Health Policy Commons^™

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Rebalancing Long-Term Care Under The Affordable Care Act, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

Federal approval of Rhode Island’s Global Consumer Choice Compact Global Waiver in 2009 provided Rhode Island with greater flexibility to modify its Medicaid program. Because 96% of long-term care expenditures in Rhode Island were directed toward institutional settings, a primary goal was to facilitate the state’s efforts to shift the locus of long-term care to non-institutional settings. This study draws lessons from Rhode Island’s experience with the Global Waiver for the long-term care rebalancing provisions of the Patient Protection and Affordable Care Act of 2010. Data derive from 325 archival sources and 26 semi-structured interviews. Results suggest that prospectively documenting …

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Designing And Implementing State Health Reform, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

Provisions in the Medicaid statute permit states to apply for waivers from traditional program requirements. On January 16, 2009, the federal government approved Rhode Island's Global Consumer Choice Compact Waiver. In exchange for a cap on combined federal and state spending of $12.075 billion through 2013, Rhode Island received greater flexibility to adopt certain Medicaid program changes. This study analyzes the design and implementation of the Global Waiver to draw general lessons for health reform at the state-level, a key concern given ongoing state discretion to improve their health care systems under the Patient Protection and Affordable Care Act. Data …

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Block Granting Medicaid And Other Retrenchment, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

On January 16, 2009, the Federal government approved Rhode Island’s application for a Global Consumer Choice Compact Medicaid Waiver whereby the state became the first granted permission to operate its entire Medicaid program under the state plan and a single 1115 “research and demonstration” waiver. The Global Waiver has been implemented in the context of Republican proposals to turn Medicaid into a block grant which would give states substantially more flexibility administering the program in exchange for receiving an upfront allotment from the Federal government. Proponents have held up the Global Waiver as a successful example of what might be …

Estimating The Health And Economic Effects Of Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

Preventable health conditions account for more than 75% of the $2.7 trillion spent annually on health care in the U.S., yet less than 5% of these expenditures are devoted to public health programs and services that are designed to prevent and control disease and injury rather than to treat the downstream consequences of these conditions. Such limited expenditures in public health may contribute to the higher rates of preventable morbidity, mortality and excess medical costs experienced in the U.S. compared to other high-income countries. In this presentation, I update previous estimates of the health effects and medical cost offsets associated …

E-Learning In Medical Education In Resource Constrained Low- And Middle-Income Countries, Seble Frehywot, Yianna Vovides, Zohray Talib, Nadia Mikhail, Heather Ross, Hannah Wohltjen, Selam Bedada, Kristine Korhumel, Abdel Karim Koumare, James Scott

Health Policy and Management Faculty Publications

Background

In the face of severe faculty shortages in resource-constrained countries, medical schools look to e-learning for improved access to medical education. This paper summarizes the literature on e-learning in low- and middle-income countries (LMIC), and presents the spectrum of tools and strategies used.

Methods

Researchers reviewed literature using terms related to e-learning and pre-service education of health professionals in LMIC. Search terms were connected using the Boolean Operators “AND” and “OR” to capture all relevant article suggestions. Using standard decision criteria, reviewers narrowed the article suggestions to a final 124 relevant articles.

Results

Of the relevant articles found, most …

Ensuring The Health Care Needs Of Women: A Checklist For Health Exchanges, Paula Johnson, Therese Fitzgerald, Laura Cohen, Susan F. Wood, D. Richard Mauery, Trenton M. White, Alina Salganicoff, Usha Ranji

Health Policy and Management Faculty Publications

To inform the development of the state health insurance Exchanges under the Affordable Care Act, this checklist identifies key coverage, affordability and access issues that are important for women. Based on lessons learned from women’s health research and the Massachusetts experience, the checklist considers essential health benefits, implementation of no-cost preventive services including contraception, provider networks and affordability, outreach and enrollment efforts, and the importance of including gender and other demographic characteristics in data collection and reporting standards. It was jointly authored by policy experts at the Kaiser Family Foundation, The Connors Center for Women’s Health and Gender Biology at …

