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on Health Economics |
| By: | Fabrizio Mazzonna (Università della Svizzera Italiana (USI) and MEA (Munich Center for the Economics of Ageing) at Max Planck Institute for Social law and Social Policy); Paola Salari (Università della Svizzera Italiana (USI)) |
| Abstract: | This paper evaluates the causal negative effect of environmental tobacco exposure on health by exploiting the time and geographical variation in public-place smoking bans implemented in Switzerland between 2007 and 2011. Using monthly data from the universe of Swiss hospitals between 2004 and 2012, we show that the incidence of acute myocardial infarction hospitalizations decreases by about 10-12% immediately after the law implementation. We also find evidence of heterogeneity by age and sex and across income and education groups. In particular, the policy affected mainly men aged 50+ and the regions characterized by a lower level of income and education. |
| Keywords: | smoking bans, policy evaluation, infarction, hospital data, health inequality |
| JEL: | C23 H75 H77 I14 I18 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:lug:wpidep:1409&r=hea |
| By: | Armin Falk; Fabian Kosse; Ingo Menrath; Pablo Emilio Verde; Johannes Siegrist |
| Abstract: | This paper investigates physiological responses to perceptions of unfair pay. We use an integrated approach exploiting complementarities between controlled lab and representative field data. In a simple principal-agent experiment agents produce revenue by working on a tedious task. Principals decide how this revenue is allocated between themselves and their agents. Throughout the experiment we record agents' heart rate variability, which is an indicator of stress-related impaired cardiac autonomic control and has been shown to predict coronary heart diseases in the long-run. Using three measures of perceived unfairness our findings establish a link between unfair payment and heart rate variability. Building on these findings, we further test for potential adverse health effects of unfair pay using data from a large representative data set. The analysis includes cross-sectional and dynamic panel estimations. Complementary to our experimental findings we find a strong and highly significant negative association between health outcomes, in particular cardiovascular health, and the perception of unfair pay. |
| Keywords: | Fairness, social preferences, inequality, heart rate variability, health, experiments, SOEP |
| JEL: | D91 D03 D63 I14 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwsop:diw_sp715&r=hea |
| By: | Neil Cummins |
| Abstract: | I analyse the age at death of 121,524 European nobles from 800 to 1800. Longevity began increasing long before 1800 and the Industrial Revolution, with marked increases around 1400 and again around 1650. Declines in violence contributed to some of this increase, but the majority must reflect other changes in individual behavior. The areas of North-West Europe which later witnessed the Industrial Revolution achieved greater longevity than the rest of Europe even by 1000AD. The data suggest that the `Rise of the West' originates before the Black Death. |
| Keywords: | Mortality; Health; Nobility; Divergence |
| JEL: | O52 I3 |
| Date: | 2014–09 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:wpaper:60555&r=hea |
| By: | Quan Hoang Vuong |
| Abstract: | This paper represents the first research attempt to estimate the probabilities for Vietnamese patients to fall into destitution facing financial burdens occurring during their curative stay in hospital. The study models the risk against such factors as level of insurance coverage, location of patient, costliness of treatment, among others. The results show that very high probabilities of destitution, approximately 70%, apply to a large group of patients, who are nonresident, poor and ineligible for significant insurance coverage. There is also a probability of 58% that low-income patients who are seriously ill and face higher health care costs would quit their treatment. These facts will put Vietnamese government’s ambitious plan of increasing both universal coverage (UC) to 100% of expenditure and rate of UC beneficiaries to 100% at a serious test. The study also raises issues of asymmetric information and alternative financing options for the poor, who are most exposed to risk of destitution, following market-based health care reforms. |
| Keywords: | Health insurance; Government policy on health care; Risk of destitution |
| JEL: | I18 I19 |
| Date: | 2014–12–18 |
| URL: | http://d.repec.org/n?u=RePEc:sol:wpaper:2013/185057&r=hea |
| By: | Pía Riggirozzi |
| Abstract: | Since the creation of the Union of South American Nations (UNASUR), health became a strategic driver in regional politics in South America in two ways: by redefining trans-border practices through health policies and institutions within the region; and by projecting (regional) health policies through global interventions. The paper explores these dynamics in relation to UNASUR’s policies towards access to medicine, inclusion, and demands for better governance at the World Health Organisation. It argues that regional organisations like UANSUR are significant actors in on-going attempts to address and mitigate trans-border social harms, contributing with innovative regulatory frameworks and different mechanisms of socialisation and engagement that can significant impact national policy making and management in health. But it is also argued that the significance of regional health governance as promoted by UNASUR has to be seen not only as a framework for the promotion of ‘regulatory regionalism’ (Hameiri and Jayasuriya 2009) in public health, but also for ‘regional health diplomacy’ brokering new norms and revising the terms of global health governance. This analysis hopes to contribute directly to the literature in IPE and regionalism by offering a more nuanced discussion about the links between regionalism and social policy, and new forms of regional diplomacy beyond traditional goals of trade and financial markets expansion. |
| Date: | 2014–07–23 |
| URL: | http://d.repec.org/n?u=RePEc:erp:euirsc:p0399&r=hea |
| By: | Resul Cesur; Bahadir Dursun; Naci Mocan |
| Abstract: | Although the impact of education on health is important for economic policy in developing countries, the overwhelming majority of research to identify the health returns to education has been done using data from developed countries. We use data from three waves of a nationally-representative health survey, conducted between 2008 and 2012 in Turkey, and exploit an education reform that increased the mandatory years of schooling from 5 to 8 years in 1997. Using exposure to the reform as an instrument for education, we find that for women ages 18-30, education has no impact on self-reported health, BMI, overweight, obesity, or on the propensity or intensity of smoking. Education does not influence women’s daily consumption of fruits, vegetables, or their propensity to get a flu shot either. The same results are obtained for men of the same age group with one exception: education increases men’s BMI and the propensity to be overweight and obese. Potential explanations for these findings are provided. |
| JEL: | I1 I12 I15 I21 I25 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:20764&r=hea |
| By: | Leah Boustan; Robert A. Margo |
| Abstract: | The United States has a long and ongoing history of racial inequality. This paper surveys the literature on one aspect of that history: long-run trends in racial differences in health. We focus on standard measures such as infant mortality and life expectancy but also consider the available data on specific diseases and chronic conditions. Our basic conclusion is that large improvements have occurred in the average health of African Americans over the twentieth century, both in absolute terms and relative to Whites. These health advancements occurred steadily throughout the twentieth century, with the peak period of improvement between 1920 and 1945 (for infant mortality) and 1940 and 1960 (for overall life expectancy). We attribute the improvements to successful efforts to fight specific diseases, improvements in public health, and narrowing racial gaps in education and income. Although racial inequality in health outcomes has fallen in the long term, significant disparities remain today. |
| JEL: | I14 J15 N11 N12 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:20765&r=hea |
| By: | Anirban Basu; Andrew M. Jones; Pedro Rosa Dias |
| Abstract: | We examine heterogeneity in the impacts of exposure to mixed-ability ‘comprehensive’ schools in adolescence on long-term health and smoking behaviour. We explore the roles that cognitive and non-cognitive skills may play in moderating these impacts. We use data from the 1958 National Child Development Study (NCDS) cohort, whose secondary schooling years lay within the transition years of a major reform that transformed secondary education in England and Wales from a selective system of schooling to mixed-ability comprehensive schools. We adopt a local instrumental variables approach to estimate person-centred treatment (PeT) effects of comprehensive over selective schooling system. Our results indicate that the newer comprehensive schooling system produced significant negative effects on long-term health and increased smoking behavior among a small fraction of individuals, for whom the effects were persistent over time. The ATE and TT were quantitatively similar and statistically insignificant indicating that cognitive abilities, the major driver for selection in to comprehensive schools, did not moderate the effects. The PeT effects indicate that individuals with lower non-cognitive skills were most likely to be negatively affected by exposure to mixed-ability schools. Our results also show that cigarette smoking could be a leading transmission channel of the long-term impact on health outcomes. |
