Health Policy Commons^™

Financing Community Health Centers As Patient- And Community-Centered Medical Homes: A Primer, Peter Shin, Leighton C. Ku, Emily Jones, Brad Finnegan, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

This policy brief is part of a Commonwealth Fund-supported project that examines community health centers in the context of the patient-centered medical home (PCMH) movement. Community health centers—non-profit primary care facilities that provide care to patients regardless of their ability to pay—are widely lauded as critical components of the health care safety net, providing comprehensive primary care for lowincome, high-risk populations in both urban and rural areas. Since their inception, health centers have directed their activities at improving patient care—through comprehensive primary health care, coordination with specialty care, and the provision of enabling services—as well as improving population-level health status …

The Treatment Action Campaign's First Decade: Success Achieved?, Jung Cho

Honors Scholar Theses

South Africa is known to have the largest HIV epidemic in the world with 5.7 million people currently living with HIV, according to UNAIDS. In light of the crisis, South Africa's Treatment Action Campaign (TAC) has led the social movement for increased treatment access for people living with HIV through lobbying the government, multinational pharmaceutical companies, and grassroots campaigning. Since it's founding a decade ago, TAC has been highly acclaimed both regionally and internationally for its success. In order to determine the success of this social movement organization, social movement theories, such as mobilization potential, external political opportunity structure, and …

Roundtable: Health Care Coverage, Sara J. Rosenbaum

Health Policy and Management Congressional Testimonies

At the Senate Finance Committee Hearing held on May 5, 2009, Sara Rosenbaum, J.D., addressed three issues related to health care coverage: How can coverage be made more affordable and workable for individuals and small businesses? What are the roles and responsibilities of individuals, employers, and government in achieving health coverage for all Americans? What role should public programs play? This transcript of her official statement begins with general observations concerning Health Coverage in America in order to provide a context to address these more specific questions.

The Continuing Cost Of Privatization: Extra Payments To Medicare Advantage Plans Jump To $11.4 Billion In 2009, Brian Biles, Jonah Pozen, Stuart Guterman

Health Policy and Management Faculty Publications

The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, MA plans have, for the past six years, been paid more for their enrollees than they would be expected to cost in traditional fee-for-service Medicare. Payments to MA plans in 2009 are projected to be 13 percent greater than the corresponding costs in traditional Medicare—an average of $1,138 per MA plan enrollee, for a total of $11.4 billion. Although the extra payments are used to provide enrollees additional benefits, those benefits are not available to all beneficiaries—but they are financed by …

The H1n1 Influenza A Virus: A Test Case For A Global Response, Rebecca L. Katz, Karyn Feiden

Health Policy and Management Faculty Publications

The threat of widespread infection from the new H1N1 influenza A virus (also known as a swine flu virus) provides the first real-time test of the global and domestic preparedness activities that have moved forward over the past few years. The World Health Organization has declared the event a "public health emergency of international concern," the first time that designation has been used under the revised International Health Regulations. A public health emergency has also been declared in the United States.

Those steps have pushed influenza plans at the local, state, national, and global levels into motion. This paper reviews …

Isp Indicators / Combined Report, Helen Hemminger Mmhs

Disability & Aging

No abstract provided.

Controlling The Cost Of Municipal Health Insurance: Lessons From Springfield, Robert L. Carey

Edward J. Collins Center for Public Management Publications

The study finds that, by joining the Group Insurance Commission (GIC), Springfield cut increases in its health care costs an estimated $14 million to $18 million over two years. It saved an additional $5 million per year by requiring eligible municipal retirees to enroll in Medicare Part B as a precondition of receiving supplemental health coverage from the City. These two actions, together, reduced increases in the City’s health care costs an estimated 15-19% annually, on average, with savings growth each year due to compounding. Furthermore, the study estimates that if the GIC continues its past pattern of keeping its …

State Report Of Unmet Needs For Quarter 3 Fy '09 (Jan- Mar '09), Helen Hemminger Mmhs

Disability & Aging

No abstract provided.

Food Justice As Crime Prevention, Avi Brisman

Journal of Food Law & Policy

In December 2008, Governor David Paterson (D-NY) proposed an 18 percent tax on nondiet sodas and fruit drinks containing less than 70 percent natural fruit juice. While the tax was part of a broader budget proposal designed to address New York State's fiscal crisis - a plan that that included new taxes and tax hikes on 137 items and services' - state officials promoted the "obesity tax," as the soft drink levy came to be called, as a public health measure.

