Health Policy Commons^™

Combating Medicare Fraud: A Struggling Work In Progress, Natalie Thorpe,, Stacie Deslich, Andrew Sikula Sr., Alberto Coustasse

Management Faculty Research

INTRODUCTION: The United States has spent approximately $2.6 trillion on healthcare in recent years. This accounts for 17.9% of the national gross domestic product. Fraud has been identified as one of the leading causes of the nation's increasing health expense. Medicare fraud has taken many forms including overutilization, upcoding, billing for services not provided and filing false cost reports. Fraud has been found throughout the healthcare industry and has been difficult to detect.

METHODOLOGY: The methodology for this qualitative study was a literature review. Four electronic databases and several government websites were utilized. Thirty nine sources were referenced for this …

The Emergence And Potential Impact Of Medicine 2.0 In The Healthcare Industry, Terra Stump, Sarah Zilch, Alberto Coustasse

Management Faculty Research

Medicine 2.0 has emerged within healthcare information technology to enable more defined relationships among providers and patients. Physicians, hospitals, and patients are using Medicine 2.0 through social networking to maintain their foothold in the evolution of medical technologies. The authors’ purpose was to determine potential improvements that Medicine 2.0 has on communication and collaboration of healthcare information. Research has shown that Medicine 2.0 has integrated into the healthcare industry and is enabling an increase in communication in healthcare matters. The provider-patient relationship is improving through the use of Medicine 2.0 and has positively impacted society so far.

Using First Nations Children's Perceptions Of Food And Activity To Inform An Obesity Prevention Strategy, Ashlee-Ann E. Pigford, Noreen D. Willows, Nicholas L. Holt, Amanda S. Newton, Geoff D.C. Ball

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Do Indigenous Australians Age Prematurely? The Implications Of Life Expectancy And Health Conditions Of Older Indigenous People For Health And Aged Care Policy, Philippa R. Cotter, John R. Condon, Tony Barnes, Ian P.S. Anderson, Leonard R. Smith, Teresa Cunningham

Aboriginal Policy Research Consortium International (APRCi)

Objective. To assess whether Indigenous Australians age prematurely compared with other Australians, as implied by Australian Government aged care policy, which uses age 50 years and over for population-based planning for Indigenous people compared with 70 years for non-indigenous people.

Methods. Cross-sectional analysis of aged care assessment, hospital and health survey data comparing Indigenous and non-indigenous age-specific prevalence of health conditions. Analysis of life tables for Indigenous and non-indigenous populations comparing life expectancy at different ages.

Results. At age 63 for women and age 65 for men, Indigenous people had the same life expectancy as non-indigenous people at age 70. …

Growing Up Our Way : The First Year Of Life In Remote Aboriginal Australia, Sue Kruske, Suzanne Belton, Molly Wardaguga, Conceptual Narjic

Aboriginal Policy Research Consortium International (APRCi)

In this study, we attempted to explore the experiences and beliefs of Aboriginal families as they cared for their children in the first year of life. We collected family stories concerning child rearing, development, behavior, health, and wellbeing between each infant’s birth and first birthday. We found significant differences in parenting behaviors and childrearing practices between Aboriginal groups and mainstream Australians. Aboriginal parents perceived their children to be autonomous individuals with responsibilities toward a large family group. The children were active agents in determining their own needs, highly prized, and included in all aspects of community life. Concurrent with poverty, …

Evaluation Of A Culturally Adapted Training In Indigenous Mental Health And Wellbeing For The Alcohol And Other Drug Workforce, Racheal Hinton, Tricia Nagel

Aboriginal Policy Research Consortium International (APRCi)

Indigenous Australians have high rates of mental illness comorbid with substance misuse. The complex needs of this client group create challenges for the alcohol and other drug (AOD) workforce. This paper describes the outcomes of an Indigenous-specific “Yarning about Mental Health” training for the AOD workforce to strengthen knowledge and skills in mental health approaches and in their engagement with Indigenous clients. The training provides culturally adapted strategies and tools for understanding mental health, promoting wellbeing, and delivering brief interventions in the substance misuse setting. A nonexperimental evaluation which incorporated pre-post questionnaires was conducted with workshop participants attending one of …

Building A Relationship Between Medicaid, The Exchange And The Individual Insurance Market, Sara J. Rosenbaum, Trish Riley

Health Policy and Management Faculty Publications

The alignment of Medicaid and State Health Insurance Exchange (Exchange) policy and practice is a basic tenet of the Patient Protection and Affordable Care Act (ACA). Through both legislative provisions and implementing regulations, the ACA addresses this relationship. At the same time, the federal framework provides states with considerable discretion to flesh out the fuller dimensions of system interaction.

Physician Wages In States With Expanded Aprn Scope Of Practice, Patricia Pittman, Benjamin Williams

Health Policy and Management Faculty Publications

In recent years, states have looked to reforms in advanced practice nursing scope of practice (SOP) barriers as a potential means to increase access to primary care while reducing costs. Currently, 16 states and the District of Columbia permit advanced practice registered nurses to practice independently of physicians, allowing them to perform functions such as diagnosing and prescribing under their own authority within the primary care setting. Given the resistance of many physician associations to these reforms, we asked whether the economic interests of primary care physicians might be affected by reforms. Using the Bureau of Labor Statistics data on …

The Experiences Of Men Engaged In Transactional Sex With Other Men In Urban Nigeria—A Size Estimation And Qualitative Study, Population Council

HIV and AIDS

Reports on a mixed-method research study to estimate the population size and understand the experiences of a sub-group of men who have sex with men presumed to be at particularly high risk of infection with HIV and other sexually transmitted infections: men who engage in transactional sex with other men.