| JEL: | C21 C26 I12 I28 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:20811&r=hea |
| By: | Junjian Yi; James J. Heckman; Junsen Zhang; Gabriella Conti |
| Abstract: | An open question in the literature is whether families compensate or reinforce the impact of child health shocks. Discussions usually focus on one dimension of child investment. This paper examines multiple dimensions using household survey data on Chinese child twins whose average age is 11. We find that, compared with a twin sibling who did not suffer from negative early health shocks at ages 0-3, the other twin sibling who did suffer negative health shocks received RMB 305 more in terms of health investments, but received RMB 182 less in terms of educational investments in the 12 months prior to the survey. In terms of financial transfers over all dimensions of investment, the family acts as a net equalizer in response to early health shocks for children. We estimate a human capital production function and establish that, for this sample, early health shocks negatively affect child human capital, including health, education, and socioemotional skills. Compensating investments in health as measured by BMI reduce the adverse effects of health shocks by 50%, but exacerbate the adverse impact of shocks on educational attainment by 30%. |
| JEL: | C23 D13 I12 J13 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:20757&r=hea |
| By: | Vilsa Curto; Liran Einav; Jonathan Levin; Jay Bhattacharya |
| Abstract: | We estimate the economic surplus created by Medicare Advantage under its reformed competitive bidding rules. We use data on the universe of Medicare beneficiaries, and develop a model of plan bidding that accounts for both market power and risk selection. We find that private plans have costs around 12% below fee-for-service costs, and generate around $50 dollars in surplus on average per enrollee-month, after accounting for the disutility due to enrollees having more limited choice of providers. Taxpayers provide a large additional subsidy, and insurers capture most of the private gains. We use the model to evaluate possible program changes. |
| JEL: | D43 I11 I13 L13 L33 L51 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:20818&r=hea |
| By: | Esther Duflo; Pascaline Dupas; Michael Kremer |
| Abstract: | A seven-year randomized evaluation suggests education subsidies reduce adolescent girls' dropout, pregnancy, and marriage but not sexually transmitted infection (STI). The government's HIV curriculum, which stresses abstinence until marriage, does not reduce pregnancy or STI. Both programs combined reduce STI more, but cut dropout and pregnancy less, than education subsidies alone. These results are inconsistent with a model of schooling and sexual behavior in which both pregnancy and STI are determined by one factor (unprotected sex), but consistent with a two-factor model in which choices between committed and casual relationships also affect these outcomes. |
| JEL: | I12 I25 I38 O12 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:20784&r=hea |
| By: | Tatiana V. Kossova (National Research University Higher School of Economics); Elena V. Kossova (National Research University Higher School of Economics); Maria A. Sheluntcova (National Research University Higher School of Economics) |
| Abstract: | This paper aims to investigate differences in the volume and structure of alcohol consumption and then to reveal the impact of alcohol consumption on life expectancy in Russian regions. We consider the contribution of different product to the dynamics of consuming absolute alcohol. Necessary data were collected from the Federal State Statistics Service of Russia from 2008 to 2012. Data on the volume of regional alcohol sales in liters were used as proxy variables because of the shortage of regionally divided statistical data on alcohol consumption. The data on absolute alcohol consumption in each region were obtained from the weighted-average share of spirits in each kind of alcoholic product considered. We estimate panel data models and reveal macroeconomic determinants of alcohol consumption that reflect economic development of regions, living standards, unemployment and degree of urbanization. We find strong positive relationship between alcohol consumption and mortality from external causes and negative with life expectancy in Russian regions. Results are valid for both male and female population |
| Keywords: | alcohol consumption, alcohol abuse, inter-regional differences, life expectancy, mortality, Russian regions |
| JEL: | I15 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:hig:wpaper:82/ec/2014&r=hea |
| By: | Irina Denisova; Polina Kuznetsova |
| Abstract: | The main objectives of this paper are to estimate the burden of tobacco-caused mortality as a whole and by main tobacco-related diseases in Kazakhstan, the Russian Federation, and Ukraine, and to assess the distributional health impact of an increase in tobacco taxation in these three countries. According to the results obtained, in 2012 smoking caused around 310,000 deaths in Russia, about 70,000 in Ukraine, and 14,300 in Kazakhstan, representing a key factor of mortality among the working-age population. Using data from various sources, the paper estimates the distributional consequences of a hypothetical tax rise in the three countries that leads to an approximately 30 percent increase of the average retail price of cigarettes. The analysis includes an estimation of changes in smoking prevalence, mortality, life expectancy, and public health expenditures by income quintile and gender. Considered excise growth can lead to about 3.5 to 4.0 percent fall in smoking prevalence, which in turn can avert about 600,000 tobacco-related deaths in Russia, 140,000 in Ukraine, and 30,000 in Kazakhstan over a 50 years period. Reduced tobacco-related morbidity will also result in substantial decrease in health expenditures for the treatment of tobacco-related diseases. Positive health effects are expected to be pro-poor, as almost 60 percent of the reduction in mortality is concentrated in the two lower-income quintiles of the population of the three countries. |
| Keywords: | Addiction, adult population, Age Groups, age mortality, alcohol, alcohol abuse, alcohol consumption, arteriosclerosis, cancers, cardiovascular diseases, Causes of Death ... See More + Cigarette, Cigarette Taxes, Circulatory System, citizens, Clinical Research, Cost Effectiveness, current smoking, death rates, dependence, Developing Countries, Disease Control, economic costs, Economics of Tobacco Control, EFFECTS OF TOBACCO, excise taxes, female mortality, females, Global Health, health care, health care system, Health Consequences, health effects, health impact, Health Insurance, health system, health systems, heart disease, intervention, life expectancy, lifestyles, long-term smokers, lung cancer, male mortality, Medical Care, Medicine, Ministry of Health, morbidity, mortality, mortality rate, mortality reduction, neoplasms, Nicotine, number of deaths, number of people, Nutrition, Peer Reviewers, Population Processes, premature mortality, PRICE ELASTICITY, Price Increases, price of cigarettes, Price Policies, public health, pulmonary disease, Respect, respiratory diseases, Risk Factors, smoker, smokers, smoking, smoking cessation, smoking prevalence, smoking prevalence data, smoking rates, Social Impact, Tobacco Addiction, tobacco consumption, Tobacco Control, tobacco control measures, Tobacco Control Policies, tobacco excises, tobacco industry, tobacco products, Tobacco Research, tobacco smoking, tobacco tax, Tobacco Tax Increases, tobacco taxation, TOBACCO TAXES, TOBACCO USE, tobacco-related disease, tobacco-related diseases, tobacco-related illnesses, treatment, Tuberculosis, working-age population, World Health Organization, young women |
| Date: | 2014–10 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:hnpdps:92765&r=hea |
| By: | World Bank |
| Keywords: | Health Monitoring and Evaluation Public Sector Expenditure Policy Health Economics and Finance Health Systems Development and Reform Health, Nutrition and Population - Population Policies Public Sector Development |
| Date: | 2013–08 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wboper:20771&r=hea |
| By: | Göllner S.; Nimeh Z. (UNU-MERIT) |
| Abstract: | This paper analyses the current burden of obesity in the female population of Jordan on a national scale and examines the factors associated with it. Demographics and Health Surveys DHS were used for the years 2002, 2007 and 2009 covering a total of 23,197 women, 15-49 years of age, and variables including body mass index, age, governorate, educational level, marital status and wealth index, among others were investigated. The overall prevalence of obesity body mass index, BMI 30 in Jordanian women was found to be 26.3 percent in 2002, 19.7 percent in 2007 and 28.2 percent in 2009. Multivariate analysis demonstrated that being obese was significantly associated with increasing age, being married and having only primary education. Apart from age, the strength of these associations decreased from 2002 to 2009 which could point to a generalisation obesity epidemic, for all population groups. This paper contributes to the increasing research on obesity in Jordan, and confirms many findings of smaller studies, by including a larger sample size and greater geographic coverage, on a national scale. The contextual policy analysis reveals that the public health efforts of the Jordanian government are relatively limited in this area, and concludes by trying to make a case for a more comprehensive approach in order to moderate the health impact of obesity in Jordan. |
| Keywords: | Health and Economic Development; Health: Government Policy; Regulation; Public Health; |
