Category Archives: Medicaid

Jul 24 2014
Comments

RWJF Scholars in the News: Stereotype threat, hand hygiene, misbehaving science, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Anxiety caused by “stereotype threat” could help explain health disparities that persist across race, suggests research co-authored by Cleopatra Abdou, PhD, an RWJF Health & Society Scholars program alumna. News Medical covers the study, describing it as the first of its kind to empirically test, in the context of health sciences, the impact of the “threat of being judged by or confirming a negative stereotype about a group you belong to.” Abdou’s research offers a possible explanation for ethnic and socioeconomic differences in morbidity and mortality between Black and White women because, as Abdou says, the research goes beyond nature vs. nurture, “bringing situation and identity into the equation.” For example, in the study, Black women with a strong connection to their race had the highest anxiety levels when in waiting rooms filled with posters that displayed negative health-related racial stereotypes dealing with such topics as unplanned pregnancy and AIDS.

Having health insurance improves access to medical care for pregnant, low-income women, and results in long-term health benefits for their babies, according to a study by RWJF Scholar in Health Policy Research Sarah Miller, PhD, and RWJF Health & Society Scholar Laura Wherry, PhD, that was reported by Vox. Miller and Wherry found the expansion of Medicaid in the 1980s made prenatal care much more accessible to low-income women, many of whom would otherwise have been without insurance. The result was improvements in obesity, preventable hospitalizations, and preventable, chronic disease-related hospitalizations among children. 

Read more

Jul 2 2014
Comments

RWJF Scholars in the News: Menopause and heart disease, nurses and health care finance, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples: 

Changes in hormone levels during early menopause could be linked to an increased risk of heart disease, finds a new study co-authored by RWJF Health & Society Scholars program alumna Rebecca Thurston, PhD. Health Canal covers the study, describing it as a first-of-its-kind evaluation because it used nuclear magnetic resonance spectroscopy to assess the lipoproteins that carry cholesterol through the blood, rather than relying on conventional blood tests. Thurston’s study was published in the Journal of Lipid Research.

For Alice Goffman, PhD, an RWJF Scholars in Health Policy Research alumna, an undergraduate assignment turned into a six-year study of a low-income Philadelphia neighborhood in which, she concluded, “the young men in this community feel hunted.” In the resulting book, On the Run: Fugitive Life in an American City, Goffman says that a “climate of fear and suspicion pervades everyday life” in the community. The New York Times Sunday Book Review calls Goffman’s work “riveting” and her ability to understand her subjects “astonishing.”

The Colorado Department of Health Care Policy and Financing has received a $13.6 million grant from the federal Centers for Medicare and Medicaid Services to integrate and coordinate physical, behavioral, and social-health needs for people enrolled in both Medicare and Medicaid, reports the Northern Colorado Business Report. The story quotes Susan Birch, MBS, BSN, RN, executive director of the department: “This grant allows Colorado to coordinate our members' care, while achieving greater value and health outcomes for our citizens who are on both Medicare and Medicaid.” Birch is an RWJF Executive Nurse Fellows alumna.

Read more

Mar 24 2014
Comments

Obama Administration Proposes to Fix Medicaid Funding 'Glitch'

One of the key recommendations in the landmark Institute of Medicine report on the future of nursing is to advance access to primary care by reducing barriers to practice for nurses. Implementation of this recommendation is now one step closer, thanks to a provision in President Obama’s budget proposal for fiscal year 2015, which was released this month.

Obama’s budget includes a provision that would extend an increase in Medicaid payments for primary care providers for one year at a cost of about $5.4 billion, according to an article in USA Today. The extension would, for the first time, apply to nurse practitioners (NPs) and physician assistants (PAs).

The Institute of Medicine recommended fixing this Medicaid “glitch” in its report on the future of nursing. The report is the foundation for the Future of Nursing: Campaign for Action, a national effort backed by the Robert Wood Johnson Foundation (RWJF) and AARP that is working to transform health care through nursing.

Obama’s budget proposal also calls for nearly $4 billion over six years to grow the National Health Services Corps (NHSC) from 8,900 primary care providers to at least 15,000 providers annually, starting in 2015, according to an analysis by the Campaign. Ten percent of the funding would be reserved for NPs and PAs.

