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Articles 1 - 30 of 61
Full-Text Articles in Health Policy
Graduate Medical Education In The Mountain West, Mohit Pande, Nicole Diaz Del Valle, Yashesvi Sharma, Caitlin J. Saladino, William E. Brown Jr.
Graduate Medical Education In The Mountain West, Mohit Pande, Nicole Diaz Del Valle, Yashesvi Sharma, Caitlin J. Saladino, William E. Brown Jr.
Health
This fact sheet examines Graduate Medical Education (GME) metrics in the Mountain West (Arizona, Colorado, Nevada, New Mexico, and Utah). The original report from the Association of American Medical Colleges (AAMC) includes data from all 50 states and includes measures of graduate medical education and the facilities needed to conduct graduate medical education. This fact sheet builds upon data previously published in fact sheets on Nevada medical residencies for the 2021, 2022, and 2023 graduating classes of the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV) and the University of Nevada, Reno (UNR) School of …
Financial Alignment Initiative: New York Fully Integrated Duals Advantage For Individuals With Intellectual And Developmental Disabilities: Preliminary Third Evaluation Report, Kimberly I. Snow Mhsa, Elizabeth Gattine Jd, Amy Kandilow Phd, Matthew Toth Phd, Amy Chepaitis Phd
Financial Alignment Initiative: New York Fully Integrated Duals Advantage For Individuals With Intellectual And Developmental Disabilities: Preliminary Third Evaluation Report, Kimberly I. Snow Mhsa, Elizabeth Gattine Jd, Amy Kandilow Phd, Matthew Toth Phd, Amy Chepaitis Phd
Disability & Aging
The New York FIDA-IDD demonstration was launched in 2016 in nine downstate counties and was the first comprehensive managed care demonstration exclusively serving individuals with intellectual and developmental disabilities (IDD) in the nation. Due at least in part to a lack of provider participation, less than 8 percent of eligible beneficiaries enrolled. Beneficiaries who did enroll reported high levels of satisfaction, especially with care coordination and the ease of obtaining durable medical equipment. The MedicareMedicaid Plan’s (MMP) assessment and care coordination model provided person-centered care planning that identified goals and helped to achieve them, improving enrollees’ quality of life. The …
Financial Rewards Tied To Quality Measures Lead Home Health Agencies To Exaggerate Their Improvements, Jun Li, Meher Chahal
Financial Rewards Tied To Quality Measures Lead Home Health Agencies To Exaggerate Their Improvements, Jun Li, Meher Chahal
Population Health Research Brief Series
More than 4 million people in the United States use home health care each year, but the quality varies and is often poor. In 2016, the Centers for Medicare & Medicaid Services (CMS) began rewarding and penalizing home health agencies for their performance on a set of predetermined quality measures in an experiment called the Home Health Value-Based Purchasing (HHVBP) program. This brief summarizes the results of a recent study evaluating the program’s impact on quality measures within the HHVBP and whether there was a relationship between incentive size and apparent quality. Findings suggest that while financial rewards improved the …
Prescription Drug Retail Sales In The Mountain West, Caren Royce Yap, Caitlin J. Saladino, William E. Brown Jr.
Prescription Drug Retail Sales In The Mountain West, Caren Royce Yap, Caitlin J. Saladino, William E. Brown Jr.
Health
This fact sheet synthesizes data on prescription drug retail sales in the Mountain West (Arizona, Colorado, Nevada, New Mexico, and Utah). "Retail Sales for Prescription Drugs Filled at Pharmacies by Payer," a 2019 report by the Kaiser Family Foundation, includes data on the amount of retail sales for prescription drugs made in each state by dollar amount, along with the method of coverage, including commercial, Medicare, Medicaid and cash payment.
Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph
Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph
Access / Insurance
The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+. Understanding these differences, and the socioeconomic characteristics that contribute to them, can have important implications for Medicare policies aimed at serving the age 85+ population. Using the Medicare Current Beneficiary Survey 2010-13 Cost and Use and 2015-17 Cost Supplement Files, we examined whether and how rural and urban Medicare beneficiaries age 85+ differ in terms of their:
- socioeconomic and health characteristics that may inform health care use;
- trends in health care use, including use of inpatient and emergency department (ED) care; …
J Mich Dent Assoc December 2021
J Mich Dent Assoc December 2021
The Journal of the Michigan Dental Association
Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!