| JEL: | I18 I15 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:unm:unumer:2014079&r=hea |
| By: | Jayaswal, Sachin |
| Abstract: | We study the problem of locating Emergency Medical Service (EMS) facilities in the presence of service level constraints for patients with acuity levels ranging from resuscitation to non-urgent. Each patient arriving at any EMS facility is triaged as either resuscitation/high priority or less urgent/low priority, where high priority patients are always served on a priority basis. The problem is to optimally locate EMS facilities and allocate their service zones to satisfy the following coverage and service level constraints: (i) each user zone is served by an EMS facility that is within a given coverage radius; (ii) at least h proportion of the resuscitation cases at any EMS facility should be admitted immediately without having to wait; (iii) at least l proportion of the cases belonging to low priority class at any EMS facility should not have to wait for more than l minutes. For this, we model the network of EMS facilities as spatially distributed M/M/1 priority queues, whose locations and user allocations need to be determined. The resulting integer programming problem is challenging to solve, especially in absence of any known analytical expression for the waiting time distribution of low priority customers in an M/M/1 priority queue. We develop a cutting plane based solution algorithm, exploiting the concavity of the waiting time distribution of low priority customers to approximate its non-linearity using tangent planes, determined numerically using matrix geometric method. Using a case study of locating EMS facilities in Austin, Texas, we present computational results and managerial insights. |
| URL: | http://d.repec.org/n?u=RePEc:iim:iimawp:13011&r=hea |
| By: | Adam Pilny; Magdalena A. Stroka |
| Abstract: | Existing literature analyzing the choice of received long-term care by frail elderly (65+ years) predominantly focuses on physical and psychological conditions of elderly people as factors that influence the decision for a particular type of care. Until now, however, the regional in-patient long-term care supply has been neglected as influential factor in the individual’s decision-making process. In this study, we analyze the choice of received long-term care by explicitly taking the regional supply of nursing homes into account. When estimating a discrete choice model, we distinguish between four different types of formal and informal care provision. We find that the decision for long-term in-patient care is significantly correlated with the regional supply of nursing home places, while controlling for physical and psychological conditions of the individual. |
| Keywords: | Informal care; formal care; choice of care; administrative data; nursing home supply |
| JEL: | C35 D12 I11 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:rwi:repape:0525&r=hea |
| By: | Johannes Geyer; Thorben Korfhage |
| Abstract: | In Germany, individuals in need of long-term care receive support through benefits of the long-term care insurance. A central goal of the insurance is to support informal care provided by family members. Care recipients can choose between benefits in kind (formal home care services) and benefits in cash. From a budgetary perspective family care is a cost-saving alternative to formal home care and to stationary nursing care. However, the opportunity costs resulting from reduced labor supply of the carer are often overlooked. We focus on the labor supply decision of family carers and the incentives set by the long-term care insurance. We estimate a structural model of labor supply and the choice of benefits of family carers. We find that benefits in kind have small positive effects on labor supply. Labor supply elasticities of cash benefits are larger and negative. If both types of benefits increase, negative labor supply effects are offset to a large extent. |
| Keywords: | Labor supply; long-term care; long-term care insurance; structural model |
| JEL: | J22 H31 I13 |
| Date: | 2014–11 |
| URL: | http://d.repec.org/n?u=RePEc:rwi:repape:0515&r=hea |
| By: | Giuseppe Migali; Eugenio Zucchelli |
| Abstract: | High school dropout is an important policy issue and its determinants are a longstanding interest of economics. However, very little is known on the roles of noncognitive traits in influencing school dropout decisions. We employ voluntary forgone health care as a proxy for the underlying noncognitive traits that may induce adolescents to dropout and estimate its effects on early school attrition. We exploit data from the US National Longitudinal Study of Adolescent to Adult Health (Add Health) and employ a series of flexible specifications with school fixed effects and cohort effects. Our models account for well-established determinants of dropout, including individual and parental characteristics, together with personality traits. Forgone health care consistently appears to be a statistically significant and substantial predictor of dropout among adolescents. We suggest that forgone health care could be used as a signaling device for policy makers targeting potential high school dropouts. |
| Keywords: | forgone health care, high school dropout, Add Health |
| JEL: | I1 I2 I18 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:lan:wpaper:71679142&r=hea |
| By: | Gilbert Gimm; Denise Hoffman; Henry T. Ireys |
| Abstract: | This rigorous study found that early intervention programs with a personal navigator can reduce dependence on federal disability benefits for adult workers with mental health conditions. |
| Keywords: | Disability, Employment, Mental Health, Early Intervention, Random Assignment |
| JEL: | I J |
| Date: | 2013–08–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:518707cf1de34082a0b45812185868a7&r=hea |
| By: | Ellen Albritton; Dana Petersen; Margo Edmunds |
| Abstract: | The Evaluation Highlight focuses on how six States—Alaska, Idaho, Massachusetts, Oregon, Utah, and West Virginia—are using grant funds to support practices’ use of care coordinators by providing training, technical assistance, and/or funding as practices implement patient-centered medical home (PCMH) projects. |
| Keywords: | CHIPRA Quality Demonstration, State Support, Care Coordinators, Children's Health Care, Patient Centered Medical Home, PCMH |
| JEL: | I |
| Date: | 2014–07–17 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:95c4c481e8294eafb11af612ef2312ac&r=hea |
| By: | Jung Y. Kim; Angela M. Gerolamo; Jonathan Brown |
| Keywords: | Physical Health Care Behavioral Health Care Medicaid Beneficiaries Pennsylvania, CEDR |
| JEL: | I J |
| Date: | 2013–03–11 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7a7666035c194c27a66b50734a6db16b&r=hea |
| By: | Jenna Libersky |
| Keywords: | Medicaid, Managed Care, Long-Term Care, MLTSS, State Oversight |
| JEL: | I |
| Date: | 2014–07–28 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:e28e45c2609d4254b341ff6f2856881b&r=hea |
| By: | Jack Hadley; James D. Reschovsky; Alistair J. O'Malley; Bruce E. Landon |
| Keywords: | Medicare reimbursement, Geographic variation in Medicare cost per episode, Physician supply |
| JEL: | I |
| Date: | 2014–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:d1480ffc4dcb42b4b3e8fe4c7957a20b&r=hea |
| By: | Kate Stewart; Henry Ireys; Dana Petersen; Joe Zickafoose; Lisa Schottenfeld |
| Keywords: | NCQA Medical Home Health Care Utilization Children in Medicaid |
| JEL: | I J |
| Date: | 2013–03–11 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:6dea90a559cf4f7587190470bbf43296&r=hea |
| By: | Marsha Gold; Gretchen Jacobson; Anthony Damico; Tricia Neuman |
| Abstract: | This data spotlight, prepared by Mathematica and Kaiser Family Foundation health experts, provides an overview of Medicare Advantage enrollment patterns in March 2013 and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans, including variations by plan type, and describes the out-of-pocket limits and prescription drug coverage in the Part D "donut hole." |
| Keywords: | Medicare Advantage, Enrollment Market Update, Affordable Care Act , Health |
| JEL: | I |
| Date: | 2013–06–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:84cf3dc8257a4decb655f1b9521c14d3&r=hea |
| By: | Adam Dunn Leslie Foster |
| Abstract: | This is the second brief in a series about the first year of California’s Health-e-App Public Access (HeA PA) self-service, public health benefits enrollment system, following its introduction in December 2010. It describes HeA PA applicants and their experiences with the tool. Findings suggest that tools like HeA PA are a good option for people who have convenient access to high-speed internet service and do not need extensive in-person help when applying for coverage. |
| Keywords: | Health-e-App Public Access Children's Health Care Coverage California Health |
| JEL: | I |
| Date: | 2013–02–28 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:dfa35680329e4e0a84e2cba1ab9f4686&r=hea |
| By: | Rosemary Borck; Laura Ruttner; Vivian Byrd; Karina Wagnerman |
| Keywords: | Medicaid Analytic eXtract 2010 Chartbook Appendix Tables, MAX |
| JEL: | I |
| Date: | 2014–10–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:75b5c782f4fc4f20993434bf55827289&r=hea |
| By: | Eric Lammers |
| Abstract: | Hospitals have greater administrative control over the actions and resources of physicians they employ, enabling the implementation of new technology and initiatives. This study tested for and found that hospital employment of physicians is associated with significant increases in the probability of physicians using hospital health information technology. |
| Keywords: | hospitals, physicians, vertical integration, health information technology, transaction, cost economics |
| JEL: | I |
| Date: | 2013–10–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:6a68e00cc27c45e6a2e7653d8631298a&r=hea |