Read more

Dec 18 2013
Comments

RWJF Clinical Scholars Podcast: NY Health Commissioner Discusses Health Reform

In his first two years in office, New York State Health Commissioner Nirav Shah, MD, MPH, has been deeply engaged in the state’s ambitious Medicaid redesign process. Shah oversees the $50 billion state public health agency and has been praised for his health system reform efforts. Moving forward, he is focusing on issues such as securing federal funding for “supportive housing” to offer chronically ill, low-income individuals subsidized living quarters in building complexes that also contain in-house medical and social services.

Shah, an RWJF Clinical Scholar alumnus, discusses this and more in the latest Robert Wood Johnson Foundation (RWJF) Clinical Scholars Health Policy Podcast, a monthly series co-produced with Penn’s Leonard Davis Institute of Health Economics and hosted by RWJF Clinical Scholar Chileshe Nkonde-Price, MD.

The video is republished with permission from the Leonard Davis Institute.

Dec 9 2013
Comments

Do Mergers with State Medicaid Programs Result in Cuts to State Public Health Department Funding?

Paula Lantz, PhD, is professor and chair of the Department of Health Policy in the School of Public Health and Health Services at the George Washington University (GW).  Before joining the GW faculty, she was professor and chair of health management and policy at the University of Michigan School of Public Health, where she served as the director of the Robert Wood Johnson Foundation (RWJF) Scholars in Health Policy Research Program. In addition, Lantz is an alumna of the Scholars in Health Policy Research Program. She recently co-authored a study with Jeffrey Alexander, PhD, professor emeritus at the University of Michigan, where he was the Richard Jelinek Professor of Health Management and Policy in the School of Public Health.*

file

It is not uncommon for state governments to periodically reorganize, and this often involves creating new agencies/departments or consolidating ones that already exist. Some in the health field have voiced concerns about such reorganizations when they involve the consolidation of a state’s public health department and the Medicaid agency. The main fear has been that when public health functions are combined with the invariably larger and growing Medicaid program, public health loses out in terms of economic resources and a sustained focus on disease prevention and health promotion. By virtue of the sheer size and focus on medical care, there would be a “giant sucking sound” of economic resources and priority attention going to the Medicaid program and away from the smaller and often less visible activities of public health.

Read more

Oct 18 2013
Comments

Who Will Benefit From Medicaid Expansion and What Will it Mean for These Patients?

Tammy Chang, MD, MPH, MS, is an assistant professor in the Department of Family Medicine at the University of Michigan Medical School and an alumnus of the Robert Wood Johnson Foundation Clinical Scholars program.

file

Over kitchen tables as well as on Capitol Hill, the discussion continues over the Affordable Care Act including who will benefit and what it means for everyday Americans.

To shed light on this debate, my co-author Matthew Davis, MD, MAPP, and I recently published a study that describes the characteristics of Americans potentially eligible for the Medicaid expansion under the Affordable Care Act.  The study, published in the Annals of Family Medicine, uses a national source of data used by many other researchers who look at national trends—such as high blood pressure and obesity—called the National Health and Nutrition Examination Survey (NHANES).

Read more

Oct 16 2013
Comments

A Success Story: Health Insurance Enrollment in Colorado

Sue Birch, MBA, BSN, RN, is executive director of the Colorado Department of Health Care Policy and Financing, and a Robert Wood Johnson Foundation Executive Nurse Fellow (2002).

file

Now that I have caught my breath, I wanted to share the Colorado report on Obamacare’s October 1st Birthday!  Our state has decided to expand our Medicaid program and to form our own marketplace for Coloradans to shop and compare health insurance plans.  These changes will help us cover many uninsured Coloradans. 

In its first week, Connect for Health Colorado, our state’s health insurance marketplace, successfully attracted more than 162,941unique website visitors, had 9,658 calls and chats to the service center, and 18,174 accounts created.  We think this is a strong start and know that it will take time for Coloradans who have not had insurance before to learn about their options and apply for coverage.  We are working across state government to help make this happen.       

At my department, Health Care Policy and Financing, Coloradans can enroll through our new modularized interoperable cloud-based system, PEAK.  We had more than 9,000 applications come through this site in the first 10 days of October.  It is foundational to our desire to increase new consumerism and greater client responsibility by walking through a self-enrollment process.  Our website is Colorado.gov/PEAK and we have seen record traffic to the application site.