Kebutuhan Jaminan Kesehatan Masyarakat Di Wiliyah Perdesaan, Arif Kurniawan, Arih Diyaning Intiasari

Kesmas

Jaminan kesehatan adalah salah satu cara untuk mengurangi beban pembiayaan kesehatan yang dikeluarkan masyarakat. Sebagian besar masyarakat perdesaan di Kabupaten Banyumas yang mempunyai tingkat kemampuan membayar pelayanan kesehatan rendah belum mempunyai jaminan kesehatan. Penelitian ini bertujuan untuk menganalisis kebutuhan jaminan dan faktor-faktor yang memengaruhi kesehatan masyarakat daerah. Penelitian ini merupakan penelitian observasional dengan desain studi cross sectional. Populasi penelitian adalah seluruh kepala keluarga diKabupaten Banyumas dengan jumlah sampel 130 orang. Metode analisis yang digunakan meliputi analisis univariat, bivariat, dan multivariat. Penelitian menemukan bahwa sebagian besar masyarakat Kabupaten Banyumas (72,3%) membutuhkan jaminan kesehatan daerah (Jamkesda). Terdapat hubungan antara pendidikan, pengetahuan, pendapatan, …

Commentary: Hospital Tax-Exempt Policy: A Comparison Of Schedule H And State Community Benefit Reporting Systems, Laura L. Hitchcock

Frontiers in Public Health Services and Systems Research

In Hospital Tax-Exempt Policy: A Comparison of Schedule H and State Community Benefit Reporting Systems, Rosenbaum et aldescribe the numerous variations between current state law in 24 states and federal requirements regarding nonprofit hospitals’ community benefit activities. The potential for nonprofit hospitals to help shape community health is great, and how states choose to address requirements regarding community benefit, and potentially reinforce the new federal requirements to incentivize hospital participation in addressing root causes of poor health, should be of significant interest to the public, policy makers and public and population health experts, given the large percentage of …

Learning By Doing For Public Health Improvement, Glen P. Mays

Frontiers in Public Health Services and Systems Research

All too often, the knowledge gained through learning-by-doing in public health fails to be fully harvested and disseminated because of missed opportunities to carefully study the experiences and innovations occurring in practice. The field of public health services and systems research (PHSSR) has emerged to capitalize on these opportunities before they are missed.

Public Health Expenditures, Public Health Delivery Systems, And Population Health, Glen P. Mays

Health Management and Policy Presentations

This seminar examines a series of approaches for estimating the health and economic effects attributable to public health expenditures in the U.S., along with a novel method for estimating economies of scale and scope in the delivery of public health services. The use of instrumental-variables techniques and network analytic methods are described in these research approaches.

Increased Use Of Dental Services By Children Covered By Medicaid: 2000-2010, Leighton C. Ku, Jessica Sharac, Brian K. Bruen, Megan Thomas, Laurie Norris

Health Policy and Management Faculty Publications

This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children receiving dental services under Medicaid climbed continuously over the decade. In FFY 2000, 6.3 million children ages 1 to 20 were reported to receive some form of dental care (either preventive or treatment); the number more than doubled to 15.4 million by FFY 2010. Part of the increase was because the overall number of children covered by Medicaid rose by 12 million (50%), but the percentage of children who received dental care climbed …

Readiness For Meaningful Use Of Health Information Technology And Patient Centered Medical Home Recognition Survey Results, Peter Shin, Jessica Sharac

Health Policy and Management Faculty Publications

Objective. Determine the factors that impact HIT use and MU readiness for community health centers (CHCs).

Background. The HITECH Act allocates funds to Medicaid and Medicare providers to encourage the adoption of electronic health records (EHR), in an effort to improve health care quality and patient outcomes, and to reduce health care costs.

Methods. We surveyed CHCs on their Readiness for Meaningful Use (MU) of Health Information Technology (HIT) and Patient Centered Medical Home (PCMH) Recognition, then we combined responses with 2009 Uniform Data System data to determine which factors impact use of HIT and MU readiness.

Results. Nearly 70% …

State Foodborne Illness Surveillance And Response Laws: Compilation And Analysis, Stephanie David, Jenna Burton, Chris Chadwick, Rebecca Katz

Health Policy and Management Faculty Publications

Objective

To document and assess the variation in state legislation relating to foodborne disease surveillance and outbreak response for all 50 states and the District of Columbia by creating a database and appendix of laws and regulations that will be made available to researchers and policymakers.

Introduction

Foodborne illnesses sicken 48 million and kill 3,000 Americans every year, presenting an enduring threat to the public’s health. In just the past three years alone, the United States has experienced at least four major multistate outbreaks in food. Despite this growing problem, efforts to prevent foodborne illness pose a particular public health …

Enhancing Communication Between Scientists, Government Officials, And The Lay Public: Advancing Science And Protecting The Public's Welfare Through Better Multi-Stakeholder Interfacing, Clark J. Lee, Patrick P. Rose, Earl Stoddard Iii

Homeland Security Publications

No abstract provided.

Intellectual Property And Public Health – A White Paper, Ryan G. Vacca, James Ming Chen, Jay Dratler Jr., Thomas Folsom, Timothy S. Hall, Yaniv Heled, Frank A. Pasquale Iii, Elizabeth A. Reilly, Jeffrey Samuels, Katherine J. Strandburg, Kara W. Swanson, Andrew W. Torrance, Katharine A. Van Tassel

Law Faculty Scholarship

On October 26, 2012, the University of Akron School of Law’s Center for Intellectual Property and Technology hosted its Sixth Annual IP Scholars Forum. In attendance were thirteen legal scholars with expertise and an interest in IP and public health who met to discuss problems and potential solutions at the intersection of these fields. This report summarizes this discussion by describing the problems raised, areas of agreement and disagreement between the participants, suggestions and solutions made by participants and the subsequent evaluations of these suggestions and solutions. Led by the moderator, participants at the Forum focused generally on three broad …

From Problem-Solving To Research Utilization: How Operations Research And Program Evaluation Can Make Programs Better, Karen Foreit

HIV and AIDS

HIV treatment, care, and support, and PMTCT programs are most effective when based on the best available research evidence. This is the fundamental premise of evidence-based medicine. Equally well known is the dilemma of transforming evidence into practice, which is the subject of knowledge translation and implementation science. Even when the findings of clinical trials make their way into international and national program guidelines, they run up against competing priorities within public health and community programs, resource constraints, and institutional and human inertia. Understanding how to effectively change the approach used in program operations requires understanding how programs work in …

Discounted Health Insurance Premium Systems, Krupa Pravin Patel

Theses Digitization Project

The purpose of this project is to address the issue of the rising health care in the United States, specifically the issues which will arise after the implementation of Obamacare. The project provides insurance companies and the U.S. government with an approach to implementing a discounted health insurance system. This insurance system will help the people spend less for health insurance premiums by providing with the discounted premium system.

Rural Acute Myocardial Infarction Survey (Ramis), Nikiah Nudell Ba, Nrp, Tom Bouthillet Nremt-P, Don Rice Md, John A. Gale Ms, Gary Wingrove Emt-P

Rural Hospitals (Flex Program)

The purpose of this study is to evaluate why current treatment goals for patients with Acute Myocardial Infarction (AMI) are not being achieved despite a large body of evidence supporting regionalized ST Elevation Myocardial Infarction (STEMI) systems. An online survey tool,developed by the research project team, was used to poll the Critical Access Hospitals in Nebraska in order to understand delay factors and other barriers to executing a STEMI system in a rural area. The authors found that the rural STEMI care system lacks a coordinated systems considered to be essential for urban areas. Several areas of potential failure in …