| By: | Maggie Colby |
| Abstract: | This is the third brief in a series about the first year of California’s Health-e-App Public Access (HeA PA) enrollment system, introduced in December 2010. Available in English and Spanish, HeA PA was a self-service online application for the Healthy Families Program and a screening tool for Medi-Cal for families. This brief describes the ways that California made families aware of HeA PA, including a formal outreach campaign during the second half of 2011, and evaluates the outreach strategies’ effectiveness in attracting eligible applicants. |
| Keywords: | Health-e-app , Public Access , Children's Health Care Coverage , California , Low-Income Families |
| JEL: | I |
| Date: | 2013–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:478cf80b074d45bfabebec900b734958&r=hea |
| By: | Margaret B. Hargreaves; Todd Honeycutt; Cara Orfield; Michaela Vine; Charlotte Cabili; Michaella Morzuch; Sylvia K. Fisher; Ronette Briefel |
| Abstract: | This report from the field describes the design, implementation, and early evaluation results of the Healthy Weight Collaborative, a federally supported learning collaborative to develop, test, and disseminate an integrated change package of six promising, evidence-based clinical and community-based strategies to prevent and treat obesity for children and families. |
| Keywords: | Healthy Weight Evaluation Learning Collaboratives, Childhood Obesity , Children and families, Nutrition |
| Date: | 2013–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:9400b95bca5045d2878be1b45f02dffb&r=hea |
| By: | Nan L. Maxwell |
| Abstract: | This working paper examines the potential changes in the disparities in employer-sponsored health insurance (ESI) and other benefits between low- and high-wage workers under health reform. The analysis suggests that potential changes firms make in compensation could decrease disparities between low- and high-skilled workers in the quality of ESI and increase the disparities in the offering of benefits other than ESI, if the legislation does not slow rising health care costs. |
| Keywords: | Affordable Care Act employer-sponsored health insurance, workforce skills benefits, disparities low-wage workers |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:cbf89dba1f494bfbb654acde712b204b&r=hea |
| By: | Matthew Kehn |
| Abstract: | This report, prepared for CMS, is the last in a series of annual reports on participation in the Medicaid Buy-In program. It provides updates on both national- and state-level trends in enrollment, employment, and earnings among the 35 reporting Medicaid Infrastructure Grant (MIG) states with a Buy-In program in 2011. Additionally, it addresses recent changes to state program rules and policies, and identifies factors that have affected recent Buy-In program enrollment, as reported by the states in an annual questionnaire. |
| Keywords: | Medicaid, disability, employment, Health , Earnings, Buy-In |
| JEL: | I |
| Date: | 2013–05–20 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:a7ab35913e104e5cb3d95517ed0f2660&r=hea |
| By: | Joseph S. Zickafoose; Lisa R. DeCamp; Lisa A. Prosser |
| Abstract: | Measures the prevalence of enhanced access services in pediatric primary care and assesses whether enhanced access services are associated with lower emergency department utilization. |
| Keywords: | Emergency Departments Pediatric Care Parent Survey Health |
| JEL: | I |
| Date: | 2013–11–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7a642b8ad2ae4768b5128e4a76c3b1ec&r=hea |
| By: | Samuel T. Edwards; Melinda K. Abrams; Richard J. Baron; Robert A. Berenson; Eugene C. Rich; Gary E. Rosenthal; Meredith B. Rosenthal; Bruce E. Landon |
| Abstract: | The patient-centered medical home (PCMH) and the accountable care organization (ACO) are models of delivery system reform. Although there is theoretical alignment between PCMHs and ACOs, the discussion of physician payment within each model has remained distinct. This article compares payment for the two models, considers opportunities for integration, and discusses implications for policymakers and payers considering promoting primary care through ACOs. |
| Keywords: | Medical Homes, Affordable Care Act, Patient Centered Medical Home, Health |
| JEL: | I |
| Date: | 2014–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:dd0e2f030cba4476884ae711b35241c0&r=hea |
| By: | Vanessa Oddo; Angela Gerolamo; David R. Mann; Catherine DesRoches |
| Keywords: | Disability, Managed Care Plans, Medicaid Enrollees, Health |
| JEL: | I J |
| Date: | 2014–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:3996f68cb1a04310afcd98a1e0eea10a&r=hea |
| By: | Chapin White Megan Eguchi |
| Abstract: | Reference pricing, or capping payment for a particular medical service, has been gaining interest as a strategy to reduce health care costs. Using private insurance data as a measure, reference pricing applied to a narrow scope of inpatient services was shown to produce limited savings—only a few tenths of a percentage of total spending; reference pricing applied to a much broader set of “shoppable†inpatient and ambulatory services was shown to potentially save about 5 percent of total spending. When considering reference pricing, employers and health plans would need to weigh the potential savings against the additional resources needed to implement and manage a more complex program. |
| Keywords: | Reference pricing, health care cost, insurance, price cap, autoworker |
| JEL: | I |
| Date: | 2014–10–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:1572400f4c214f6889c08c1dd02adfbd&r=hea |
| By: | Bonnie O'Day; Crystal Blyler; Benjamin Fischer; Claire Gill; Todd Honeycutt; Rebecca Kleinman; Joseph Mastrianni; Eric Morris; Lisa Schottenfeld; Allison Thompkins; Allison Wishon-Siegwarth; Michelle Bailey |
| Keywords: | Employment, Psychiatric Disorders, Disability |
| JEL: | I J |
| Date: | 2014–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b4fe9ac23df949f09c8dab4a1964841c&r=hea |
| By: | Allison Hedley Dodd; Ronette Briefel; Charlotte Cabili; Ander Wilson; Mary Kay Crepinsek |
| Abstract: | This paper used data from the third School Nutrition Dietary Assessment Study to identify disparities by race/ethnicity and obesity status in the consumption of sugar-sweetened beverages and other beverages among United States schoolchildren. The analysis found that beverage consumption patterns did not substantially differ across weight status groups, but they differed by race/ethnicity in the home. Non-Hispanic black elementary schoolchildren consumed sugar-sweetened beverages other than soda more often and unflavored, low-fat milk less often at home than non-Hispanic white schoolchildren. |
| Keywords: | child, overweight, sugar-sweetened beverages, racial/ethnic disparities , United States schoolchildren |
| JEL: | I0 I1 |
| Date: | 2013–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:16915a85fed04852ae9d62482879724c&r=hea |
| By: | Jenna Libersky Debra Lipson |
| Abstract: | This brief describes a novel approach that Mathematica Policy Research used to evaluate state oversight of a new Medicaid managed care program for individuals people with disabilities in Washington State. |
| Keywords: | Medicaid, Managed Care Organizations, Health |
| JEL: | I J |
| Date: | 2014–12–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0c6a7a2c7a704fbe880683e03e65be28&r=hea |
| By: | Grace Anglin; Karina Wagnerman; Leslie Foster |
| Abstract: | This issue brief highlights the communications strategies that the David and Lucile Packard Foundation’s state-based Finish Line grantees in Colorado, Ohio, and Wisconsin are using to keep children’s health coverage on their state’s policy agendas. |
| Keywords: | Communications Strategies for Children's Coverage Advocacy During ACA Implementation, Insuring America's Children , Finish Line, Affordable Care Act, advocacy, children , health insurance , coverage, communications |
| JEL: | I |
| Date: | 2014–12–09 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:a296f357ea0f42ceaea4cc30e6760ae1&r=hea |
| By: | Alex Bohl; John Schurrer; Dean Miller; Wilfredo Lim; Carol V. Irvin |
| Abstract: | This report focuses on the medical and long-term care expenditures for Medicaid beneficiaries who transition from institutional to community-based long-term services and supports (LTSS) and how those expenditures change after the transition. An initial analysis of expenditures finds evidence that total Medicaid and Medicare expenditures decline, sometimes substantially, during the first 12 months after someone transitions from institutional care to home and community-based services (HCBS). For people with physical disabilities or mental illness, Money Follows the Person (MFP) participation is associated with increased post-transition total expenditures, but there is no association between MFP participation and post-transition total expenditures for older adults or people with intellectual disabilities. |
| Keywords: | Money Follows the Person, expenditures, Medicaid, mental illness, disability, home and community-based services, long-term services and supports, community transitions, expenditures, costs, Medicare, Medicare-Medicaid enrollees, dual eligible |
| JEL: | I J |
| Date: | 2014–10–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:d1ae12f90ba7479cacb90e5ae826e1cd&r=hea |
| By: | Leslie Foster; Adam Dunn; Maggie Colby |
| Abstract: | California's Health-e-App Public Access (HeA PA) system enables low-income families to apply online for publicly funded children's health insurance. Findings from a study funded by the California Healthcare Foundation and the David and Lucile Packard Foundation have implications for Affordable Care Act implementation in California and other states. HeA PA contributed to growth in program applications, was used and well received by a segment of Internet-connected applicants, and complemented the system of assisted-online applications that many applicants used. |
