Download or read book Investigating State Incentives and Decision Making During Section 1115 Waiver Application written by Kathryn Brooks Vaughn and published by . This book was released on 2022 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt: The social determinants of health are relatively well-documented, considering that the academic and research concept of studying the non-clinical causes of health disparities is little more than twenty years old. The World Health Organization recognizes ten different social elements that are likely to influence health outcomes in both positive and negative ways: income and social protection, education, unemployment and job insecurity, food insecurity, housing, basic amenities and the environment, early childhood development, social inclusion and non-discrimination, structural conflict, and access to affordable services of decent quality. The United States healthcare system is one of few among the developing nations that centers health policy decisions upon favoring employer sponsored insurance, or ESI. Such a practice has deep roots in American history and policy. What is concerning about this focus, however, is that less than fifty percent of Americans actually access their primary insurance coverage through employer-sponsored plans. Lower-income families and workers are traditionally less likely to be covered by employer plans, meaning that those who qualify are all but forced to seek coverage through state and federal insurance programs, like Medicaid. As prices and overall spending continues to increase at concerning rates, the reliance upon insurance as a mechanism to facilitate affordability is nearly cemented. Overall health outcomes among the uninsured (or underinsured) tend to be worse than those who have insurance, as we know that in many cases, the uninsured end up delaying or avoiding care due to cost.States that consistently rank as having the worst health outcomes , tend to coincide with data that indicates that they also spend less on care per capita. There are a multitude of reasons why this could be - some research points to burdens in accessing public health care provisions (both insurance and clinical care), others point to high rates of uninsurance due to cost, while others examine the relationship between cultural and dietary habits and health maintenance. Many of these concentrations in poor health outcomes tend to reside in states that also have poor outcomes in education, poverty, and other social metrics that tend to be predictors of health outcomes. For these reasons, this paper will explore the access to affordable and quality services in the United States, specifically in the realm of Medicaid and state efforts to alter its accessibility and quality. Section 1115 Medicaid waivers have long been utilized by states to change health care policy in ways that the federal government does not. From expanding eligibility criteria, to imposing work requirements, it is often implied that state leaders use this tool for political posturing rather than program improvement. However, almost every state has applied for a waiver at some point in time, making irrelevant the argument that one party rather pulls this lever more than another. This paper seeks to quantify some of the assumptions about why states use this tool to alter Medicaid and its structure: by incorporating state demographic factors, I will examine the varying incentives that states have to apply for Medicaid demonstration waivers. I will investigate this question by using data from a combination of sources including for poverty and income levels, employment, state gross domestic product, Medicaid enrollment, state legislative leanings, and more. Due to the multi-faceted nature of these waivers, my research will examine waivers in all states, along with separate analyses for states that are re-applying for existing waivers, and further stratification for addressing the individual likelihoods of applying for “progressive” waivers (that seek to expand Medicaid access and enrollment) versus “regressive” waivers (or waivers that seek to restrict Medicaid access and enrollment). This research will provide valuable context for further discussion around political incentives, and whether state efforts to better manage (or better afford) Medicaid programs are really of merit.
Download or read book Federalism and Health Policy written by Alan Weil and published by The Urban Insitute. This book was released on 2003 with total page 448 pages. Available in PDF, EPUB and Kindle. Book excerpt: The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.
Download or read book The Oxford Handbook of U S Health Law written by I. Glenn Cohen and published by Oxford University Press. This book was released on 2017 with total page 1233 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Oxford Handbook of U.S. Health Law covers the breadth and depth of health law, with contributions from the most eminent scholars in the field. The Handbook paints with broad thematic strokes the major features of American healthcare law and policy, its recent reforms including the Affordable Care Act, its relationship to medical ethics and constitutional principles, how it compares to the experience of other countries, and the legal framework for the patient experience. This Handbook provides valuable content, accessible to readers new to the subject, as well as to those who write, teach, practice, or make policy in health law.
Download or read book The Health Care Case written by Nathaniel Persily and published by Oxford University Press, USA. This book was released on 2013-07-04 with total page 401 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Supreme Court's decision in the Health Care Case, NFIB v. Sebelius, gripped the nation's attention during the spring of 2012. This volume gathers together reactions to the decision from an ideologically diverse selection of the nation's leading scholars of constitutional, administrative, and health law.
Download or read book Government Code written by Texas and published by . This book was released on 2000 with total page 556 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Integrating Social Care into the Delivery of Health Care written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-01-30 with total page 195 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.
Download or read book Medicaid Eligibility Quality Control written by United States. Social and Rehabilitation Service and published by . This book was released on 1975 with total page 460 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Improving the Quality of Long Term Care written by Institute of Medicine and published by National Academies Press. This book was released on 2001-02-27 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
Download or read book Social Isolation and Loneliness in Older Adults written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-05-14 with total page 317 pages. Available in PDF, EPUB and Kindle. Book excerpt: Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
Download or read book Making Medicines Affordable written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-01 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
Download or read book Health Care Financing Review written by and published by . This book was released on 2002 with total page 636 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Public Hospital Systems in New York and Paris written by Victor Rodwin and published by NYU Press. This book was released on 1992 with total page 292 pages. Available in PDF, EPUB and Kindle. Book excerpt: With sixteen hospitals and almost 10,500 beds, the New York City Health and Hospitals Corporation(HHC) is the largest municipal hospital system in the United States. With forty-seven hospitals and almost thirty-three thousand beds, the Paris Hospital Corporation, Assistance Publique-Hopitaux de Paris(AP), is three times as large, the biggest municipal hospital system in France. This book compares these two vast systems. It analyzes staffing, outpatient and inpatient care, the desirability of private faculty practice plans, budgeting, quality assurance, and the role of medical education in these two very different systems. In addition, it reviews how both HHC and AP plan to adapt their systems over the next decade and beyond. Aging populations, the development and diffusion of new medical technologies, and the growth of hospitals and physicians throughout the 1960s and 1970s have led to massive increases in health care costs in both the United States and in France. Both New York City and Paris have suffered the shock of the AIDS epidemic. Detailed, informed, and authoritative, this book will stand for years as the standard comparative study of two large municipal hospital systems.
Download or read book Human Resources Code written by Texas and published by . This book was released on 2007 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Health Care Quality Improvement System for Medicaid Managed Care written by and published by . This book was released on 1993 with total page 114 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book AFDC Waiver Demonstration Programs written by United States. Congress. House. Committee on Government Operations. Human Resources and Intergovernmental Relations Subcommittee and published by . This book was released on 1995 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicaid Hospital Payment written by Jennifer Baldwin and published by . This book was released on 1991 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Water Code written by Texas and published by . This book was released on 1972 with total page 548 pages. Available in PDF, EPUB and Kindle. Book excerpt:
