicans previously excluded from insurance. Universal coverage in Mexico is synonymous with social protection of health. This report analyses the road to universal coverage along three dimensions of protection: against health risks, for patients through quality assurance of health care, and against the financial consequences of disease and injury. We present a conceptual discussion of the transition from labour-based social security to social …

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 …

Justice Roberts’ America, Robin West

Georgetown Law Faculty Publications and Other Works

Less than a week after the Roberts Court issued its decision in National Federation of Independent Business v Sebelius, Jeffrey Toobin, writing in The New Yorker, compared the first part of Chief Justice John Roberts's opinion, in which he found that the Commerce Clause did not authorize Congress to enact the "individual mandate" section of the Affordable Care Act (ACA) that requires all individuals to buy health insurance, with an Ayn Rand screed, noting that the pivotal sections of the argument were long on libertarian rhetoric but short on citations of authority. Roberts held (although "held" might be …

How The Supreme Court's Medicaid Decision May Affect Health Centers: An Early Estimate, Katherine J. Hayes, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The nation's federally funded health centers are the principal source of primary health care for medically underserved populations. In CY 2011, more than 1,200 health centers, operating in more than 8,500 urban and rural locations, served 20.2 million patients, 36 percent of whom were uninsured and 93 percent of whom had family incomes below twice the federal poverty level. Federal grants provide core support to health centers, but Medicaid represents the largest single health center financing mechanism, accounting for 39 percent of revenues. Medicaid revenue growth allows health centers to preserve their core grant funding to reach uninsured patients while …

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.

An O’Neill Institute Briefing Paper: The Supreme Court’S Landmark Decision On The Affordable Care Act: Healthcare Reform’S Ultimate Fate Remains Uncertain, Emily W. Parento, Lawrence O. Gostin

O'Neill Institute Papers

The Supreme Court’s decision on the constitutionality of the Patient Protection and Affordable Care Act (ACA) is a landmark on the path toward ensuring universal access to health care in the United States. In a 5-4 decision written by Chief Justice Roberts, the Court upheld the law in its entirety with the sole exception that Congress may not revoke existing state Medicaid funding to penalize states that decline to participate in the Medicaid expansion under the ACA. In this O’Neill Institute Briefing, we explain and analyze the Court’s decision, focusing on the individual purchase mandate and the Medicaid expansion, while …