| Keywords: | Health E App, Children's Health Care Coverage, California, Health |
| JEL: | I |
| Date: | 2013–10–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:5e69aa1496e24875bfb6ccba4fa9be72&r=hea |
| By: | Jeffrey Ballou; Valerie Cheh; Dean Miller; Audra Wenzlow |
| Abstract: | To better understand the population of Medicaid enrollees living in nursing homes or intermediate care facilities for individuals with intellectual disabilities (ICFs/IID), researchers analyzed data from the Medicaid Analytic eXtract (MAX) from 2006 and 2007 to determine the characteristics of enrollees remaining in nursing homes and ICFs/IID and their stays and assess how the length of institutional stays varies at the state level with changes in state constraints and policies. More specifically, the report explored the use of home and community-based services (HCBS) both before and after institutional stays and whether the length of institutional stays throughout a state corresponded to the percentage of Medicaid long-term care (LTC) spending the state allocated to HCBS. |
| Keywords: | long-term care, long-term services and supports, home and community-based care services, nursing homes, intermediate care facilities, individuals with intellectual disabilities, Medicaid |
| JEL: | I J |
| Date: | 2013–08–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:2a425710d3dc48d587b5b9862531b475&r=hea |
| By: | Marsha Gold; Gretchen Jacobson; Anthony Damico; Tricia Neuman |
| Keywords: | Medicare Advantage Plan Availability Premiums Health |
| JEL: | I |
| Date: | 2013–11–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:d37198390fb94e5a90d2befefbb2bc17&r=hea |
| By: | Ellen Bouchery |
| Abstract: | This study reviews dental services among Medicaid-enrolled children in nine states identified characteristics associated with underutilization of dental services, including age, length of Medicaid enrollment, and disability status. |
| Keywords: | Dentistry, Dental Care, Medicaid, Pediatrics , Children, Early Childhood |
| JEL: | I |
| Date: | 2013–09–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7c5130bb81584f429c23501317e10e46&r=hea |
| By: | Ha T. Tu; Laurie Felland; Paul B. Ginsburg; Kristie Liao; Kevin Draper; Rebecca Gourevitch |
| Abstract: | Despite acknowledging the inevitable shift from fee-for-service to value-based payment and the need to develop population-management capabilities, most D.C. metro area hospitals are sticking to fee-for-service competitive strategies to attract patients by building urgent care centers and freestanding emergency departments in affluent, well-insured areas, according to a new qualitative study by Mathematica Policy Research for the Jayne Koskinas Ted Giovanis Foundation for Health and Policy. |
| Keywords: | DC Area Health Care, Fee for Service, Value-Based Payment |
| JEL: | I |
| Date: | 2014–12–02 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0bd45d982cdd4b7aa8364a4365fa97b3&r=hea |
| By: | James Verdier; Sonya Streeter; Danielle Chelminsky; Jessica Nysenbaum |
| Abstract: | This technical assistance brief explores ways of improving the coordination of these overlapping benefits in the Centers for Medicare & Medicaid Services (CMS) Financial Alignment Initiative’s capitated model demonstrations. |
| Keywords: | Medicare, Medicaid, Dual Eligible, Durable Medical Equipment, Fee-for-Service |
| JEL: | I |
| Date: | 2014–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:ac51ab2dfe204a928d3967cb3116f203&r=hea |
| By: | Jonathan Brown |
| Keywords: | In Focus , Integrating Care , Behavioral Health Needs, Health, Mental Health |
| JEL: | I |
| Date: | 2014–09–11 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:38f2f70cfa8043f2a947a67c5f06640c&r=hea |
| By: | Jenna Libersky; Melanie Au; Allison Hamblin |
| Abstract: | This brief discusses the key components of existing disease management and care management programs that could be incorporated into integrated care programs for Medicare-Medicaid enrollees and other high-cost, high-need Medicaid beneficiaries. |
| Keywords: | Medicare, Medicaid, Dual Eligible, Integrated Care, Care Management |
| JEL: | I |
| Date: | 2014–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:159dacfe28dd45008c0c32ab24012b50&r=hea |
| By: | Karen Donelan; Catherine M. DesRoches; Robert S. Dittus; Peter Buerhaus |
| Abstract: | A study finds that, although primary care physicians and nurse practitioners mostly agree that nurse practitioners should be able to practice to the full extent of their education and training, they strongly disagree about proposed changes to the scope of nurse practitioners' responsibilities. The survey—led by investigators from Massachusetts General Hospital, the Institute for Medicine and Public Health at Vanderbilt University Medical Center, and Mathematica—revealed points of disagreement on appropriate leadership roles for nurse practitioners, reimbursement levels, and overall quality of services. |
| Keywords: | Physicians, Nurse Practitioners, Primary Care Practice, Health Care System |
| JEL: | I |
| Date: | 2013–05–16 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b66c95bc1f9d4d5483168c4be5a1f288&r=hea |
| By: | Nicholas Beyler; Susanne James-Burdumy; Martha Bleeker; Jane Fortson; Max Benjamin |
| Abstract: | Using measurement error models to analyze physical activity data collected from recess periods will allow for more accurate and reliable inferences on students' physical activity. |
| Keywords: | Playworks, physical activity |
| JEL: | I |
| Date: | 2014–09–29 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:fac4510b3d3b45ec9fca3e95e35c5a7b&r=hea |
| By: | Deborah Peikes; Rebecca SweetlLester; Boyd Gilman; Randall Brown |
| Abstract: | Reviews the evidence for six promising models being implemented by the Centers for Medicare and Medicaid Services' Community-based Care Transitions Program (CCTP) awardees. |
| Keywords: | Transitional Care Models Re-Admissions Long-Term Care Chronic Illness |
| JEL: | I |
| Date: | 2013–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:baddce6ec0734f8885ee02f6814cf6ae&r=hea |
| By: | Joshua Leftin; Allison Dodd; Kai Filion; Rebecca Wang; Andrew Gothro; Karen Cunnyngham |
| Abstract: | The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and the Pew Charitable Trusts, is conducting a health impact assessment intended to inform congressional consideration of changes to the Supplemental Nutrition Assistance Program (SNAP) included as part of the 2013 Farm Bill reauthorization. The analysis used SNAP program data on the number of participating households and individuals and SNAP benefit amounts by month and state to estimate the potential effects of converting SNAP to a block grant program that reverts total benefits to 2008 levels. The analysis found that had state block grants been implemented in fiscal year 2012, total SNAP benefits would have been 53.6 percent lower than they were, potentially decreasing average SNAP monthly household benefits by $149. |
| Keywords: | SNAP Eligibility, Benefit Determination, Farm Bill, Cardiometabolic Health Status, Low-Income Nonparticipants |
| JEL: | I0 I1 |
| Date: | 2013–08–02 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:a0e252ba3926445aa0ef1589e6b64ca9&r=hea |
| By: | Timothy K. Lake; Eugene C. Rich; Christal Stone Valenzano; Myles M. Maxfield |
| Abstract: | This article reviews the recent research, policy, and conceptual literature on the effects of payment policy reforms on evidence-based clinical decision making by physicians at the point of care. Payment reforms include recalibration of existing fee structures in fee-for-service, pay-for-quality, episode-based bundled payments and global payments. The authors review the advantages and disadvantages of these reforms in terms of their effects on physicians’ and patients’ use of evidence in clinical decisions related to the diagnosis, testing, treatment, and management of disease. They conclude with a recommended pathway for improving payment incentives to better support evidence-based decision making. |
| Keywords: | Comparative Effectiveness Research, Evidence-Based Decision-Making, Incentive Physician Payment Reform |
| JEL: | I |
| Date: | 2013–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b4a159cebf604aff9f6d904d82ce181b&r=hea |
| By: | Integrated Resource Care Center |
| Abstract: | This brief from the Integrated Care Resource Center (ICRC) describes options for attracting and retaining enrollment in capitated models of care integration. |
| Keywords: | Medicare, Medicaid, Care Initiatives, Capitated Models |
| JEL: | I |
| Date: | 2013–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:c6ceafee8b9a484587659cd3341cdfee&r=hea |
| By: | Eric J. Lammers; Julia Adler-Milstein; Keith E. Kocher |
| Abstract: | This study is among the first of its kind to find empirical support for the anticipated benefit of health information exchange (HIE) to lower health care costs by reducing repeat medical tests. It found that HIE, in which patients' clinical data follow them across care delivery settings, is associated with decreases in repeat imaging in emergency departments. |
| Keywords: | Health Information Exchange , HIE , Emergency Departments , Health |
| JEL: | I |
| Date: | 2013–12–26 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7e88cfc7ff7149ebb366ae7dede93986&r=hea |
| By: | Greg Peterson; Randy Brown; Allison Barrett |
| Keywords: | Home, Community Based Services Consumers Medicaid Costs Iowa |
| JEL: | I J |
| Date: | 2013–03–11 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:5b5cc17a59ee4a0b8fe91c2c73f79618&r=hea |
| By: | Richard J. Manski; John F. Moeller; Haiyan Chen; Jody Schimmel; Patricia A. St. Clair; John V. Pepper |