Overall, the marketplace opening went quite smoothly for Colorado—the exchange opened successfully, Medicaid began, and our technology functioned efficiently for being such a large, complex system. With the marketplace now up and running, individuals, families, and small employers can start making appointments with Health Coverage-Guides, learn about plan options, and apply for insurance when ready.

This is an exciting moment in health care history and we are proud to be working with partners across our state and our nation to provide affordable health insurance options to all residents of Colorado!

Sep 12 2013
Comments

Human Capital News Roundup: The cost of overtriaging, ‘medical students’ disease,’ the demographics of new Medicaid enrollees, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

People who will be newly eligible for Medicaid after expansion under the Affordable Care Act will be younger and healthier than those currently enrolled in the program, according to a study by RWJF Clinical Scholars alumna Tammy Chang, MD, MPH, and program site co-director Matthew Davis, MD, MAPP. The researchers found that the new Medicaid enrollees will also be less likely to be obese or to suffer from depression, although more of them will be smokers and drinkers. Among the outlets to report on the findings: Reuters, Kaiser Health News, NBC News, NPR’s Shots blog, and Medpage Today.

Medpage Today reports on a study led by RWJF Physician Faculty Scholars alumnus Craig Newgard, MD, MPH, finding that nearly one-third of patients sent to major trauma centers by first responders did not need that level of care and could have been sent elsewhere for diagnosis and treatment. This “overtriaging" raises per-patient health care costs by as much as 40 percent, the study finds. Read more about it.

While in Australia for a conference on reforming health care systems to meet the challenges of aging populations, RWJF Harold Amos Medical Faculty Development Program alumna Alicia Arbaje, MD, MPH, sat down for two interviews—one with The Australian Financial Review on how stereotypes about aging are changing, and one with Australian Broadcasting Corporation Radio about transitional care and reducing readmissions among older adults after they leave hospitals. Read a post Arbaje wrote for the RWJF Human Capital Blog about navigating care across settings and the role of caregivers.

Read more

Aug 9 2013
Comments

The Real Deal: ACA and the Underserved – Panel Discussion at the National Association of Black Journalists

Keon L. Gilbert, DrPH, MA, MPA, is an assistant professor in the Department of Behavioral Science & Health Education at St. Louis University's College for Public Health and Social Justice. As a Robert Wood Johnson Foundation New Connections grantee, his research focuses on the social and economic conditions structuring disparities in the health of African American males.

file

The Real Deal of the Affordable Care Act (ACA) is that many Americans have many questions regarding how the ACA will affect their health care coverage or if they will be covered at all. Our panel discussion at the National Association of Black Journalists (NABJ) convention revealed many of these questions concerning how Americans will be enrolled, how their existing health insurance plans will change, and what means tests will be used to determine their eligibility. This panel discussion suggested that many Americans were not aware of what the changes will be and if their state will expand Medicaid.

Medicaid expansion will not occur in many states where close to six of ten African Americans reside. This suggests that many African Americans will remain without health insurance or will be under-insured. This is a real challenge to improving health care outcomes and reducing health care costs over time.

Read more

Jul 8 2013
Comments

Dental Benefits to be Restored for Low-Income Californians

In 2009, budget shortfalls spurred California lawmakers to eliminate virtually all dental benefits under its Adult Denti-Cal program, leaving millions in the state without adequate dental care. But in late June, Governor Jerry Brown signed a budget that restores virtually all of those dental benefits to the 3 million low-income Californians who qualify for the program.

The 2013-2014 state budget also expands other health care services for low-income Californians through an expansion of the state’s Medicaid program (Medi-Cal) under the Affordable Care Act. An estimated 1.6 million additional Californians will receive coverage under this expansion by 2015.

The dental benefits won’t be available until May 1, 2014, but California Dental Association President Lindsey Robinson, DDS, issued a statement called it a significant achievement. “We look forward to working with the administration to effectively implement Adult Denti-Cal, a vital service that will benefit the health of millions of Californians,” she said.

Read more about the state budget in the Fresno Bee.
Read the California Dental Association news release.