Linkage Politics And The Persistence Of National Policy Autonomy In Emerging Powers: Patents, Profits, And Patients In The Context Of Trips Compliance, Aseema Sinha, Tricia Olsen

CMC Faculty Publications and Research

The Trade Related Intellectual Property Agreement (TRIPS) has had a profound effect on industrialization and innovation, as well as access to medicines in cases of public health crisis such as HIV/AIDS. However, compliance with TRIPS has varied in developing countries, despite heightened international pressure. For instance, Brazil has pursued a coherent approach to its HIV/AIDS health crisis, while India has failed to take care of its HIV patients despite late compliance with the TRIPS agreement and the presence of business firms that produce the generic medicines for HIV/AIDS. This article suggests that divergence in TRIPS compliance is the result of …

Household Catastrophic Medical Expenses In Eastern China: Determinants And Policy Implications, Xiaohong Li, Jay J. Shen, Jun Lu, Mei Sun, Chengyue Li, Fengshui Chang, Mo Hao

School of Public Health Faculty Research

Background: Much of research on household catastrophic medical expenses in China has focused on less developed areas and little is known about this problem in more developed areas. This study aimed to analyse the incidence and determinants of catastrophic medical expenses in eastern China.

Methods: Data were obtained from a health care utilization and expense survey of 11,577 households conducted in eastern China in 2008. The incidence of household catastrophic medical expenses was calculated using the method introduced by the World Health Organization. A multi-level logistic regression model was used to identify the determinants.

Results: The incidence of household catastrophic …

Accounting For Product Substitution In The Analysis Of Food Taxes Targeting Obesity, Zhen Miao, John C. Beghin, Helen H. Jensen

Department of Agricultural Economics: Faculty Publications

We extend the existing literature on food taxes targeting obesity. We systematically incorporate the implicit substitution between added sugars and solid fats into a comprehensive food demand system and evaluate the effect of taxes on sugars and fats. The approach conditions how food and obesity taxes affect total calorie intake. The proposed methodology accounts for the ability of consumers to substitute leaner low-fat and low-sugar items for rich food items within the same food group. This substitution is integrated into a calibrated demand system in addition to the substitution among food groups, using recent food intake data and existing demand …

Implementing Incentive-Based Hiv Interventions In Zambia: The Compact Model, Sam Kalibala, Waimar Tun, Chabu Kangale, Jill Keesbury, Ray Handema, Mwaka Monze

HIV and AIDS

The Population Council received a cooperative agreement from USAID to implement the Community Mobilization for Preventive Action (COMPACT) project, to develop and determine the feasibility of “community compacts” as an innovative approach to prevent HIV in Zambian communities. The aim is to mobilize the communities through a capacity-building process that enables them to identify HIV prevention targets, develop interventions to achieve those targets, and measure the results. This study determined baseline levels of key indicators related to HIV, sexual behaviors, gender-based violence, alcohol abuse, and reproductive health. These baseline measures will be compared with midline and endline levels to assess …

Motivations For Entering Volunteer Service And Factors Affecting Productivity: A Mixed Method Survey Of Steps-Ovc Volunteer Hiv Caregivers In Zambia, Jessica Price, Tina Moyo, Stephanie Topp, Drosin Mulenga, Mardieh Dennis, Mathew Ngunga

HIV and AIDS

This study by the Population Council and the Zambia-Led Prevention Initiative was designed to examine the motivations of individuals volunteering as STEPS-OVC caregivers; to explore their experiences in service, including perceived barriers to carrying out their volunteer work and if, and how, their expectations for volunteering had been met or not; to assess individuals’ intent to continue caregiving; and to ascertain factors associated with volunteer productivity. Two main findings stand out from this study: that communitarian and religious helping values were virtually universal in the study population, and that a majority of the volunteers indicated economic and material interests and …

Not For Bathing: Bath Salts And The New Menace Of Synthetic Drugs, Jake Shaller

Journal of Health Care Law and Policy

No abstract provided.