| Abstract: | This study examined the use of physician, inpatient hospital, home health, and outpatient surgery for Americans more than 50 years of age. The study found that overall health and changes in health are more strongly correlated with seeking and using health care over time than financial status or changes to one’s financial status. |
| Keywords: | Health Care Utilization, Older Americans, Health Insurance Coverage, Health |
| JEL: | I |
| Date: | 2013–07–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:f4cfe7c0c04a45ae914fb8715dca107c&r=hea |
| By: | Eugene C. Rich; Timothy K. Lake; Christal Stone Valenzano; Myles M. Maxfield |
| Abstract: | This article dvelops a framework for understanding how financial and nonfinancial incentives can complicate point-of-care decision making by physicians, leading to the over- or under-use of health care services. The analysis highlights contributing factors that promote and impede evidence-based decision making, using examples from the “Choosing Wisely†program. The authors discuss how the existing fee-for-service payment system can contribute to the problems of over- and under-testing, diagnosis, and treatment. |
| Keywords: | Comparative Effectiveness Research, Evidence-Based Decision-Making, Incentive, Physician Payment Reform |
| JEL: | I |
| Date: | 2013–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0f90ee2365ca4ad98bfb3298a8266623&r=hea |
| By: | JudyAnn Bigby |
| Abstract: | To prevent closings of critical access hospitals (CAHs), or rural hospitals, Congress authorized cost-based rather than prospective payments. This commentary responds to research suggesting that when CAHs join integrated systems, the relative portion of a system's costs of shared services attributed to CAHs increased by 40 percent. The finding highlights the need to examine payments to integrated delivery systems that support CAHs as part of a continuum of care in rural communities. |
| Keywords: | Critical Access, Hospital Payment Policies, Integrated Systems Health |
| JEL: | I |
| Date: | 2013–11–04 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7515fd0a4d984e9d9127186d163b1180&r=hea |
| By: | Barrett T. Kitch; Catherine DesRoches; Cara Lesser; Amy Cunningham; Eric G. Campbell |
| Abstract: | This article found that characteristics of organizations such as hospitals, group practices, and physician organizations can help foster a consistent systems model of physician professionalism. |
| Keywords: | Systems Model Physician Professionalism |
| JEL: | C |
| Date: | 2013–02–28 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b9d1fbc678e14aa988dd96716ef4fad8&r=hea |
| By: | Keith Kranker; So O’Neil; Vanessa Oddo; Miriam Drapkin; Margo Rosenbach |
| Abstract: | This technical assistance brief discusses strategies for accessing vital records for quality measurement and improvement efforts related to maternal and infant health care in Medicaid and the Children's Health Insurance Program (CHIP). The brief also gives guidance and describes resources available to states for linking vital records and Medicaid/CHIP data to increase states’ capacity to report two measures in the Core Set of children's health care quality measures: low birth weight rate and Cesarean section rate. |
| Keywords: | Medicaid, CHIP, Quality Measures, Health |
| Date: | 2014–01–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:4c9ca4dbc4d24cf5ac7dc59238de8d67&r=hea |
| By: | Marsha Gold; Gretchen Jacobson; Anthony Damico; Tricia Neuman |
| Keywords: | Medicare Advantage, Enrollment Market , Health |
| JEL: | I |
| Date: | 2014–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:9c9fe41463fd4afb8e0c3797bbbf1b4e&r=hea |
| By: | Catherine M. DesRoches; Dustin Charles; Michael F. Furukawa; Maulik S. Joshi; Peter Kralovec; Farzad Mostashari; Chantal Worzala Ashish K. Jha |
| Abstract: | This article measured current hospital use of electronic health record (EHR) systems using data from the 2012 health IT supplement to the American Hospital Association’s annual survey. According to the data, 44 percent of hospitals report having at least a basic EHR system, a 17 percent increase from 2011 and a near-tripling of the 2010 adoption rate. Also, large urban hospitals continued to outpace rural and nonteaching hospitals. Although 42.2 percent of all hospitals met all the stage 1 meaningful-use criteria, only 5.1 percent had advanced to stage 2. While considerable progress has been made, findings suggest a need for a focus on hospitals still trailing behind, notably small and rural institutions. This focus is especially important as stage 2 meaningful-use criteria become the rule, and positive incentives are replaced by penalties for noncompliance. |
| Keywords: | Electronic Health Records, EHRs, Health Information Technology, HIT |
| JEL: | I |
| Date: | 2013–07–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0d8d890b940d4e0f835fa1adeb45eae1&r=hea |
| By: | Tricia Collins Higgins; Dana Petersen; Lyndee Knox; Lisa Schottenfeld; Liz Babalola; Erin Taylor; Jesse Crosson; Deborah Peikes |
| Abstract: | Three case studies of exemplar Primary Care Practice Facilitation training programs provide an overview of each program’s design and content, training approaches, format, administrative structure, funding, staffing and curriculum. The case studies were developed by Mathematica under a contract with the Agency for Healthcare Research and Quality. |
| Keywords: | Exemplary Primary Care, Practice Facilitation, Training Programs, Health |
| JEL: | I |
| Date: | 2014–08–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:3bdd85dd3c29425e8ee6fe3bd2b45e3c&r=hea |
| By: | Denise Hoffman; Kristin Andrews; Valerie Cheh |
| Abstract: | This study examined the characteristics and service use of Medicaid Buy-In participants with higher incomes (above 250 percent of the federal poverty line), relative to participants with lower incomes. The study found higher-income participants were less likely to enroll in Medicare and more likely to be enrolled in third-party insurance. Service use for higher-income Buy-In participants concentrated on prescription drugs and durable medical equipment, and Medicaid expenditures for a selected set of services among higher-income participants were generally lower than expenditures for the same services among all Buy-In participants. |
| Keywords: | Medicaid Buy-In, High Earners, Service Use, Health, Disability |
| JEL: | I |
| Date: | 2013–05–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:75fc7efacbd74631bd2de3314a3c0486&r=hea |
| By: | Jung Y. Kim; Tricia Collins Higgins; Dominick Esposito; Angela M. Gerolamo; Mark Flick |
| Abstract: | Mathematica's mixed methods evaluation suggests that states can promote integration across separate financing and delivery systems and improve quality of care. |
| Keywords: | SMI Serious Mental Illness Medicare Beneficiaries Adult Care |
| JEL: | I J |
| Date: | 2014–02–28 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:c07aaeddd5114df9b6619aa3fdbbb9d7&r=hea |
| By: | Michelle Herman Soper; James Verdier; Fiona Donald |
| Keywords: | care coordination, home health services, durable medical equipment, Medicare-Medicaid enrollees, financial alignment, Health |
| JEL: | I |
| Date: | 2014–09–08 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:c49bd4ef2fad4636bba07841b06d4ba8&r=hea |
| By: | Mary Harrington; Genevieve M. Kenney; Kimberly Smith; Lisa Clemans-Cope; Christopher Trenholm; Ian Hill; Sean Orzol; Stacey McMorrow; Sheila Hoag; Jennifer Haley; Joseph Zickafoose; Timothy Waidmann; Claire Dye; Sarah Benatar; Connie Qian; Matthew Buettgens; Tyler Fisher; Victoria Lynch; Lauren Hula; Nathanial Anderson; Kenneth Finegold |
| Abstract: | This is the final report on findings from an evaluation of the Children’s Health Insurance Program (CHIP) that was mandated in the CHIP Reauthorization Act. The evaluation was conducted by Mathematica Policy Research and its partner The Urban Institute, and was overseen by the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. |
| Keywords: | CHIP, Medicaid, Child Health, Insurance, Uninsured, Access , Children |
| JEL: | I |
| Date: | 2014–08–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:a999a32f3d9946d6aa908ce8c94e424c&r=hea |
| By: | Adam Dunn; Dana Petersen; Leslie Foster |
| Abstract: | This brief presents the views of certified application assistants on barriers to the use of California's Health-e-App Public Access, a self-service online enrollment system for Healthy Families and Medicaid, and the potential role they could play in raising awareness of the system. |
| Keywords: | Health-e-app, Children's Health Care Coverage, California, HeA PA |
| JEL: | I |
| Date: | 2013–07–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0d4b3ec8db594dfcb1b13e92167815dd&r=hea |
| By: | Susanne James-Burdumy |
| Keywords: | Playworks, Physical Activity, Recess , RCT, Randomized Controlled Trial |
| JEL: | I |
| Date: | 2014–03–11 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:ceddf2959fb441c1ae0d745aa243e161&r=hea |
| By: | Allison Wishon Siegwarth Crystal Blyler |
| Abstract: | Mental illness, like any health concern, can disrupt the ability to work. Less than 20 percent of people who receive publicly funded mental health services are employed, although research consistently demonstrates that, with the right supports, 40-60 percent of people with serious mental illness (SMI) can work. |
| Keywords: | Affordable Care Act, Employment, Mental Illness |
| JEL: | I J |
| Date: | 2014–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:85f8b176874d4497983285c5f60708d0&r=hea |
| By: | Chapin White; James D. Reschovsky; Amelia M. Bond |
| Abstract: | This issue brief finds that when episodes of care involving hospitalizations, similar to Model 2 of the ongoing Centers for Medicare & Medicaid Services Bundled Payment for Care Improvement demonstration, are applied to privately insured patients, inpatient prices drive the bulk of episode-spending variation. |
| Keywords: | Inpatient Hospital Prices Spending Variation Privately Insured Patients NIHCR |
