Health Policy Commons^™

La Operación Y Estructura De Salud Familiar Comunitaria Intercultural En El Caso De Achocalla, Dominic Strada

Independent Study Project (ISP) Collection

Esta investigación se centra en la nueva política sanitaria del programa Salud Familiar Comunitaria Intercultural, su nueva administración y su aplicación en Bolivia. La Salud Familiar Comunitaria Intercultural es una política de salud social que décadas después del proceso de descentralización del poder ha puesto la responsabilidad sanitaria en manos de las comunidades. Este estudio se centra en las estructuras de Salud Familiar Comunitaria Intercultural desde el nivel municipal, hasta un total de ocho estructuras, en el municipio de Achocalla. Achocalla es un caso interesante ya que es a la vez una localidad urbana, por formar parte de los suburbios …

A Case Study Of Health Interventions And The Caste System: Addressing The Social Determinants Of Health Through Development At Crhp Jamkhed, Laura Kroart

Independent Study Project (ISP) Collection

In the Southeast Asian country of India, the ancient but in some cases still rigidly intact caste system plays a role in determining health status and outcomes for much of its population of over 1.2 billion people.[1] The Comprehensive Rural Health Project, located in Jamkhed in the state of Maharashtra, India, approaches health interventions from a development standpoint, addressing biomedical needs, structural and environmental concerns, and the social and economic determinants of health that impact the lives of over a million villagers in the surrounding area.[2] This independent study project was designed to analyze how the Comprehensive Rural …

Pay-For-Performance Reimbursement In Health Care: Chasing Cost Control And Increased Quality Through "New And Improved" Payment Incentives, Rick Mayes, Jessica Walradt

Political Science Faculty Publications

Pay-for-performance (P4P) reimbursement has become a popular and growing form of health care payment built on the belief that payment incentives strongly affect medical providers' behavior. By paying more to those providers who are deemed to deliver better care, the goal is to increase quality and, hopefully restrain cost growth. This article provides a brief explanation of: (1) how previous P4P plans in the U.S. have fared, along with their special relationship to primary care, and (2) how England's experience with P4P and newer versions of these kinds of plans being pursued in places such as Massachusetts might provide valuable …

The Role Of Community Health Centers In Addressing The Needs Of Uninsured Low-Income Workers: Implications Of Proposed Federal Funding Reductions, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The severe economic downturn over the past few years has demonstrated the heightened importance of strengthening the health care safety net, particularly for working Americans who may have lost their health insurance coverage or do not have access to employer-sponsored benefits. Both historically and most recently during the current recession, health centers have played a critical role in providing services to the working poor, assuring that they continue to receive timely preventive care that obviates the need for, and minimizes use of, more costly services. We estimate that 1 in 4 low income, uninsured working adults depend on health centers …

The Health Care Access And Cost Consequences Of Reducing Health Center Funding, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

For over four decades, community health centers have served a critical role in providing affordable access to quality care to some of the nation's most vulnerable populations. Health centers have historically enjoyed broad bipartisan support, based on the evidence documenting their high quality care, crucial role in both urban and rural communities, and ability to "bend the cost curve."

On February 20, 2011, the U.S. House of Representatives voted to reduce discretionary health center funding by $1.3 billion in FY 2011 alone. Although the spending bill was rejected by the U.S. Senate on March 10, 2011, final spending measures for …

The Essential Health Benefits Provisions Of The Affordable Care Act: Implications For People With Disabilities, Sara J. Rosenbaum, Joel B. Teitelbaum, Katherine J. Hayes

Health Policy and Management Faculty Publications

In establishing minimum coverage standards for health insurance plans, the Affordable Care Act includes an "essential health benefits" statute that directs the U.S. Secretary of Health and Human Services not to make coverage decisions, determine reimbursement rates, establish incentive programs, or design benefits in ways that discriminate against individuals because of their age, disability, or expected length of life. This issue brief examines how this statute will help Americans with disabilities, who currently are subject to discrimination by insurers based on health status and health care need. The authors also discuss the complex issues involved in implementing the essential benefits …

Why Doctors Order Too Many Tests (It's Not Just To Avoid Lawsuits), Jesse M. Pines, Zachary F. Meisel

Health Policy and Management Informal Communications

Advanced radiology tests such as CT scans, MRIs and ultrasounds have dramatically changed how patients are diagnosed and treated. Just a decade ago, patients were still being subjected to exploratory surgery, in which a surgeon cuts open the abdomen to look for problems; today, CT scans allow doctors to make diagnoses without a scalpel.

Who Are The Health Center Patients Who Risk Losing Care Under The House Of Representatives' Proposed Fy 2011 Spending Reductions?, Sara J. Rosenbaum, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

On February 20, 2011, the United States House of Representatives approved more than $61 billion in discretionary spending reductions for the remainder of FY 2011. The legislation includes $1.3 billion in direct spending cuts for community health centers. Using the NACHC patient estimates, we present evidence on the characteristics of patients whose continuing access to health center services is at risk. We arrived at these estimates using data from the Uniform Data System (UDS), the federal reporting system in which all health centers must participate, as well as national estimates from the Medical Expenditure Panel Survey (MEPS), and published reports …

Who Are The Health Center Pati Ents Who Risk Losing Care Under The House Of Representatives’ Pr Oposed Fy 2011 Spending Reductions?, Sara J. Rosenbaum, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

The States' Next Challenge--Securing Primary Care For Expanded Medicaid Populations, Leighton C. Ku, Karen Jones, Peter Shin, Brian K. Bruen, Katherine J. Hayes

Health Policy and Management Faculty Publications

In the coming years, the United States must address both an expansion of Medicaid coverage and an unexpected shortage of primary care physicians. Under the Patient Protection and Affordable Care Act (ACA), the Medicaid eligibility threshold for nonelderly adults will rise to 133% of the federal poverty level (about $30,000 for a family of four) in 2014. States with restrictive Medicaid eligibility requirements and high rates of uninsured residents will expand coverage substantially, while programs in states with higher current Medicaid eligibility thresholds and fewer uninsured residents will grow less. However, since many of the states with the largest anticipated …

Mcdonald's Medicine: Are We Too Impatient To Wait For Care?, Zachary F. Meisel, Jesse M. Pines

Health Policy and Management Informal Communications

The prospect of waiting for health care is not only distasteful to Americans, it's downright threatening: indeed, the specter of Canadian-style waiting lists for certain tests and procedures evoked enough American-style fear that it became a key Republican talking point to challenge the concept of government-subsidized health care.