In this issue, the reader will find the following original content:
- Two cover stories presenting perspectives from both ends of the practice life continuum: “Starting Your Practice Life” and “Preparing for Retirement”.
- A feature article, “What Happened in Vegas Became ADA Policy”.
- A feature article, “An Oversight Corrected: 2020 MDA Life Members Recognized”.
- The 2021 Author/Title Index to the Journal of the Michigan Dental Association. …
The U.S. Should Expand Access To Dental Care For Older Adults, Madonna Harrington Meyer, Sarah Reilly, Julia Finan
The U.S. Should Expand Access To Dental Care For Older Adults, Madonna Harrington Meyer, Sarah Reilly, Julia Finan
Population Health Research Brief Series
Older adult Medicare recipients face high out-of-pocket dental expenses due to a lack of appropriate dental care coverage. Older adults with lower socioeconomic status tend to have worse oral health, less dental insurance coverage, greater difficulties finding a dentist, and low-quality care. This brief details the experiences socioeconomically disadvantaged older adults face in obtaining appropriate and affordable dental care and calls on Congress to include preventative and restorative dental care as part of the federal funding agenda.
Health Care Use And Access Among Rural And Urban Nonelderly Adult Medicare Beneficiaries, Erika C. Ziller Phd, Amanda Burgess Mppm, Deborah Thayer Mba
Health Care Use And Access Among Rural And Urban Nonelderly Adult Medicare Beneficiaries, Erika C. Ziller Phd, Amanda Burgess Mppm, Deborah Thayer Mba
Access / Insurance
Little is known about the characteristics and health care use of rural residents with disabilities. Using the Medicare Current Beneficiary Survey (2009-2013), we compared access to and use of health services among rural and urban nonelderly Medicare beneficiaries with a disability, and examined their health and functional status along with sociodemographic characteristics. We found that the characteristics of nonelderly Medicare beneficiaries with a disability reflected the differences observed between rural and urban populations overall: rural recipients were more likely than their urban peers to be older, non-Hispanic white, and have a lower level of educational attainment. Although self-reported access to …
Rural Health Clinic Costs And Medicare Reimbursement, John A. Gale Ms, Zachariah T. Croll Mph, Andrew F. Coburn Phd
Rural Health Clinic Costs And Medicare Reimbursement, John A. Gale Ms, Zachariah T. Croll Mph, Andrew F. Coburn Phd
Rural Health Clinics
The Rural Health Clinic (RHC) Program is one of the nation’s oldest rural primary care programs. A key feature of the RHC Program is Medicare and Medicaid volume-appropriate, cost-based reimbursement, which is designed to sustain these vulnerable rural primary care providers. Medicare currently pays RHCs for the lesser of reasonable costs (expressed as an adjusted cost per visit) for a defined package of RHC services or a per-visit reimbursement cap, from which provider-based RHCs owned by hospitals with fewer than 50 beds are exempt. Although the per-visit cap is updated periodically, RHC administrators, policymakers, and stakeholders question whether the updates …
The American Pathology Of Inequitable Access To Medical Care, Allison K. Hoffman, Mark A. Hall
The American Pathology Of Inequitable Access To Medical Care, Allison K. Hoffman, Mark A. Hall
All Faculty Scholarship
What most defines access to health care in the United States may be its stark inequity. Daily headlines in top newspapers paint the highs and lows. Articles entitled: “We Mapped the Uninsured. You’ll notice a Pattern: They tend to live in the South, and they tend to be poor” and op-eds with titles like “Do Poor People Have a Right to Health Care?” and “What it’s Like to Be Black and Pregnant when you Know How Dangerous That Can Be” run side-by-side with headlines touting “The Operating Room of the Future,” and advances in gene therapy that promise cures …
The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd
The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd
Disability & Aging
This study sought to determine the Medicare and Medicaid costs experienced by dual eligible older adults in Maine for whom Maine Adult Protective Services (APS) substantiated allegations of elder financial exploitation and to compare them to those of Maine’s general older population. The analysis is an important step forward in estimating the medical costs associated with elder abuse.