| JEL: | I |
| Date: | 2014–02–28 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:749f3a224d5f4b748201e982354b5664&r=hea |
| By: | Chapin White; James D. Reschovsky; Amelia M. Bond |
| Abstract: | A study examining the relationship between hospital characteristics and hospital prices can help inform the debate on controlling health care costs. |
| Keywords: | Hospitals Health Economics Cost of Healthcare |
| JEL: | I |
| Date: | 2014–02–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:c7716bb6443d4eceaccc5a2c1d966097&r=hea |
| By: | Catherine M. DesRoches; Chantal Worzala; Scott Bates |
| Abstract: | This article cite progress on the adoption of health information technology (HIT) that meets Medicare’s criteria for “meaningful use.†Through an analysis of Medicare data, the study found a substantial increase in the percentage of hospitals receiving electronic health record incentive payments between 2011 (17.4 percent) and 2012 (36.8 percent). However, critical-access, smaller, and publicly owned or nonprofit hospitals appeared to be at risk of failing to meet the criteria. |
| Keywords: | Meaningful Use, Hospitals, EHR, Health , Criteria, Vulnerable Penalties |
| JEL: | I |
| Date: | 2013–08–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:f9fe4c55e2c14a399a5361df2a753852&r=hea |
| By: | James Verdier |
| Keywords: | Medicaid, Long-Term, Services, Supports, MLTSS |
| JEL: | I |
| Date: | 2014–07–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:a217a70537ee41d0b9a20109fc2b375c&r=hea |
| By: | Greg Peterson; Randy Brown; Allison Barrett; Beny Wu; Christal Stone Valenzano |
| Abstract: | Using a quasi-experimental design, this study assessed the effects of waiting periods on the costs of Medicaid long-term care and the risk of long-term nursing home stays and hospitalizations. |
| Keywords: | Home and Community Based Services, Medicaid, Long-Term Care Costs, Iowa, Disability, Health |
| JEL: | I J |
| Date: | 2014–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:dc4c25dbb6a64a65bae14bd3883d67be&r=hea |
| By: | James M. Verdier Ashley Zlatinov |
| Abstract: | This brief presents noteworthy trends and patterns in the use and costs of prescription drugs for Medicaid beneficiaries from 1999 to 2009. It builds on previous annual tables and chartbooks, and describes trends in drug usage and costs. The brief emphasizes trends for beneficiaries with disabilities and chronic illnesses, whose drug use is much more extensive than that of children and nondisabled adults. |
| Keywords: | Medicaid , prescription drugs , prescription drug expenditures , MAX |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:92fe93894f594de7a94ec216fb2a8d21&r=hea |
| By: | Marsha Gold; Winnie Wang; Julia Paradise |
| Abstract: | Mathematica health experts collaborated with staff at the Kaiser Commission for Medicaid and the Uninsured to author this brief, the second of three case studies examining key operational aspects of coordinated care initiatives in Medicaid, which focuses on the Transitional Care Program conducted by Community Care of North Carolina (CCNC). CCNC is a medical home program that serves 83 of all North Carolina Medicaid beneficiaries. The Transitional Care Program identifies high-risk enrollees when they are admitted to a hospital, and plans, coordinates, and arranges their transition back to the community. |
| Keywords: | Care Transitions, Medicaid, North Carolina, Health |
| JEL: | I |
| Date: | 2013–10–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:8ff99413e48f4472b4eccabc7bf3353f&r=hea |
| By: | Catherine M. DesRoches; Jennifer Gaudet; Jennifer Perloff; Karen Donelan; Lisa I. Iezzoni; Peter Buerhaus |
| Abstract: | This study examines the geographic distribution and county characteristics of nurse practitioners (NPs) billing Medicare, compares the types and quantities of primary care services provided to Medicare beneficiaries by NPs and primary care physicians, and analyzes the characteristics of beneficiaries receiving primary care from each type of clinician. The study found approximately 45,000 NPs provided services to beneficiaries and billed under their own provider numbers in 2008. Aspects of NP practice patterns differed from those of primary care physicians, and NPs appeared more likely to provide services to disadvantaged Medicare beneficiaries. |
| Keywords: | Advanced Practice Nurse Medicare Patient Characteristics |
| JEL: | I |
| Date: | 2013–11–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:2066a56ce2fa48898dccc867e7a29a69&r=hea |
| By: | Audra Wenzlow; Rosemary Borck; Dean Miller; Pamela Doty; John Drabek |
| Abstract: | This report explores interstate variations in long-term care (LTC) expenditure and service use patterns, not only in terms of institutional and non-institutional services, but also by Medicaid LTC users’ age and type of disability (for example, intellectual and developmental disabilities [ID/DD] or other adult-onset disabilities). Some states have reoriented more toward home and community-based services (HCBS) than others. It also well known that greater progress has been made in serving certain subgroups within the LTC population in the community (those with ID/DD) compared to others and that reliance on institutional care remains greatest among older adults, although interstate variations exist. This report seeks to quantify the magnitude of such differences. |
| Keywords: | state variation, Medicaid Long-term care use, Expenditures, 40 states, Disability, HCBS |
| JEL: | I J |
| Date: | 2013–07–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:6297eba14aa7484d8cad21d787ee9842&r=hea |
| By: | Kate A. Stewart; Joseph S. Zickafoose; Beny Wu; Randall S. Brown; Henry T. Ireys |
| Keywords: | NCQA, Patient-Centered Medical Homes, Primary Care Practices, Quality of Care, Children, Disability, Special Health Care Needs |
| JEL: | I J |
| Date: | 2014–01–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0ba6ce2e27774094b3a5c15564bc03f3&r=hea |
| By: | Mynti Hossain; Rebecca Coughlin; Joseph Zickafoose |
| Abstract: | This brief presents descriptive and analytic findings from the national evaluation of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant Program. It focuses on a joint CHIPRA quality demonstration project in Colorado and New Mexico and the efforts of school-based health centers (SBHCs) to integrate the patient-centered medical home (PCMH) approach to quality improvement. |
| Keywords: | CHIPRA, School-based health centers, Medical Home, Health |
| JEL: | I |
| Date: | 2014–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:08e3c368c2584c4492e6e5bb34d41a16&r=hea |
| By: | Committee on Evaluating Progress of Obesity Prevention Effort; Food Nutrition Board; Institute of Medicine; of which Ronette Briefel is a member |
| Abstract: | This IOM committee developed a concise and actionable plan for measuring the nation’s progress in obesity prevention efforts. |
| Keywords: | Obesity Prevention , IOM , Nutrition |
| JEL: | I0 I1 |
| Date: | 2013–08–02 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:094b9a584a2340c08ae1f9b1ae0c76cc&r=hea |
| By: | Karen Donelan; Carol Romano; Catherine DesRoches; Sandra Applebaum; Johanna R.M. Ward; Bruce A. Schoneboom; Ada Sue Hinshaw |
| Abstract: | This study explores perceptions of military careers, nursing careers and barriers, and incentives to pursue military nursing careers in all populations. |
| Keywords: | Military Personnel, Nursing Students, National Survey |
| JEL: | C I |
| Date: | 2014–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:433f04581aa641e0a2a847ff2c9a43a1&r=hea |
| By: | Nicholas Beyler; Wayne Fuller; Sarah Nusser; Gregory Welk |
| Abstract: | Physical activity measurements derived from self-report surveys are prone to measurement errors. Monitoring devices like accelerometers offer more objective measurements of physical activity, but are impractical for use in large-scale surveys. A model capable of predicting objective measurements of physical activity from self-reports would offer a practical alternative to obtaining measurements directly from monitoring devices. |
| Keywords: | estimated generalized least squares , NHANES , physical activity , accelerometry , validation study |
| JEL: | C |
| Date: | 2014–11–19 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:f70079100e834e689c2e776010744fdb&r=hea |
| By: | Mai Hubbard; Sloane Frost; Kimberly Siu; Nicole Quon; Dominick Esposito |
| Abstract: | A retrospective analysis of Medicare claims data examined the relationship between outpatient visits within 14 days after hospital discharge and readmission for beneficiaries with atrial fibrillation or other chronic conditions. About half of those beneficiaries with a hospitalization had an outpatient visit within 14 days of discharge. Readmission rates were 11 to 24 percent lower for beneficiaries with an outpatient visit than for those without one. These findings suggest that follow-up care shortly after discharge may lower readmissions for patients with atrial fibrillation or other chronic conditions. |
| Keywords: | Care Transitions, Quality of Care, Follow-up Visits, Readmissions, Atrial Fibrillation , Outpatient, Discharge, Hospital, Medicare Beneficiaries |
| JEL: | I |
| Date: | 2013–07–29 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0565aec1425b4754a6097a369fe8f32b&r=hea |
| By: | Bruce E. Landon; A. James O'Malley; M. Richard McKellar; Jack Hadley; James D. Reschovsky |
| Abstract: | The relationship between practice intensity and the quality and outcomes of care has not been studied. |
| Keywords: | quality of care/patient safety, incentives in health care, payment systems, Medicare |
| JEL: | I |
| Date: | 2014–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:1c8817289a664a8da484bccfa0fc9251&r=hea |
| By: | Jelena Zurovac; Lorenzo Moreno; Jesse Crosson; Randall Brown; Robert Schmitz |