Statement On Essential Benefits, Sara J. Rosenbaum

Health Policy and Management Faculty Posters and Presentations

The essential health benefits statute is unique. Because its legislative history is quite limited, the text itself takes on particular importance. The provisions of the statute differ significantly from the highly detailed coverage terms of Medicare Parts A and B. Similarly, its provisions differ from the coverage provisions of the Employee Retirement Income Security Act, which governs virtually all private employer-sponsored health benefit plans and which (with the important exception of the insured small group market) remains unaffected by the essential health benefits provision. In referencing broad benefit categories, the essential health benefits statute bears some resemblance to the structure …

Darke County Community Health Assessment, Center For Urban And Public Affairs, Wright State University

Public Health

In 2011, APRI (formerly CUPA) conducted a community health assessment for the Darke County Health Department (DCHD). The survey was based upon the Behavioral Risk Factor Surveillance System (BRFSS) conducted by the Centers for Disease Control and Prevention (CDC), as well as health assessments conducted by neighboring counties and priority health needs within the county. The purpose of the health needs assessment is to assess the prevalence of disease and behavioral risk factors,assess broad community health issues and shape a broader definition of community health, monitor the impact of community health action plans and trends in behavioral modifications and provide …

Citizen-Centered Health Promotion: Building Collaboration To Facilitate Healthy Living, Steven H. Woolf, Mercedes M. Dekker, Fraser Rothenberg Byrne, Wilhelmine Miller

Health Policy and Management Faculty Publications

Unhealthy behaviors, notably tobacco use; unhealthy diets; and inadequate physical activity are major contributors to chronic disease in the U.S. and are more prevalent among socioeconomically disadvantaged groups. Differences in the prevalence of unhealthy behaviors among communities with different physical, social, and economic resources suggest that contextual environmental factors play an important causal role. Yet health promotion interventions often are undertaken in isolation and with inadequate attention to these holistic social and economic influences on lifestyle. For example, clinicians' advice to patients to stop smoking or lose weight can help motivate people to change behaviors, but their ability to take …

Snapshot 2011: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

Accountable Care Organization Musical Chairs: Will There Be A Seat Remaining For The Small Group Or Solo Practice?, Amy Vaughan, Alberto Coustasse

Management Faculty Research

When it was introduced in the Affordable Care Act of 2010 as the new 2012 payment model for Medicare, an accountable care organization (ACO) was a new and untested concept in healthcare delivery and payment. The authors estimated the likelihood of engagement in ACOs by small group and solo healthcare practitioners. An evaluation of five case studies showed that significant organizational, financial, and technological challenges had to be met in order to launch an ACO. Sufficient resources to meet those challenges were best supplied by large organizations. Small or solo practices participated only through varying levels of integration as salaried …

Indigenous Communities And Evidence Building, Holly Echo-Hawk

Aboriginal Policy Research Consortium International (APRCi)

Indigenous populations in the U.S. and Pacific Islands are underrepresented in mental health and substance abuse research, are underserved, and have limited access to mainstream providers. Often, they receive care that is low quality and culturally inappropriate, resulting in compromised service outcomes. The First Nations Behavioral Health Association (U.S.) and the Pacific Substance Abuse and Mental Health Collaborating Council (Pacific Jurisdictions), have developed a Compendium of Best Practices for American Indian/Alaska Native and Pacific Island Populations. The private and public sector’s increasing reliance on evidence-based practices (EBP) leaves many Indigenous commu- nities at a disadvantage. For example, funding sources may …

Using The Commons To Facilitate Health Communication, Anna Liebzeit, Karen Adams, Mat Jakobi

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

What Are The Options? Pricing And Taxation Policy Reforms To Redress Excessive Alcohol Consumption And Related Harms In Australia, Natacha Carragher, Jenny Chalmers

Aboriginal Policy Research Consortium International (APRCi)

Increasing community and political concern about excessive alcohol consumption and related harms in Australia has prompted calls for the introduction of tighter regulatory controls. From an evidence-based, research perspective, measures which increase alcohol prices and taxes, in particular, are considered most effective for reducing alcohol consumption and related harms. Accordingly, this report presents a review of pricing and taxation policy levers that have been considered and/or implemented nationally

and internationally. These policies include: alcohol taxation and differential price by beverage; special/additional taxation on alcopops; minimum pricing; and bans on price discounts and promotions. Industry response to these policy initiatives is …

Issues In Health Reform: How Changes In Eligibility May Move Millions Back And Forth Between Medicaid And Insurance Exchanges, Benjamin D. Sommers, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

The Affordable Care Act will extend health insurance coverage by both expanding Medicaid eligibility and offering premium subsidies for the purchase of private health insurance through state health insurance exchanges. But by definition, eligibility for these programs is sensitive to income and can change over time with fluctuating income and changes in family composition. The law specifies no minimum enrollment period, and subsidy levels will also change as income rises and falls. Using national survey data, we estimate that within six months, more than 35 percent of all adults with family incomes below 200 percent of the federal poverty level …