Elder financial exploitation may result in significant public burden on Medicare and Medicaid, shouldered by taxpayers. Efforts to detect, investigate, prosecute, and mitigate this abuse will benefit not only the victims, but also the financial stewardship of these public programs.
Quality Regulation? Access To High-Quality Specialists For Medicare Advantage Beneficiaries In California, Simon F. Haeder
Quality Regulation? Access To High-Quality Specialists For Medicare Advantage Beneficiaries In California, Simon F. Haeder
Faculty & Staff Scholarship
Medicare Advantage enrollment has seen tremendous growth over the past decade. However, we know comparatively little about the experience of beneficiaries in the program. Our knowledge of Medicare Advantage provider networks is particularly limited. This article is one of the first major assessments of the issue. It seeks to answer 3 important questions. First, are Medicare Advantage plan networks made up of higher quality providers? Second, how significant are the network restrictions imposed by Medicare Advantage plans with regard to access to higher quality providers? And finally, how much provider choice are Medicare Advantage beneficiaries left with? To assess these …
Searching For The Fulcrum: Can Accountable Care Organizations Lower Spending By Balancing Specialists-To-Primary Care Providers?, Vishal Shetty
Searching For The Fulcrum: Can Accountable Care Organizations Lower Spending By Balancing Specialists-To-Primary Care Providers?, Vishal Shetty
Masters Theses
Background:
While value-based payment models emphasizing care coordination have been widely implemented to improve quality and lower expenditures, supporting empirical evidence is sparse. Our objective was to quantify the impact of specialist-to-primary care physician involvement within accountable care organization (ACO) and its association with lower spending.
Methods:
We conducted a retrospective cohort study of Medicare Shared Savings Program ACOs from 2012-2016 using publicly available data provided by the Centers for Medicare and Medicaid Services at the ACO level. We examined the association between the proportion of primary care services delivered by specialists versus other types of care providers and ACO …
Healthcare Utilization & Health Behaviors Among Older Adults: The Role Of Insurance, Jennifer Rose Geiger
Healthcare Utilization & Health Behaviors Among Older Adults: The Role Of Insurance, Jennifer Rose Geiger
LSU Doctoral Dissertations
As the population of older adults in the U.S. continues its exponential growth, so too will the need for high-quality health and preventive services. Despite the widely acknowledged need for proactive solutions to the coming public health challenges for this rapidly expanding age cohort, healthcare providers and social work practitioners continue to lack the proper education training to serve the needs of older adults. Furthermore, these allied health professionals also frequently engage in ageist behaviors across care settings that also often employ institutionally ageist policies and procedures. As a result, older adults may be particularly at risk of negative health …
Residential Settings And Healthcare Use Of The Rural "Oldest-Old" Medicare Population, Nathan Paluso Mph, Zachariah T. Croll Mph, Deborah Thayer Mba, Jean A. Talbot Phd, Mph, Andrew F. Coburn Phd
Residential Settings And Healthcare Use Of The Rural "Oldest-Old" Medicare Population, Nathan Paluso Mph, Zachariah T. Croll Mph, Deborah Thayer Mba, Jean A. Talbot Phd, Mph, Andrew F. Coburn Phd
Long Term Services and Supports
The aging of the baby boom generation is projected to dramatically increase the population aged 65 and older in the coming decades. In particular, those aged 85 and older (the ‘oldest old’) are expanding at a faster rate than any other age group and by 2050 are expected to make up 4.5 percent of the population, compared to 1.9 percent in 2012. Faster growth in the percentage of older people (65+) in rural than in urban areas is likely to challenge the healthcare and long term services and supports (LTSS) capacity in many rural communities.
This study used Medicare Current …
Spillover Theory: Unintended Consequences Of Provisions In The Affordable Care Act, Robert T. Braun
Spillover Theory: Unintended Consequences Of Provisions In The Affordable Care Act, Robert T. Braun
Theses and Dissertations
Objective: To examine spillovers from a federal policy, managed care market, and community perspective.
Data Sources/Study Setting: We studied spillovers from a federal policy and managed care market perspective using the Health Care Utilization Project’s (HCUP) State Inpatient Database (SID). American Hospital Association (AHA) data, Interstudy Commercial Managed Care, and Area Health Resource File (AHRF). Medicare Advantage county-level payment schedules originate from CMS. We examined community uninsurance spillovers using 2011-2015 Medical Expenditure Panel Survey (MEPS), the Area Health Resource File (AHRF), and the Small Area Health Insurance Estimator (SAHIE).