| Abstract: | This paper identifies opportunities for using multifactorial designs and electronic health record data to evaluate quality improvement efforts in physicians' practices. Examples include using multifactorial designs to evaluate clinical decision support features and studying components of a patient-centered medical home. |
| Keywords: | Comparative Effectiveness Research, CER Electronic Health Record, EHR Multifactorial Experiments Physician Practices |
| JEL: | I |
| Date: | 2013–12–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:401fde77cf424b09b767d17135b92a76&r=hea |
| By: | Jonathan D. Brown; Allison Barrett; Emily Caffery; Kerianne Hourihan; Henry T. Ireys |
| Abstract: | This study examines whether medication continuity among Medicaid beneficiaries with schizophrenia and bipolar disorder was associated with medication utilization management practices (prior authorization, copayment amounts, and refill and pill quantity limits); managed care enrollment; and other state and beneficiary characteristics. The study found that prior-authorization requirements and copayments for medications can present barriers to refilling medications for Medicaid beneficiaries with schizophrenia or bipolar disorder. |
| Keywords: | Medication Continuity Medicaid Beneficiaries Schizophrenia Bipolar Disorder |
| JEL: | I J |
| Date: | 2013–06–03 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:c24f1d94328f42fba89e3726347af4d3&r=hea |
| By: | Alisa B. Busch; Frank Yoon; Colleen L. Barry; Vanessa Azzone; Sharon-Lise T. Normand; Howard H. Goldman; Haiden A. Huskamp |
| Abstract: | This article counters concerns that benefit expansion under parity would increase spending. The study finds that mental health parity provisions in the Federal Employees Health Benefits program reduced total out-of-pocket spending for patients with more-severe behavioral health conditions, while the level of services they received remained largely unchanged. The study also found, however, that individuals with less-severe but acute mental health conditions received fewer services, suggesting that health plans manage benefits selectively. |
| Keywords: | Bipolar Disorder Adjustment Disorder Mental Health Parity |
| JEL: | I J |
| Date: | 2013–02–28 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:8041bf27559640ea81e1e98d84f8bc49&r=hea |
| By: | Dana Rotz; Anu Rangarajan; Evan Borkum Swetha Sridharan; Sukhmani Sethi; Mercy Manoranjini |
| Keywords: | TBGI, Frontline Health Worker Team Based Goals, Bihar, Ananya, International |
| JEL: | F Z |
| Date: | 2014–02–28 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:f3b937284a114b9a90644b1eb3849019&r=hea |
| By: | Pedro F. Saint-Maurice; Gregory J. Welk; Nicholas K. Beyler; Roderick T. Bartee; Kate A. Heelan |
| Abstract: | This study demonstrates the potential of calibrating self-reports of physical activity against objective measures of physical activity in youth, using a commonly used self-report tool called the Physical Activity Questionnaire. |
| Keywords: | youth, accelerometry, measurement, public health, survey |
| JEL: | C I |
| Date: | 2014–05–16 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0e79fbccf62d4a8f807d7b004aec8169&r=hea |
| By: | Jenna Libersky James Verdier |
| Abstract: | This technical assistance brief from the Integrated Care Resource Center (ICRC) provides basic information on the Medicare program, the services it covers, and the process used to set rates. |
| Keywords: | Medicare, States, Integrate care, Medicare-Medicaid, Enrollees, cost-sharing, Medicare Advantage |
| JEL: | I |
| Date: | 2013–07–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:651dd12057e4480f9bcd4f74af226e0a&r=hea |
| By: | Marsha Gold |
| Abstract: | The analysis uses qualitative methods to gain practical insight into how policy makers and health system leaders view the connections between HIT and changing healthcare delivery. |
| Keywords: | HIT Health Information Technology Transform Delivery |
| JEL: | I |
| Date: | 2013–11–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:a82f833455044518af8f13ba2d892fb9&r=hea |
| By: | Allison Hedley Dodd Rosalie Malsberger |
| Abstract: | This issue brief presents the results of the first study conducted using data from Medicaid Analytic eXtract (MAX) data and the Medicare Current Beneficiary Survey to assess the use of home- and community-based services by the presence and level of functional limitations, as measured by limitations in activities of daily living. |
| Keywords: | long-term services and supports, LTSS, home- and community-based services, HCBS, Medicare-Medicaid, enrollee , Medicaid Analytic eXtract , MAX, Medicare Current Beneficiary Survey , MCBS from 2007–2008 , health |
| JEL: | I |
| Date: | 2013–09–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:d51521d3c5a7414c8cb5b27a23dbddc3&r=hea |
| By: | Jody Schimmel Hyde Gina A. Livermore |
| Abstract: | Using data from the 2006–2010 National Health Interview Surveys, we document the characteristics and health insurance profiles of workers with a disability and consider the extent to which these factors are correlated with the ability to access adequate and timely health care. |
| Keywords: | Access to Care , Workers, Disability Status, ACA |
| JEL: | I J |
| Date: | 2014–09–12 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:d7d8d56b04294c59b4a1a62e72d55cd7&r=hea |
| By: | Brian Goesling; Silvie Colman; Mindy Scott; Elizabeth Cook |
| Abstract: | Part of the broader Evaluation of Adolescent Pregnancy Prevention Approaches (PPA), this study evaluated the impacts of a Chicago Public School demonstration project to support the implementation of HealthTeacher, a nationally popular and affordable online K–12 health education program, in a select number of 7th-grade classrooms. |
| Keywords: | Family Health, Sexuality Module, HealthTeacher, Family Support |
| JEL: | I |
| Date: | 2014–05–16 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b9d1f6a678b149138f3e92f9dba77b5e&r=hea |
| By: | Kristin Andrews; Jonathan D. Brown Tara Ferragamo; Rebecca Kleinman; Rebecca Newsham; Allison Wishon Siegwarth |
| Keywords: | Coordinating Care, Behavioral Health Populations, Health |
| JEL: | I |
| Date: | 2014–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:c80040fb695c413083841e51d8b3bec4&r=hea |
| By: | Ann S. O'Malley; Rebecca Gourevitch; Kevin Draper; Amelia Bond; Manasi A. Tirodkar |
| Abstract: | There is emerging consensus that enhanced inter-professional teamwork is necessary for the effective and efficient delivery of primary care, but there is less practical information specific to primary care available to guide practices on how to better work as teams. |
| Keywords: | Primary Health Care, Patient care team, Patient-Centered Medical Home, Quality of Health Care, Practice Management |
| JEL: | I |
| Date: | 2014–11–11 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:4273d4eae231430ca07a9446220bd8d2&r=hea |
| By: | Deborah Peikes; Erin Fries Taylor; Janice Genevro; David Meyers |
| Abstract: | The Agency for Healthcare Research and Quality (AHRQ) has released a new Evaluation Guide for designing real-world evaluations of interventions such as the patient-centered medical home (PCMH) and other models to improve primary care delivery. Effective primary care can improve health and cost outcomes, and patient, clinician and staff experience, and evaluations can help determine how best to improve primary care to achieve these goals. |
| Keywords: | Primary Care Interventions, Medical Homes, Health |
| JEL: | I |
| Date: | 2014–10–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:4a3f9bf3429b45a9841f21ff79c305e2&r=hea |
| By: | Erin Fries Taylor; Deborah Peikes; Janice Genevro; David Meyers |
| Keywords: | Primary Care, Quality Improvement, Patient-Center Medical Homes, Health |
| JEL: | I |
| Date: | 2013–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b1d54203e3354a4897d282b5bf7b21bb&r=hea |
| By: | John L. Czajka |
| Keywords: | Income Eligibility Affordable Care Act; ACA Nonelderly Adults Health |
| JEL: | I |
| Date: | 2013–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:344cf8a42a4649dd92dc477582a0a543&r=hea |
| By: | Ludovico Carrino (Department of Economics, University Of Venice Cà Foscari); Cristina Elisa Orso (Department of Economics, University Of Venice Ca’Foscari) |
| Abstract: | Although economic literature has recently started to concentrate on the design, the scope and the regulations of main public programmes of Long-Term-Care in Europe, no analysis have, so far, compared different systems in terms of their degree of inclusiveness with respect to vulnerable elderly’s health status. Focusing on several European countries, this paper investigate how LTC regulations assess vulnerability, as well as how they define a minimum level of objective-dependency that would entitle individuals to receive public benefits (in-kind or in-cash) for home-based care. Our contribution is threefold. We provide detailed information on assessment and eligibility frameworks for eleven LTC programmes in Europe. We show that substantial heterogeneities exist both at the extensive margin (the health-outcomes that are included in the vulnerability-assessment) and at the intensive margin (the minimum vulnerability threshold that defines benefit eligibility) of the assessment strategies. Building on this information, we compare LTC programmes in terms of their degree of inclusiveness, i.e., we investigate the extent to which each programme is able to cover a standard population of elderly individuals facing functional and cognitive limitations. The comparison is performed following both a directly- and an indirectly- adjusted strategy using SHARE data. |
| Keywords: | Long-term care, eligibility, access to home-care, vulnerability, direct adjustment, indirect adjustment, inclusiveness, Europe |
| JEL: | H53 I18 I11 |
| URL: | http://d.repec.org/n?u=RePEc:ven:wpaper:2014:28&r=hea |