Getting Real With Youth-Friendly Services In Africa: Report Of A Satellite Session At The Xix International Aids Conference, Population Council

HIV and AIDS

Overview of an AIDS 2013 satellite session which aimed to engage young people with and react to the study findings and in the light of the findings, discuss and share their perspectives, experiences and concerns about how responsive existing policies, programs and services are to the HIV prevention and impact mitigation needs of young Africans.

Valuing Health Care: Improving Productivity And Quality, Barak D. Richman, Arti K. Rai

Faculty Scholarship

No abstract provided.

Prevalence And Correlates Of Hiv Infection In A Cohort Of Male Injection Drug Users In Delhi, Waimar Tun, Vartika Sharma, Mary Philip Sebastian, Ira Madan, Amita Yadav, Meredith Sheehy, Dean Lewis, Ibou Thior, Avina Sarna

HIV and AIDS

Baseline assessment of HIV infection among male injection drug users to understand the correlates of HIV infection and high risk injection practices and sexual behavior in Delhi, India.

Attitudes, Beliefs, And Practices Of Providers And Key Opinion Leaders On Emergency Contraception In India, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady

Reproductive Health

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECP) among providers in public and private facilities and pharmacies in India. The objectives of the study were to: assess providers' knowledge of ECP's biological mechanism; understand providers' knowledge and attitudes about ECP's safety, effectiveness, and availability as an OTC drug; and identify providers' definitions of “repeated use” and profiling women who are “repeated users” of ECP. This study's findings show that most providers, including doctors and some KOLs, were incorrectly informed about ECP's mechanism of action. Service guidelines are necessary for accurate and …

Hiv/Aids In The Muslim-Majority Countries: Formula For Low Prevalence, Kaoru Yamaguchi

Political Science Theses and Capstones

The Muslim-majority countries long had been considered to be free of HIV/AIDS epidemic because of their strict religious and moral codes. However, the HIV prevalence rates are increasing in some Islamic states, and even more or so rapidly in a several cases that it is no longer valid to assume the Islamic religion protects its followers from the risks of contracting HIV. Contrary to the popular belief concerning the prevention of the HIV/AIDs epidemic, data collected from well-recognized international organizations such as the WHO and Freedom House indicate that democratization, strong government leadership, and wider and equal human rights for …

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 …

Household Survey To Evaluate The Zambia-Led Prevention Initiative: Baseline Report, Zambia-Led Prevention Initiative

HIV and AIDS

With an estimated HIV prevalence of 14.3 percent among men and women age 15–49, Zambia is one of the sub-Saharan African countries most affected by the HIV and AIDS pandemic. The Zambia-led Prevention Initiative Program (ZPI) was developed by a consortium led by FHI360, with the Population Council as the evaluation partner. This study determined baseline levels of key indicators related to HIV, gender-based violence, and reproductive health. Additionally, the baseline findings provide critical insights into key areas for interventions in Zambia and highlights variability in the populations across provinces and between males and females that provide valuable guidance for …

Study Guide For United In Anger: A History Of Act Up, Matt Brim

Open Educational Resources

The United in Anger Study Guide facilitates classroom and activist engagement with Jim Hubbard’s 2012 documentary, United in Anger: A History of ACT UP. The Study Guide contains discussion sections, projects and exercises, and resources for further research about the activism of the New York chapter of ACT UP (AIDS Coalition to Unleash Power). The Study Guide is a free, interactive, multimedia resource for understanding the legacy of ACT UP, the film’s role in preserving that legacy, and its meaning for viewers' lives.

Measuring Equity In Disability And Healthcare Utilization In Afghanistan, Jean-Francois Trani, Cecile Barbou Des Rosieres

Brown School Faculty Publications

This paper analyses equity in health and healthcare utilization in Afghanistan based on a representative national household survey. Equitable access is a cornerstone of the Afghan health policy. We measured socioeconomic-related equity in access to public health care, using disability– because people with disabilities are poorer and more likely to use health care – and a concentration index (CI) and its decomposition. The socioeconomicrelated equity in healthcare utilization was measured using a probit model and compared with an OLS model providing the horizontal inequity index (HI). We found low rate of healthcare facilities utilization (25%). Disabled persons are using more …

What Is A Healthy Community?, Denise Tanata Ashby, Jennifer Pharr

Lincy Institute Reports and Briefs

The health of a community is dependent not only upon the genetics of its residents, but also upon the environment within which those individuals live. A person’s health is a product of their environment. As such, a healthy community is one in which all residents have access to a quality education, safe and healthy homes, adequate employment, transportation, physical activity, and nutrition, in addition to quality health care. Unhealthy communities lead to chronic disease, such as cancers, diabetes, and heart disease. The health of our communities is critical to the growth and development of our region. To build healthy communities …

Deinstitutionalization And Its Discontents: American Mental Health Policy Reform, Olga Loraine Kofman

CMC Senior Theses

In 1963, President John F. Kennedy signed the Mental Retardation and Community Mental Health Centers Construction Act, establishing the beginnings of deinstitutionalization in the United States. By some counts, this Act was a stupendous policy success—by others, a dismal failure. 50 years later, no cohesive national mental health care policy has emerged to deal with increased rates of mental illness among the homeless and the incarcerated. However, California has made enormous strides to create a state policy which provides adequate services to the mildly, moderately, and severely mentally ill as well as adequate funding for those services through Proposition 63, …