Study Design: Ordinary Least Squares (OLS) and difference-in-difference regression analyses were …
Healthcare: What Comes Next?, William H. Lane
Healthcare: What Comes Next?, William H. Lane
English Faculty Publications
Where do we go from here on healthcare?
America has been talking about fixing its fragmented and overly expensive healthcare system for quite a while now. At times, it seems as though we simply keep having the same conversation (or argument, if you prefer) over and over again without making much progress in ensuring access to affordable care to all Americans. In fact, however, some significant gains have been made. Twenty million left without insurance (our situation now) has got to be better than forty million left without (our situation a decade ago).
Covering The Care: Health Insurance Coverage In New Hampshire, Jo Porter, Lucy Hodder
Covering The Care: Health Insurance Coverage In New Hampshire, Jo Porter, Lucy Hodder
Law Faculty Scholarship
the first in a series of data and policy briefs that seek to inform the current conversations about health reform happening across the state. The first brief uses data from the American Community Survey to provide information about the health insurance coverage landscape in NH.
The Economics Of Health, Donald J. Meyer Editor
The Economics Of Health, Donald J. Meyer Editor
Upjohn Press
Donald J. Meyer leads a group of notable health economists who explore critical issues—and their economic impacts—facing the nation's healthcare system today. These include lifestyle choices and their health impacts, decisions on medical care and self-care, the fee-for-service payment model, disability and workers’ compensation insurance claims, long-term care, and how various aspects of the Patient Protection and Affordable Care Act (ACA) impact the nation’s healthcare system. Contributors include M. Kate Bundorf, Marcus Dillender, John H. Goddeeris, Donald J. Meyer, Edward C. Norton, and Charles E. Phelps.
Rural Disabled Medicare Beneficiaries Spend More Out-Of-Pocket Than Their Urban Counterparts, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd
Rural Disabled Medicare Beneficiaries Spend More Out-Of-Pocket Than Their Urban Counterparts, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd
Access / Insurance
The majority of Medicare beneficiaries experience gaps between the care they need and costs covered by Medicare and seek supplemental coverage to meet this gap, including private plans offered by former employers or purchased individually, or public coverage through Medicaid. Since rural beneficiaries are more likely to purchase supplemental indemnity coverage individually, to participate in Medicaid, or to go without supplemental coverage altogether, it is likely that their out-of-pocket spending differs from that of urban residents, although the magnitude and direction of these differences may vary for individual beneficiaries. This study used data from the 2006-2010 Medical Expenditure Panel Survey …
Out-Of-Pocket Spending Among Rural Medicare Beneficiaries, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd
Out-Of-Pocket Spending Among Rural Medicare Beneficiaries, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd
Access / Insurance
The majority of Medicare beneficiaries experience gaps between the care they need and costs covered by Medicare and seek supplemental coverage to meet this gap, including private plans offered by former employers or purchased individually, or public coverage through Medicaid. Since rural beneficiaries are more likely to purchase supplemental indemnity coverage individually, to participate in Medicaid, or to go without supplemental coverage altogether, it is likely that their out-of-pocket spending differs from that of urban residents, although the magnitude and direction of these differences may vary for individual beneficiaries. This study used data from the 2006-2010 Medical Expenditure Panel Survey …
Health Literacy And Medicare Recipient's Knowledge Of Health Insurance Options, Marsha R. Lawrence
Health Literacy And Medicare Recipient's Knowledge Of Health Insurance Options, Marsha R. Lawrence
South Florida Education Research Conference
Health literacy is a major problem for the aging population (Parker, Ratzan, & Lurie, 2003). The significance of this study was to access the relationship between health literacy and knowledge of Medicare to determine ways in which seniors can effectively navigate their healthcare insurance.