Primary Health Care Access Reform: Community Health Centers And The National Health Service Corps, Fitzhugh Mullan

Health Policy and Management Congressional Testimonies

This testimony by Fitzhugh Mullan, M.D., addresses the following issues:

• Improving access to health care in the United States will require modifications in the U.S. health care workforce, the foremost of which will be the construction of a strong primary care base.
• Two-thirds of the U.S. physician workforce practice as specialists and the number of young physicians entering primary care is declining.
• The distribution of health care providers in the U.S. heavily favors urban areas. Metropolitan areas have 2-5 times as many physicians as non-metropolitan areas and economically disadvantaged areas have significant health care access problems.
• Today's physician-to-population ratio is …

Examining The Experiences Of Puerto Rico's Community Health Centers Under The Government Health Insurance Plan, A. Seiji Hayashi, Brad Finnegan, Peter Shin, Emily Jones, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This research brief examines the experiences of Puerto Rico's community health centers under the Commonwealth’s 1994 Government Health Insurance Plan (GHIP) – the Commonwealth's Medicaid program – also known as the Reforma. Of particular interest are the effects of Medicaid under-financing coupled with health centers' continuing obligations to furnish subsidized care for uninsured patients. To finance GHIP, the Commonwealth substantially curtailed its involvement with the direct provision of health care in both community and inpatient settings, transforming the former system of direct care provision into health insurance premium subsidies.

In 2007, the 47 operating sites of Puerto Rico's 19 federally …

Children’S Health Care: Health Information Technology And Electronic Health Records, David M. Stevens

Health Policy and Management Faculty Publications

The panel addressed: Why pediatric electronic health records are different from adult EHRs; How HIT/EHRs can be helpful in the area of prevention with pediatric populations; How using HIT/EHRs can help improve quality and outcome measures for children and underserved communities; Barriers to getting HIT/EHRs into underserved communities and ways to overcome these challenges; Opportunities for stimulus funds to support HIT access for underserved pediatric populations; and Privacy and confidetiality concerns regarding pediatric EHRs.

Overview Of Mapping Applications In Health Research, Helen Hemminger Mmhs

Disability & Aging

No abstract provided.

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.

Over-Utilization Of Advanced Imaging In The Hospital Setting: An Educational Approach To Reduce Unnecessary Inpatient Studies, Guillermo Madero, J. Platnick, L. Voutsinas, R. Wetz, S. Buchbinder

Internal Medicine

By several measures, health care spending continues to rise, forcing businesses and families to cut back on operations and household expenses. In 2008, health care spending in the United States reached $2.4 trillion dollars, and is projected to reach $3.1 trillion in 2012.During the past decades, there has been a steady increase in the utilization of expensive inpatient imaging studies, with an overall increase in health care costs. In particular, advanced imaging includes CT, MRI and Nuclear Medicine, used for the diagnosis and management of hospitalized patients. The reasons for unnecessary imaging examinations include indirect financial benefit to physicians, medico-legal …

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 …

Health Care Workforce Issues And Access To Care: Assessing The Present And Preparing For The Future, Fitzhugh Mullan

Health Policy and Management Congressional Testimonies

Summary of Testimony Fitzhugh Mullan, M.D. Before the House Energy and Commerce Subcommittee on Health, March 24, 2009

• Improving access to health care in the United States will require modifications in the structure of the U.S. physician workforce, the foremost of which will be the construction of a strong primary care delivery base.
• There are over 800,000 practicing physicians today or 280 physicians per 100,000 people. This represents a greater physician density than Canada (210) and the United Kingdom (250) but a density less than France (340) and Germany (350).
• The distribution of physicians in the U.S. heavily favors urban …

U.S. District Court Directs Fda To Reevaluate Previous Plan B Decision, Susan F. Wood, D. Richard Mauery

Health Policy and Management Faculty Publications

Judge Edward R. Korman of the U.S. District Court, Eastern District of New York, issued a decision today (Mar. 23, 2009) in the case of Annie Tummino et al v. Frank M. Torti, Acting Commissioner of the Food and Drug Administration. The case involved plaintiffs' claims that the FDA, in deciding that Plan B, known as emergency contraception or the morning-after pill, be made available over-the-counter (OTC) only with age restrictions, was unduly and inappropriately influenced by pressures from the White House among other factors.

An Overview Of Major Health Information Technology, Public Health, Medicaid, And Cobra Provisions Of The American Recovery And Reinvestment Act Of 2009, Sara J. Rosenbaum, Melissa M. Goldstein, Taylor Burke, Phyllis Borzi, Lara Cartwright-Smith

Health Policy and Management Faculty Publications

A detailed side-by-side analysis of the individual components of the American Recovery and Reinvestment Act of 2009 (ARRA), signed into law on February 17, 2009. One of the most sweeping pieces of economic legislation ever enacted, ARRA not only provides hundreds of billions of dollars in new health and health care spending but also makes comprehensive reforms in health law and policy, particularly in the area of health information law, including health information technology (HIT) adoption and health information privacy.

Workforce Issues In Health Care Reform: Assessing The Present And Preparing For The Future, Fitzhugh Mullan

Health Policy and Management Congressional Testimonies

Summary of Testimony Fitzhugh Mullan, M.D. Before the Senate Finance Committee March 12, 2009

• Health Care Reform will require modifications in the structure of the U.S. physician workforce the foremost of which is the construction of a strong primary care delivery base.
• There are over 800,000 practicing physicians today or 280 physicians per 100,000 people. This represents a greater physician density than Canada (210) and the United Kingdom (250) but a density less than France (340) and Germany (350).
• The distribution of physicians in the U.S. heavily favors urban areas. Metropolitan areas have 2-5 times as many physicians as non-metropolitan …

Community Health Centers In An Era Of Health System Reform And Economic Downturn: Prospects And Challenges, Sara J. Rosenbaum, Brad Finnegan, Peter Shin

Health Policy and Management Faculty Publications

This Policy Brief examines the role of health centers in the U.S. health care system, assessing their current and future roles in an era of both great promise and challenge. On one hand, government is poised perhaps more sharply than any time in nearly a generation to undertake a comprehensive effort at national health reform, addressing not only coverage but also access, quality, prevention, and the reinvigoration of primary health care, particularly for populations who face the highest health risks. On the other hand, the nation is facing the most severe economic recession in years, with lower income families and …

Vaccines And Autism: The Evidence And The Law, Alexandra M. Stewart

Health Policy and Management Faculty Publications

A potential link between the measles-mumps-rubella vaccine and autism was dismissed by a federal vaccine court in February 2009. The U.S. Department of Health and Human Services said the findings demonstrate a lack of medical evidence for any association, while Autism Speaks, a patient advocacy group, said questions remain about potential risks for certain subgroups.

Other legal actions are pending as the scientific and patient advocacy communities debate the need to conduct further research on the vaccine-autism link. Meanwhile, public health advocates worry that continuing concerns about the safety of vaccines may depress the population immunization rate. A small rise …

How Is The Primary Care Safety Net Faring In Massachusetts? Community Health Centers In The Midst Of Health Reform, Leighton C. Ku, Emily Jones, Brad Finnegan, Peter Shin, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

Massachusetts' landmark 2006 health reform legislation sets an important precedent for national reform. Initial evaluations have demonstrated the law's success in dramatically expanding health insurance coverage and health care access, but less is known about its effects on community health centers, which serve one of every 13 residents and one in four low-income residents. This analysis evaluates the experiences of health centers with the Massachusetts reforms, using administrative data to examine finances and patient enrollment in addition to the qualitative results of in-depth interviews conducted during site visits in August 2008 and the results of a short survey of health …

Retiree Health Vebas: A New Twist On An Old Paradigm: Implications For Retirees, Unions And Employers, Phyllis Borzi

Health Policy and Management Faculty Publications

This issue brief provides an overview of stand-alone Voluntary Employees' Beneficiary Association trusts, through which employers have been able to rid themselves of future obligations to pay retiree health benefits in exchange for making a significant payment to designed to approximate the projected cost of these benefits. The paper include three case studies, including the VEBAs at the Big Three automakers.

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.

Penerapan Prinsip Manajemen Kualitas Di Poli Umum Puskesmas Kecamatan Tebet Jakarta Selatan, Agus Fitri Angga

Kesmas

Poli Umum Puskesmas Kecamatan Tebet telah melaksanakan prinsip manajemen kualitas sesuai klausul persyaratan ISO 9001:2000. Namun, pada tahun 2005, masih terdapat masalah yang mengganggu pelayanan bermutu yang diberikan. Tujuan penelitian ini mendapat gambaran penerapan delapan prinsip manajemen kualitas sistem manajemen mutu ISO 9001:2000 di Poli Umum Puskesmas Kecamatan Tebet. Metode yang digunakan adalah kualitatif studi kasus dengan analisis dokumen, wawancara mendalam, dan observasi. Prinsip terfokus pelanggan diterapkan dengan melakukan survey kepuasan pelanggan dan temu pelanggan secara rutin. Prinsip kepemimpinan diterapkan melalui motivasi, rapat tinjauan manajemen secara rutin. Prinsip keterelibatan semua diterapkan dengan memberi kesempatan petugas poli umum dalam pengambilan keputusan …

An Overview Of Major Health Provisions Contained In The American Recovery And Reinvestment Act Of 2009, Sara J. Rosenbaum, Lara Cartwright-Smith, Taylor Burke, Phyllis Borzi, Melissa M. Goldstein

Health Policy and Management Issue Briefs

On February 17, 2009, President Barack Obama signed the American Recovery and Reinvestment Act of 2009 (ARRA) into law. One of the most sweeping pieces of economic legislation ever enacted, ARRA not only provides hundreds of billions of dollars in new health and health care spending but also makes comprehensive reforms in health law and policy, particularly in the area of health information law, including health information technology (HIT) adoption and health information privacy.

Assessing The Need For On-Site Eye Care Professionals In Community Health Centers, Peter Shin, Brad Finnegan

Health Policy and Management Issue Briefs

Poor vision health severely impacts school and work performance, quality of life, and life expectancy, and results in billions of dollars in medical expenditures each year. While eye and vision problems are often associated with age, low income and racial and ethnic minorities also have elevated risk of eye problems. Federally-funded community health centers, which are mandated to provide comprehensive primary care in underserved communities, are often the only option to improve vision health for low-income residents.

With respect to certain chronic conditions, health centers are able to provide high quality care that meets or exceeds national benchmarks despite limited …

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.