HorseRaceBlog – Health Care Reform Has Endangered the Democratic Majority | Jay Cost: RealClearPolitics

August 31, 2010

the fact that the health care bill is no longer the topic du jore does not mean it is no longer an issue. The real questions are whether the health care bill moved voters away from the Democrats, and whether those voters have since moved back now that the debate is over. The answers are yes – the debate moved voters away from the Democrats;  More at RealClearPolitics – HorseRaceBlog – Health Care Reform Has Endangered the Democratic Majority.


NCHS and AcademyHealth Name 2010 Health Policy Fellows

August 31, 2010

The Centers for Disease Control and Prevention National Center for Health Statistics (NCHS) and AcademyHealth are pleased to announce the selection of Nicole Garro and Patricia Markovich as the recipients of the 2010 NCHS/AcademyHealth Health Policy Fellowship. More at NCHS/AcademyHealth Health Policy Fellowship – Training and Professional Resources – AcademyHealth.


NCHS/AcademyHealth Health Policy Fellowship – Training and Professional Resources – AcademyHealth

August 31, 2010

The fellowship program brings visiting scholars in health services research-related disciplines to the National Center for Health Statistics (NCHS) in Hyattsville, Md. for a period of 13 months to conduct studies of interest to policymakers and the health services research community. Fellows have access to NCHS data resources for use in their proposed studies, and also work on collaborative projects with NCHS staff.

The 2011 call for applications deadline is January 10, 2011.

More at NCHS/AcademyHealth Health Policy Fellowship – Training and Professional Resources – AcademyHealth.


Sebelius: Time for ‘Reeducation’ on Obama Health Care Law | Steven Portnoy: ABC News The Note

August 31, 2010

With a number of polls showing a sustained level of opposition to the Democrats’ health care reform efforts more than five months after passage, Health and Human Services Secretary Kathleen Sebelius said the Obama administration has “a lot of reeducation to do” heading into the midterms.

While some surveys – namely the Kaiser Family Foundation monthly tracking poll – have suggested an uptick in support for the reforms, most other surveys continue to show a steady level of opposition to the new law that remains higher than the favorable opinions of it.

via Sebelius: Time for ‘Reeducation’ on Obama Health Care Law – The Note.


Inside the Refrigerator: Immigration Enforcement and Chilling Effects in Medicaid Participation

August 28, 2010

Tara Watson. Inside the Refrigerator: Immigration Enforcement and Chilling Effects in Medicaid Participation. NBER Working Paper No. 16278, August 2010.

Economists have puzzled over why eligible individuals fail to enroll in social safety net programs. “Chilling effects” arising from an icy policy climate are a popular explanation for low program take-up rates among immigrants, but such effects are inherently hard to measure. This paper investigates a concrete determinant of chilling, Federal immigration enforcement, and finds robust evidence that heightened enforcement reduces Medicaid participation among children of non-citizens. This is the case even when children are themselves citizens and face no eligibility barriers to Medicaid enrollment. Immigrants from countries with more undocumented U.S. residents, those living in cities with a high fraction of other immigrants, and those with healthy children are most sensitive to enforcement efforts. Up to seventy-five percent of the relative decline in non-citizen Medicaid participation around the time of welfare reform, which has been attributed to the chilling effects of the reform itself, is explained by a contemporaneous spike in immigration enforcement activity. The results imply that safety net participation is influenced not only by program design, but also by a broader set of seemingly unrelated policy choices. [Full Text].


SCI report outlines state policy options for reform implementation | Ohio Health Policy Review

August 28, 2010

The State Coverage Initiatives (SCI) program released a new report this week outlining policy options for states in the Patient Protection and Affordable Care Act as they move forward with national reform implementation.

State Implementation of National Health Reform: Harnessing Federal Resources to Meet State Policy Goals” (pdf, 47 pages) was authored by Stan Dorn of the Urban institute.

Ohio was one of 14 states selected three years ago to participate in the Robert Wood Johnson/ AcademyHealth SCI program. The Ohio SCI team brought together 45 leaders from diverse stakeholder groups, including HPIO, to identify the best ways to extend coverage to Ohio’s uninsured. From Ohio Health Policy Review: SCI report outlines state policy options for reform implementation.


Ohio Health Policy Review: Study: Generic drugs could offer significant Medicaid savings

August 28, 2010

A new study from the Generic Pharmaceutical Association found that every 2-percent increase in substitution of generic drugs saves Medicaid $1 billion a year (Source: “GPhA Report: Generics Offer Big Medicaid Savings Opportunity,” Wall Street Journal Health Blog, July 26, 2010).

Furthermore, “Savings Achieved Through the Use of Generic Pharmaceuticals, 2000-2009” (pdf, 9 pages) found that the generic utilization rate in Medicaid is about 64 percent, more than 10 percentage points lower than the general population, which means significant savings are realistic, the study authors contend. From Ohio Health Policy Review: Study: Generic drugs could offer significant Medicaid savings.


HPIO interim director co-authors NGA report on delivery system reform | Ohio Health Policy Review

August 28, 2010

The National Governor’s Association earlier this month released a report outlining tools available to states as they work to create improve the health care system. HPIO Interim Director Greg Moody was one of the co-authors of the report.

State Roles in Delivery System Reform (pdf, 108 pages) includes chapters on health care quality improvement; care coordination and disease management; primary care and prevention; and health care payment systems.

“Cost, quality, and efficiency must be addressed to get better value for every health care dollar and sustain health coverage, especially in the environment of expanding health insurance programs,” the report states. “This report outlines the evidence in health system reforms, as well as the opportunities for governors to lead these efforts.” From Ohio Health Policy Review: HPIO interim director co-authors NGA report on delivery system reform.


Two new chap. 58 studies: 1. Young adult provisions helped; and 2. Who’s still uninsured (and what can we do to reach them) |

August 28, 2010

Urban Institute researcher Sharon Long and colleagues released two studies today looking at a success and remaining challenge of Massachusetts health reform.

Did Young Adult Provisions Work?

First, the good news (pdf): The researchers looked at the impact of the various provisions in Chapter 58 aimed at getting young adults (age 19-26) to enroll in coverage. These include allowing children to remain on their parent’s family insurance plans, and the Young Adult Plans (YAP) offered by the Health Connector. They compared the drop in uninsurance rates between young adults in Massachusetts to slightly older adults (ages 27-33) in Massachusetts, and to young adults in New York state. The analytic model controlled for other demographic and socieconomic factors such as race/ethnicity, family size, income, etc.

The study found that the young adult provisions made a significant difference. More at Health Care for All


Per ACA, NAIC OKs MLR. Next, MA? | Health Care for All

August 28, 2010

Round one for the federal MLR [Medical Loss Ratio] definition is complete. The National Association of Insurance Commissioners (NAIC), as required under the ACA, just approved its MLR definition for 2010.

One key issue is over what is quality improvement. Plans can count spending “to improve health care quality and increase the likelihood of desired health outcomes” as medical benefits. A battle has raged over the past few months as the NAIC has parsed out what actually improves quality from what insurers have argued improves quality (carriers have requested computer claims system upgrades, taxes and fees be considered quality improvement). Caught up in the middle of this battle are consumers and employers- who want value for their health care premiums. Brokers entered the fray too, wanting their commissions to be excluded from administrative expenses. More at Health Care for All