Severe Deprivation in America: An Introduction

Published: | 6:04 pm | Posted in: Poverty

A Life Crystal Mayberry was born prematurely on a spring day in 1990 shortly after her pregnant mother was stabbed eleven times in the back during a robbery.1 The attack induced labor. Both mother and daughter survived. It was not the first time Crystal’s mother had been stabbed. For as far back as she can […]

Medicare and the Future of Retirement Security

Published: | 3:49 pm | Posted in: Medicare

President Bush’s failed effort to privatize part of the Social Security program received a lot of attention from the media during the first half of 2005. Congressional efforts to begin privatizing the Medicare program over the last ten years have received far less attention. This absence of media attention may be one of the reasons […]

The High Stakes Struggle Over the Future of Medicare

Published: | 3:47 pm | Posted in: Medicare

Following the passage of the Medicare Modernization Act (MMA) of 2003, the future of Medicare is less clear than at any time since its inception almost 40 years ago. Medicare policy regarding financing coverage and delivery mechanisms has been the object of intermittently fierce political debate and maneuvering since 1995 when a conservative Republican majority […]

National Health Expenditure Projections, 2015–25: Economy, Prices, And Aging Expected To Shape Spending And Enrollment

Published: | 10:08 pm | Posted in: Health Care Policy and Reform

Health spending growth in the United States for 2015–25 is projected to average 5.8 percent—1.3 percentage points faster than growth in the gross domestic product—and to represent 20.1 percent of the total economy by 2025. As the initial impacts associated with the Affordable Care Act’s coverage expansions fade, growth in health spending is expected to be influenced by […]

The 2016 Medicare Trustees Report: Is Medicare Doomed?

Published: | 8:51 pm | Posted in: Medicare

The June 22 release of the annual Medicare Trustees Report has, as usual, elicited conflicting responses. Some have focused on the positive—Medicare spending per enrollee has continued to grow at a historically slow rate—while others have emphasized the negative — the Medicare Hospital Insurance Trust Fund is now projected to run out of resources in […]

Early Performance of Accountable Care Organizations in Medicare

Published: | 8:33 pm | Posted in: Health Care Policy and Reform

BACKGROUND In the Medicare Shared Savings Program (MSSP), accountable care organizations (ACOs) have financial incentives to lower spending and improve quality. We used quasi-experimental methods to assess the early performance of MSSP ACOs. METHODS Using Medicare claims from 2009 through 2013 and a difference-in-differences design, we compared changes in spending and in performance on quality […]

Health Spending Growth: Still Facing A Triangle Of Painful Choices

Published: | 1:21 am | Posted in: Health Care Policy and Reform, Neoliberalism

In the four years immediately following the recession (2010 through 2013), health spending grew at a historically low average annual rate of 3.6 percent, about the same as gross domestic product (GDP). This era was interrupted in 2014 with the advent of expanded coverage under the Affordable Care Act (ACA)—the newly insured used more care […]

Medicare Help At Home

Published: | 1:02 am | Posted in: Medicare

Nine million community-dwelling Medicare beneficiaries—about one-fifth of all beneficiaries—have serious physical or cognitive limitations and require long-term services and supports (LTSS) that are not covered by Medicare. Nearly all have chronic conditions that require ongoing medical attention, including three-fourths who have three or more chronic conditions and are high-need, high-risk users of Medicare covered services. […]

Twenty-First Century Medicaid: The Final Managed Care Rule

Published: | 1:00 am | Posted in: MLTC

With enrollment reaching 74 percent of all beneficiaries, it is clear that managed care has become the standard organizing mechanism for a Medicaid program whose welfare roots are behind it and that now functions as a principal source of public insurance. Given this broad national policy direction, a strong yet flexible regulatory framework for Medicaid […]

Health Affairs Study On Hospital Profitability Gives Us Some Important Factors To Watch Going Forward

Published: | 12:57 am | Posted in: Health Care Policy and Reform

It is important to keep in mind that profits can be high, either because prices are high or underlying production costs are low (relative to each other). The Bai and Anderson study does not decompose profits but rather measures overall accounting profits as reported to Medicare. So, higher profits do not always indicate excess prices. […]

The U.S. Health Disadvantage And The Role Of Spending

Published: | 12:56 am | Posted in: Health Care Policy and Reform

Each week it seems, more evidence emerges regarding the poor health of Americans. We first documented a “U.S. health disadvantage” as chair and study director of the panel on understanding cross-national health differences among high-income countries at the National Academies in 2013. Our panel’s report Shorter Lives, Poorer Health showed that, as long ago as […]

Integrating Health Care And Housing To Promote Healthy Aging

Published: | 5:57 pm | Posted in: Archive

One of the most important public health findings over the last several decades has been that there are a number of factors, beyond medical care, which influence health status and contribute to premature mortality. Of these factors, social circumstances and the physical environment (particularly the home) especially impact an individual’s health. Housing takes on even […]

Aging in America: A Profile of Older Adults

Published: | 6:16 pm | Posted in: Archive

The aging population is a heterogeneous group and varies by many social factors. This article illustrates the differences by providing a detailed look at the unique characteristics of older Americans. Knowing the key trends that will shape the following decades is a first step to helping older adults create optimal futures.  Read our full paper here by Lisa Rill, […]

Combating Ageism: How Successful is Successful Aging?

Published: | 7:03 pm | Posted in: Archive

The concept of successful aging based on high level of physical cognitive functioning has become dominant in Gerontology since the 1990’s. This article indicates the concept may contribute to negative perception of aging (Ageism) and make older people feel as if they are personally responsible for failing to achieve the restrictive criteria for aging successfully.  Purpose: To […]

Paid Caregiving in the 21st Century

Published: | 5:01 am | Posted in: Archive

The quality of availability and long term care services depend most fundamentally on paid caregivers who deserve far more recognition and support than they now receive. Al-Jen Poo is a MacArthur Genesis award winner, which she received for work in organizing home health workers and related efforts to improve the lives of these and other low-wage […]

The U.S. Health Care Crisis Five Years After Passage of the Affordable Care Act A Data Snapshot

Published: | 6:07 pm | Posted in: Health Care Policy and Reform, Medicare

Despite passage of the Affordable Care Act in 2010, the U.S. health care crisis continues. While coverage has been expanded, the reform will leave 27 million people uninsured in 2024, according to the Congressional Budget Office. Much of the new coverage is of low actuarial value with high cost-sharing requirements, creating limitations to access. Choice […]

The Value of Medicaid

Published: | 7:58 pm | Posted in: Health Care Policy and Reform, Medicaid

Medicaid is the largest means-tested program in the U.S., with expenditures of over $425 billion in 2011. The Oregon Health Insurance Experiment, a recent expansion of the Medicaid program in that state that occurred by random assignment, has provided some of the most compelling evidence to date on the program’s effects. A series of previous […]

The Nursing Home Culture-Change Movement: Recent Past, Present, and Future Directions for Research

Published: | 7:33 pm | Posted in: Nursing Home Care

This article uses a retrospective approach to critique the research base underlying the nursing home culture-change movement—an effort to radically transform the nation’s nursing homes by delivering resident-directed care and empowering staff. The article traces the development of the movement from its inception 10 years ago to 2005, when the Centers for Medicare and Medicaid […]

The Oregon Health Insurance Experiment: Evidence from the First Year*

Published: | 7:31 pm | Posted in: Health Care Policy and Reform

In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled […]