Health Policy Commons^™

From The Frontier: Translating Research To Practice...A Story Of Economic Survival, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

This article is number two in the series From the Frontier: Translating Research to Practice. The narrative describes the interactions between a local health department director and two academicians in addressing the impact of the 2008 financial crisis. In a first set of activities, practice-academic partners used Financial and Operational Ratio and Trend Analysis to identify periods of a negative total margin and the impact of that on the agency’s declining fund balance. The use of private sector processes of retrenchment, repositioning, and reorganization led to a financial turnaround for the agency. In a second set of activities, practice-academic …

Assessing The Potential Impact Of Sequestration On Community Health Centers, Patients, And Medically Underserved Communities, Peter Shin, Jessica Sharac, Carmen Alvarez, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

A new report by the Peter Shin, Jessica Sharac, Carmen Alvarez, and Sara Rosenbaum examines the potential impact of sequestration on community health centers and their patients and communities. "Assessing the Potential Impact of Sequestration on Community Health Centers, Patients, and Medically Underserved Communities" estimates that the nation's 1,200 federally funded health centers will lose $120 million in grant funding, and that this funding drop can be expected to translate into 900,000 fewer patients served and 3 million fewer visits. The analysis shows that the cuts will disproportionately impact the poorest Americans, children, young families, and members of ethnic and …

Poor Immigrants Use Public Benefits At A Lower Rate Than Poor Native-Born Citizens, Leighton Ku, Brian K. Bruen

Health Policy and Management Faculty Publications

No abstract provided.

Community Health Centers In An Era Of Health Reform: An Overview And Key Challenges To Health Center Growth, Peter Shin, Jessica Sharac, Carmen Alvarez, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Today, over 1,100 federally funded community health centers play a vital role in ensuring access to health care for a predominantly low-income population in medically underserved communities. Health centers’ ability to provide comprehensive primary care and improve access to high-quality care while holding down health care cost growth has been well-documented. As health reform spurs coverage expansion and efforts to improve quality, the nation’s reliance on health centers is likely to grow.

In the Affordable Care Act (ACA), Congress invested $11 billion over five years to expand the health center program, to broaden access to care in lower-income communities as …

Embedding Concepts Of Sex And Gender Health Differences Into Medical Curricula, Virginia M. Miller, Morrisa Rice, Londa Schiebinger, Marjorie R. Jenkins, Janice Werbinski, Ana Nunez, Susan Wood, Lynne T. Shuster

Health Policy and Management Faculty Publications

Sex, a biological variable, and gender, a cultural variable, define the individual and affect all aspects of disease prevention, development, diagnosis, progression, and treatment. Sex and gender are essential elements of individualized medicine. However, medical education rarely considers such topics beyond the physiology of reproduction. To reduce health care disparities and to provide optimal, cost-effective medical care for individuals, concepts of sex and gender health need to become embedded into education and training of health professionals. In September 2012, Mayo Clinic hosted a 2-day workshop bringing together leading experts from 13 U.S. schools of medicine and schools of public health, …

Community Health Centers In An Era Of Health Reform: An Overview And Key Challenges To Health Center Growth, Peter Shin, Jessica Sharac, Carmen Alvarez, Sara J. Rosenbaum, Julia Paradise

Health Policy and Management Faculty Publications

Over 1,100 federally funded community health centers play a vital role in ensuring access to health care for a predominantly low-income population in medically underserved communities. Health centers’ ability to provide comprehensive primary care and improve access to high-quality care while holding down health care cost growth has been well-documented. As health reform spurs coverage expansion and efforts to improve quality, the nation’s reliance on health centers is likely to grow.

In the Affordable Care Act (ACA), Congress invested $11 billion over five years to expand the health center program, to broaden access to care in lower-income communities as coverage …

Providing Long Term Services & Supports To People With Impaired Decision-Making Capacity: Results Of Data Analysis And Interviews Examining Needs And Characteristics Of Persons With Impaired Decision-Making Capacity In Maine, Eileen Griffin Jd, Louise Olsen, Julie T. Fralich Mba

Disability & Aging

This document:

• Reviews the prevalence of impaired decision-making capacity among adults and older adults receiving publicly funded home care services and supports in Maine, the characteristics of this population group, and the caregivers caring for persons with impaired decision-making capacity.
• Reports on interviews with providers describing their ideas for helping people with impaired decisionmaking capacity live in the community longer.
• Reviews the legal status of persons receiving long term services and supports in Maine, including the presence of a guardian or a Power of Attorney, among those with impaired decision-making capacity across settings.
• Reports on interviews with providers, describing kinds …

Health Inequalities And The Welfare State In European Families, Simone Sarti, Marco Alberio, Marco Terraneo

The Journal of Sociology & Social Welfare

Using EU-Silc data from 2005, our aim in this article is to estimate how self-assessed health and the gradient between education and health vary among individuals in different European countries, considering their contextual socioeconomic vulnerability. In order to do this, we use a hierarchical model with individuals nested in households at the second level, and in various European countries at the third level. Our main research interest is on the modelling variables associated with better health conditions and their improvement or worsening according not only to micro/ individual and macro/national levels but also to the household: a level on which …

Federal Health Care Reform: An Overview, Andrew F. Coburn Phd

Population Health & Health Policy

This policy brief discusses three of the main components of the Patient Protection and Affordable Care Act (ACA), also known as "Obamacare". These components are helath insurance coverage, delivery system improvement, and cost containment. The policy brief highlights some of the provision of the law that have already been implemented and those where importnat implementation decisions will have to be made. The brief is authored by Dr. Andrew Coburn, PhD, Professor of Public Health and Director of the Population Health and Health Policy program at the USM Muskie School, and was presented at the Maine Policy Leaders Academy Health Care …

Evidence-Based Decision Making To Improve Public Health Practice, Ross C. Brownson, Jonathan E. Fielding, Christopher M. Maylahn

Frontiers in Public Health Services and Systems Research

Despite the many accomplishments of public health, greater attention on evidence-based approaches is warranted. This article reviews the concepts of evidence-based public health (EBPH), on which formal discourse originated about 15 years ago. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community in decision making, conducting sound evaluation, and disseminating what is learned. Core competencies for EBPH are emerging, including not only technical skills but also attention to administrative practices in public health agencies. To better bridge evidence and practice, the concepts …

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.