Medicare At Fifty Needs To Grow, William H. Lane
Medicare At Fifty Needs To Grow, William H. Lane
English Faculty Publications
In America everybody has a healthcare story. A bill impossible to read, an inscrutable "additional" charge, trouble getting insurance, trouble keeping it, a friend or family member who's fallen between the coverage "cracks." [excerpt]
Analyzing Charges And Payments Received For Discharged Patients At Teaching Hospitals In Relation To Patient Satisfaction And Overall Medicare Charges, Rob Sutter
MPA/MPP/MPFM Capstone Projects
The affordability of healthcare is a major, recurring topic in the media. One of President Obama’s cornerstone policies has been the attempt to make health care affordable. Part of the concern lies in cost differences for similar procedures. The cost for a standardized procedure such as abnormal cardiac dysrhythmia without complication varies greatly between hospitals. The cost difference of a patient getting treated for such an event can be an average of $30,000 depending on which hospital you go to. There is no immediately apparent reason for such a large difference. Another noticeable item is that all the hospitals receive …
Procedural Triage, Matthew B. Lawrence
Procedural Triage, Matthew B. Lawrence
Faculty Articles
Prior scholarship has assumed that the inherent value of a “day in court” is the same for all claimants, so that when procedural resources (like a jury trial or a hearing) are scarce, they should be rationed the same way for all claimants. That is incorrect. This Article shows that the inherent value of a “day in court” can be far greater for some claimants, such as first-time filers, than for others, such as corporate entities and that it can be both desirable and feasible to take this variation into account in doling out scarce procedural protections. In other words, …
The Reverberating Risk Of Long-Term Care, Allison K. Hoffman
The Reverberating Risk Of Long-Term Care, Allison K. Hoffman
All Faculty Scholarship
The Fiftieth Anniversary of Medicare and Medicaid offers an opportunity to reflect on how American social policy has conceived of the problem of long-term care. In this essay, based on a longer forthcoming article, I argue that current policies adopt too narrow a conception of long-term care risk, by focusing on the effect of serious illness and disability on people who need care and not on the friends and family who often provide it. I propose a more complete view of long-term care risk that acknowledges how illness and disability reverberates through communities, posing insecurity for people beyond those in …
Strategies For Health Care Cost Containment (1980s-Present), Rick Mayes
Strategies For Health Care Cost Containment (1980s-Present), Rick Mayes
Political Science Faculty Publications
The U.S. health care system during the past three decades has been over two interrelated questions: first, who will control the manner in which medical care is paid for, and, second, how much will it cost? Many health care experts believe that Medicare's efforts at cost control, primarily in the form of the program's seminal transition to and continual modification of prospective payment of health care providers, has both triggered and repeatedly intensified the economic restructuring of the U.S. health care system. Medicare is an almost $600 billion public health insurance program for individuals sixty-five years of age and older; …
Government Provided Health Insurance, Kristina Lambert, Ryan O’Connor
Government Provided Health Insurance, Kristina Lambert, Ryan O’Connor
Academic Symposium of Undergraduate Scholarship
No abstract provided.
Medicare: What Is In Store For Future Generations?, Karen L. Poon
Medicare: What Is In Store For Future Generations?, Karen L. Poon
Honors Scholar Theses
Medicare is the health insurance coverage provided to all senior citizens over the age of 65. It has been around since 1965. This paper takes an in-depth look into the Medicare program. First, the history behind Social Security is introduced. The Medicare program was created as an addition to Social Security, and its history follows. Although the ideas and goals of the Medicare program have good intentions, there are many issues with it. These problems are discussed in detail in the current issues portion of the paper. As a follow up, I have expanded upon and come up with some …
Beyond Capitation: How New Payment Experiments Seek To Find The 'Sweet Spot' In Amount Of Risk Providers And Payers Bear, Rick Mayes, Austin B. Frakt
Beyond Capitation: How New Payment Experiments Seek To Find The 'Sweet Spot' In Amount Of Risk Providers And Payers Bear, Rick Mayes, Austin B. Frakt
Political Science Faculty Publications
A key issue in the decades-long struggle over US health care spending is how to distribute liability for expenses across all market participants, from insurers to providers. The rise and abandonment in the 1990s of capitation payments—lump-sum, per person payments to health care providers to provide all care for a specified individual or group—offers a stark example of how difficult it is for providers to assume meaningful financial responsibility for patient care. This article chronicles the expansion and decline of the capitation model in the 1990s. We offer lessons learned and assess the extent to which these lessons have been …