journal
MENU ▼
Read by QxMD icon Read
search

Issue Brief of the Commonwealth Fund

journal
https://www.readbyqxmd.com/read/29345890/how-medicare-could-provide-dental-vision-and-hearing-care-for-beneficiaries
#1
Amber Willink, Cathy Shoen, Karen Davis
Issue: The Medicare program specifically excludes coverage of dental, vision, and hearing services. As a result, many beneficiaries do not receive necessary care. Those that do are subject to high out-of-pocket costs. Goal: Examine gaps in access to dental, vision, and hearing services for Medicare beneficiaries and design a voluntary dental, vision, and hearing benefit plan with cost estimates. Methods: Uses the Medicare Current Beneficiary Survey, Cost and Use File, 2012, with population and costs projected to 2016 values...
January 1, 2018: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29320140/using-community-partnerships-to-integrate-health-and-social-services-for-high-need-high-cost-patients
#2
Ruben Amarashingham, Bin Xie, Albert Karam, Nam Nguyen, Bianca Kapoor
Issue: Our health care and social services delivery systems are not well-equipped to effectively manage patients with multiple chronic diseases and complex social needs such as food, housing, or substance abuse services. Community-level efforts have emerged across the nation to integrate the activities of disparate social service organizations with local health care delivery systems. Evidence on the experiences and outcomes of these programs is emerging, and there is much to learn about their approaches and challenges...
January 1, 2018: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29272908/do-medicare-advantage-plans-minimize-costs-investigating-the-relationship-between-benchmarks-costs-and-rebates
#3
Stephen Zuckerman, Laura Skopec, Stuart Guterman
Issue: Medicare Advantage (MA), the program that allows people to receive their Medicare benefits through private health plans, uses a benchmark-and-bidding system to induce plans to provide benefits at lower costs. However, prior research suggests medical costs, profits, and other plan costs are not as low under this system as they might otherwise be. Goal: To examine how well the current system encourages MA plans to bid their lowest cost by examining the relationship between costs and bonuses (rebates) and the benchmarks Medicare uses in determining plan payments...
December 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29239575/what-s-at-stake-states-progress-on-health-coverage-and-access-to-care-2013%C3%A2-2016
#4
Susan L Hayes, Sarah R Collins, David C Radley, Douglas McCarthy
Issue: Given uncertainty about the future of the Affordable Care Act, it is useful to examine the progress in coverage and access made under the law. Goal: Compare state trends in access to affordable health care between 2013 and 2016. Methods: Analysis of recent data from the U.S. Census Bureau and the Behavioral Risk Factor Surveillance System. Findings and Conclusions: Between 2013 and 2016, the uninsured rate for adults ages 19 to 64 declined in all states and the District of Columbia, and fell by at least 5 percentage points in 47 states...
December 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29235785/the-evolution-of-private-plans-in-medicare
#5
Yash M Patel, Stuart Guterman
Issue: Since the 1980s, private plans have played an increasingly important role in the Medicare program. While initially created with the goals of reducing costs, improving choice, and enhancing quality, risk-based plans--now known as Medicare Advantage plans--have undergone significant policy changes since their inception; these changes have not always aligned with the original policy objectives. Goal: To examine major policy changes to Medicare risk plans and the effects of these policies on plan participation, enrollment, average premiums and cost-sharing, total costs to Medicare, and quality of care...
December 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29235781/addressing-the-social-determinants-of-health-through-medicaid-managed-care
#6
David Machledt
Issue: With its emphasis on coordinated care and prevention, managed care should be tailor-made to tackle social determinants of health. But various challenges discourage Medicaid health plans and providers from assisting beneficiaries with nonmedical concerns such as housing insecurity or parenting skills that are integral to improving health outcomes and lowering costs. To better address these social factors, the Centers for Medicare and Medicaid Services (CMS) updated its Medicaid managed care rule in early 2016...
November 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29232088/comparing-the-affordable-care-act-s-financial-impact-on-safety-net-hospitals-in-states-that-expanded-medicaid-and-those-that-did-not
#7
Allen Dobson, Joan E DaVanzo, Randy Haught, Luu Phap-Hoa
Issue: Safety-net hospitals play a vital role in delivering health care to Medicaid enrollees, the uninsured, and other vulnerable patients. By reducing the number of uninsured Americans, the Affordable Care Act (ACA) was also expected to lower these hospitals’ significant uncompensated care costs and shore up their financial stability. Goal: To examine how the ACA’s Medicaid expansion affected the financial status of safety-net hospitals in states that expanded Medicaid and in states that did not...
November 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29232085/use-of-paid-and-unpaid-personal-help-by-medicare-beneficiaries-needing-long-term-services-and-supports
#8
Amber Willink, Karen Davis, John Mulcahy, Jennifer L Wolff
Issue: Older adults who reside in communities, as opposed to nursing homes or other residential institutions, are largely dependent on family and unpaid caregivers for assistance with daily activities, like preparing meals or laundry, and self-care tasks like bathing or dressing. For low-income older adults, assistance with such activities, also known as long-term services and supports (LTSS), can also come from Medicaid. These sources of support will be increasingly inadequate as the population ages...
November 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29232079/behavioral-design-teams-the-next-frontier-in-clinical-delivery-innovation
#9
Ted Robertson, Matthew Darling, Jennifer Leifer, Owen Footer, Dani Gordski
Issue: A deep understanding of human behavior is critical to designing effective health care delivery models, tools, and processes. Currently, however, few mechanisms exist to systematically apply insights about human behavior to improve health outcomes. Behavioral design teams (BDTs) are a successful model for applying behavioral insights within an organization. Already operational within government, this model can be adapted to function in a health care setting. Goal: To explore how BDTs could be applied to clinical care delivery and review models for integrating these teams within health care organizations...
November 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29072894/medicaid-payment-and-delivery-system-reform-early-insights-from-10-medicaid-expansion-states
#10
Sara Rosenbaum, Sara Schmucker, Sara Rothenberg, Rachel Gunsalus, J Zoe Beckerman
Issue: Expanded Medicaid enrollment under the Affordable Care Act has heightened the importance of states’ roles as principal purchasers of health care for low-income and medically vulnerable populations. Concurrently, the federal government has augmented states’ purchasing tools. Goal: To examine the evolution of payment and delivery system reform in 10 ACA Medicaid expansion states. Methods: Analysis of state managed care policies, including a detailed review of purchasing documents as well as interviews with senior agency officials in 10 states...
October 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29068183/assessing-changes-to-medicaid-managed-care-regulations-facilitating-integration-of-physical-and-behavioral-health-care
#11
Elizabeth Edwards
Issue: As states consider how to effectively control Medicaid costs, many are looking to integrate behavioral and medical care, including long-term services and supports, particularly for individuals with complex needs. Goal: To summarize how recent federal regulations are encouraging an integrated approach to behavioral and physical health care. Findings and Conclusions: Two recent federal rules issued in 2016 are facilitating the transition to integrated care models: the Medicaid managed care rule and the Medicaid managed care mental health parity rule...
October 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29020733/how-have-health-insurers-performed-financially-under-the-aca-market-rules
#12
Michael J McCue, Mark A Hall
Issue: The Affordable Care Act (ACA) transformed the market for individual health insurance, so it is not surprising that insurers' transition was not entirely smooth. Insurers, with no previous experience under these market conditions, were uncertain how to price their products. As a result, they incurred significant losses. Based on this experience, some insurers have decided to leave the ACA’s subsidized market, although others appear to be thriving. Goals: Examine the financial performance of health insurers selling through the ACA's marketplace exchanges in 2015--the market’s most difficult year to date...
October 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28990747/paying-for-prescription-drugs-around-the-world-why-is-the-u-s-an-outlier
#13
Dana O Sarnak, David Squires, Greg Kuzmak, Shawn Bishop
Issue: Compared with other high-income countries, the United States spends the most per capita on prescription drugs. Goal: To compare drug spending levels and trends in the U.S. and nine other high-income countries — Australia, Canada, France, Germany, the Netherlands, Norway, Sweden, Switzerland, and the United Kingdom; consider potential explanations for higher U.S. spending; and explore patients’ exposure to pharmaceutical costs. Method: Analysis of health data from the Organisation for Economic Co-operation and Development, the 2016 Commonwealth Fund International Health Policy Survey, and other sources...
October 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28953345/outcomes-based-pharmaceutical-contracts-an-answer-to-high-u-s-drug-spending
#14
Elizabeth Seeley, Aaron S Kesselheim
Issue: Brand-name prescription drug prices are increasing in the United States, putting pressure on payers and patients. Some manufacturers have responded by offering outcomes-based contracts, in which rebate levels are tied to a specified outcome in the target population. Goal: To assess the expected benefits and limitations of outcomes-based pharmaceutical contracts in the U.S., including their potential impact on prescription drug spending. Methods: Semistructured interviews with payers, manufacturers, and policy experts...
September 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28929700/extending-the-children%C3%A2-s-health-insurance-program-high-stakes-for-families-and-states
#15
Sara Rosenbaum, Rachel Gunsalus, Sara Rothenberg, Sara Schmucker
Issue: Congress must decide whether to extend federal funding authority for the Children’s Health Insurance Program (CHIP), which ends September 30, 2017. CHIP operates much like Medicaid, providing federal matching payments for state program expenses, although CHIP’s funding rate is higher than the federal rate paid for traditional Medicaid and was further enhanced under the Affordable Care Act. States can use their CHIP funds to expand Medicaid, operate separate CHIP programs, or combine the two approaches...
September 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28880062/following-the-aca-repeal-and-replace-effort-where-does-the-u-s-stand-on-insurance-coverage-findings-from-the-commonwealth-fund-affordable-care-act-tracking-survey-march-june-2017
#16
Sara R Collins, Munira Z Gunja, Michelle M Doty
Issue: After Congress's failure to repeal and replace the Affordable Care Act, some policy leaders are calling for bipartisan approaches to address weaknesses in the law’s coverage expansions. To do this, policymakers will need data about trends in insurance coverage, reasons why people remain uninsured, and consumer perceptions of affordability. Goal: To examine U.S. trends in insurance coverage and the demographics of the remaining uninsured population, as well as affordability and satisfaction among adults with marketplace and Medicaid coverage...
September 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28836751/reducing-racial-and-ethnic-disparities-in-access-to-care-has-the-affordable-care-act-made-a-difference
#17
Susan L Hayes, Pamela Riley, David C Radley, Douglas McCarthy
ISSUE: Prior to the Affordable Care Act (ACA), blacks and Hispanics were more likely than whites to face barriers in access to health care. GOAL: Assess the effect of the ACA’s major coverage expansions on disparities in access to care among adults. METHODS: Analysis of nationally representative data from the American Community Survey and the Behavioral Risk Factor Surveillance System. FINDINGS AND CONCLUSIONS: Between 2013 and 2015, disparities with whites narrowed for blacks and Hispanics on three key access indicators: the percentage of uninsured working-age adults, the percentage who skipped care because of costs, and the percentage who lacked a usual care provider...
August 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28829534/how-medicaid-expansion-affected-out-of-pocket-health-care-spending-for-low-income-families
#18
Sherry Glied, Ougni Chakraborty, Therese Russo
ISSUE. Prior research shows that low-income residents of states that expanded Medicaid under the Affordable Care Act are less likely to experience financial barriers to health care access, but the impact on out-of-pocket spending has not yet been measured. GOAL. Assess how the Medicaid expansion affected out-of-pocket health care spending for low-income families compared to those in states that did not expand and consider whether effects differed in states that expanded under conventional Medicaid rules vs...
August 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28805362/how-the-affordable-care-act-has-helped-women-gain-insurance-and-improved-their-ability-to-get-health-care-findings-from-the-commonwealth-fund-biennial-health-insurance-survey-2016
#19
Munira Z Gunja, Sara R Collins, Michelle M Doty, Sophie Beautel
ISSUE: Prior to the Affordable Care Act (ACA), one-third of women who tried to buy a health plan on their own were either turned down, charged a higher premium because of their health, or had specific health problems excluded from their plans. Beginning in 2010, ACA consumer protections, particularly coverage for preventive care screenings with no cost-sharing and a ban on plan benefit limits, improved the quality of health insurance for women. In 2014, the law’s major insurance reforms helped millions of women who did not have employer insurance to gain coverage through the ACA’s marketplaces or through Medicaid...
August 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28745476/extending-marketplace-tax-credits-would-make-coverage-more-affordable-for-middle-income-adults
#20
Jodi Liu, Christine Eiber
ISSUE: Affordability of health coverage is a growing challenge for Americans facing rising premiums, deductibles, and copayments. The Affordable Care Act's tax credits make marketplace insurance more affordable for eligible lower-income individuals. However, individuals lose tax credits when their income exceeds 400 percent of the federal poverty level, creating a steep cliff. GOALS: To analyze the effects of extending eligibility for tax credits to individuals with incomes above 400 percent of the federal poverty level...
July 2017: Issue Brief of the Commonwealth Fund
journal
journal
38937
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"