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2014

Health Services Research

Articles 1 - 7 of 7

Full-Text Articles in Health Policy

The Economics Of Implementing Population Health Strategies, Glen P. Mays Dec 2014

The Economics Of Implementing Population Health Strategies, Glen P. Mays

Glen Mays

Successful strategies to scale up and spread complex community-level interventions require an understanding of the resources required for implementation, how best to distribute them among supporting institutions, and how resource consumption and distribution varies across settings. This session reviews methods and early findings from the RWJF’s Public Health Delivery and Cost Studies (DACS) Initiative, which includes 12 inter-related studies examining the causes and consequences of variation in the costs of delivering complex community-level prevention strategies across more than 300 community settings in 12 states. Findings from these studies highlight the value of studying the economics of implementation, the measurement and …


The Dynamics Of Medicaid & Public Health Spending: Implications For Aca Implementation, Glen P. Mays Nov 2014

The Dynamics Of Medicaid & Public Health Spending: Implications For Aca Implementation, Glen P. Mays

Glen Mays

We estimate the dynamics and interactions of governmental spending on Medicaid and other public health services in all 50 states over a 15 year period. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.


Aca Implementation In Kentucky: Experiences Of An Expansion State, Glen P. Mays Nov 2014

Aca Implementation In Kentucky: Experiences Of An Expansion State, Glen P. Mays

Glen Mays

Kentucky's implementation of the Affordable Care Act has included early successes with insurance coverage expansion through Medicaid and a state-operated health insurance exchange. Signals of improvements in health care accessibility and delivery of preventive services are evident in the first year after coverage expansions. Challenges associated with political opposition, delivery system transformation, and public health financing remain on the state's policy agenda.


Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen Mays Nov 2014

Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen Mays

Glen Mays

In this paper we estimate the causal impact of state Medicaid enrollment expansions and expenditures on state and local resources allocated to other public health programs and services. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.


Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays Nov 2014

Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays

Glen Mays

This lecture reviews the evidence concerning the institutional and economic characteristics of public health delivery systems and their impact on population health. Emerging findings from these studies suggest promising pathways for transforming the U.S. public health system in ways that strengthen its effectiveness, efficiency and equity in producing health. .


Value And Cost-Effectivess Of Community Health Worker Programs: Implications For Home Care Workers, Glen P. Mays Oct 2014

Value And Cost-Effectivess Of Community Health Worker Programs: Implications For Home Care Workers, Glen P. Mays

Glen Mays

This presentation reviews studies on the health and economic value of strategies to improve the coordination of medical care, public health, and social support services for high-need and high-risk populations. Community health worker (CHW) programs feature prominently in these strategies, particularly for rural and low-resource community settings. Home care workers have the potential to function as CHWs in many settings, and as such present powerful opportunities for scaling up CHW programs that connect medical care, public health, and social services delivery.


Implementation Of The Affordable Care Act: Kentucky Round I Field Network Study Results, Julia Costich, Glen P. Mays Aug 2014

Implementation Of The Affordable Care Act: Kentucky Round I Field Network Study Results, Julia Costich, Glen P. Mays

Glen Mays

This multi-state field study uses a large interdisciplinary network of policy and services researchers to examine and compare the implementation of the Affordable Care Act (ACA) in states across the US. This first field report for Kentucky examines key design and decision-making factors for the ACA's coverage expansion components.