Better Ways To Study Regulatory Elephants, Jonathan B. Wiener, Brendon Swedlow, James K. Hammitt, Michael D. Rogers, Peter H. Sand

Faculty Scholarship

No abstract provided.

Hivcore Operations Research Workshop Summary Report, Nrupa Jani

HIV and AIDS

Over the past decade, unprecedented progress has been made in the scale-up of HIV treatment, care, and support, yet substantial coverage gaps remain. Targeted operations research and program evaluation can play a significant role in ensuring efficient and effective service delivery, scaling up to reach more clients and on a broader geographical scope, enhancing quality of care, and improving the health status and health systems in developing country settings. With funding from USAID, the Population Council and partners are responding to these critical service delivery issues through HIVCore. HIVCore improves the efficiency, effectiveness, scale, and quality of HIV and AIDS …

Experiences Of Kenyan Healthcare Workers Providing Services To Men Who Have Sex With Men: Qualitative Findings From A Sensitivity Training Programme, Elise M. Van Der Elst, Evans Gichuru, Anisa Omar, Jennifer Kanungi, Zoe Duby, Miriam Midoun, Sylvia Shangani, Susan M. Graham, Adrian D. Smith, Eduard J. Sanders, Don Operario

Community & Environmental Health Faculty Publications

Introduction

Men who have sex with men (MSM) in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs) about the health issues and needs of MSM patients.

Methods

Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs) with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in …

The Community Mobilization For Preventive Action (Compact) Project In Zambia: A Midline Evaluation, Waimar Tun, Chabu Kangale, Scott Geibel, Meredith Sheehy, Ray Handema, Mwaka Monze

HIV and AIDS

The Population Council and its partner, Project Concern International, implemented the Community Mobilization for Preventive Action (COMPACT) HIV-prevention program in Zambia. The program works with communities to develop “compacts” through a participatory, community-led process, and assists them in working toward reaching HIV-related “benchmarks,” intended to result in a reduction in HIV-related risk behaviors and harmful norms and ultimately contribute over time to the reduction of HIV incidence. This mid-term evaluation in four of six COMPACT communities indicates that COMPACT is improving some HIV-related behaviors and attitudes, particularly those related to gender norms, multiple sex partnerships, and alcohol abuse. The report …

A Healthier Bottom Line: Distilling Best Practices In Corporate Wellness, Mark Auriemma, Cfa, Angela Cassidy, Kelly Dougherty, Despina Garalis, Pharmd, Rph, Judith Pelletier, Jennifer Springer

Emerging Leaders Program Team Projects

The Massachusetts Business Roundtable (MBR) collaborated with a team from the Emerging Leaders Program (ELP) from the University of Massachusetts Boston to explore ways to control health care costs. One strategy being implemented by employers to control health care costs is through “wellness programs,” employer-sponsored efforts to improve the health of employees. Members of the Massachusetts Business Roundtable (MBR) and other large employers have had success in reducing their health care costs through the implementation of corporate wellness initiatives. The purpose of this paper is to define what is working in private sector wellness programs to determine whether there is …

Cultural Competency In Health Care: Framework, Training And Evaluation - A Review Of The Literature, Diana Salas Coronado

Center for Social Policy Publications

Healthcare professionals are now more aware of the challenges they face when providing healthcare services to a culturally and racially diverse population. Cultural competency has emerged as a framework for understanding health disparities among racial and ethnic groups in particular, but also for women, the elderly, sexual orientation and gender identity, people with disabilities, and religious minorities. Although there are several definitions of cultural competency, each emphasizes the need for healthcare systems and providers to be aware of and responsive to patients’ cultural perspectives and backgrounds. One example defines cultural competency as “a set of congruent behaviors, attitudes, and policies …