Apr 18, 2019, 2:00 PM, Posted by
Giridhar Mallya, Tara Oakman
Why States Matter
States have long been laboratories for innovations that influence the health and well-being of their residents. This role has only expanded with the greater flexibility being given to the states, especially as gridlock in Washington, D.C. inspires more local action. The bevvy of new governors and state legislators who took office early this year also widens the door to creativity.
Medicaid is perhaps the most familiar example of state leadership on health. With costs and decisions shared by state and federal governments, the program allows state policymakers to tailor strategies that meet the unique needs of their residents. Among other examples, efforts are underway in California to expand Medicaid access to undocumented adults, and in Montana to connect unemployed Medicaid beneficiaries to employment training and supports.
In Washington state and elsewhere, Medicaid dollars can now cover supportive housing services, while Michigan is among the states requiring Medicaid managed care organizations to submit detailed plans explaining how they address social determinants of health for their enrollees. All of this experimentation is happening as states struggle to control the growth of their health care spending—a balancing act of immense proportions.
View full post
Jan 3, 2017, 3:00 PM, Posted by
Susan Mende, Tara Oakman
For the past 18 years, every 4-year-old in Oklahoma has been guaranteed a spot in preschool, for free. These kids are learning their letters, numbers, colors and shapes. They’re also developing arguably more important social and emotional tools--how to make friends, feel empathy, solve problems, manage conflict. These are the kind of building blocks children need to become thriving adults.
Nearly 75 percent of 4-year-olds are enrolled in Oklahoma’s pre-K program. That's one of the highest participation rates in the country. But if we look across the United States, we see that just 61 percent of kids between the ages of 3 and 6 are enrolled in pre-K, daycare or other formal early childhood education program.
Why? Of course, many parents stay home or have a friend, neighbor or relative take care of their kid. But a recent Harvard poll of parents with children under the age of five highlights the struggles families face in finding quality, affordable child care. Many parents reported having limited options and said that the cost of child care had caused financial problems. Low-income families were especially likely to report difficulty accessing care.
View full post
Oct 19, 2015, 8:00 AM, Posted by
Emmy Ganos, Tara Oakman
Sometimes, more is definitely better. Getting that extra hour of sleep can greatly benefit your mind, body and day. Cars that get more miles per gallon are cheaper and cleaner to run. And who would argue against more vacation time?
But when it comes to health care, more is not always better. Unnecessary diagnostic tests, treatments or hospitalizations can drive up health care costs, and in some cases, actually harm patients. For example, excess imaging increases exposure to radiation. Overuse of screening and diagnostic tests can lead to stressful false positives. And unnecessary treatments, drugs or procedures increase the risk of serious complications. In the larger picture, the estimated $200 billion spent on inappropriate care each year diverts resources away from services that are actually needed both within and outside of the health system—in mental health, housing, and infrastructure, for example—that can help all Americans lead healthier lives.
View full post
May 6, 2015, 3:38 PM, Posted by
Tara Oakman
My husband had been suffering from a very painful sore throat for a couple of days when he finally decided to call his doctor. Just one problem: It was a Friday morning and the office was booked for the day. The doctor called back later in the afternoon and told my husband it sounded like a virus and he should simply “wait it out.” With the weekend approaching, the next available appointment—if needed—was on Monday. Rather than suffer all weekend with a raw throat, my husband followed the advice of a relative (who also happens to be a physician) and went to a clinic at our local CVS. Less than an hour later he was diagnosed with strep throat and started on antibiotic therapy he picked up at the pharmacy. By Saturday evening he was feeling a lot better.
Access to quick, convenient care on nights and weekends is one of the prime selling points of “retail clinics” based in pharmacies, groceries, and big-box retailers. With longer operating hours and no need for an appointment, these clinics, sometimes called “doc-in-a-box,” give patients more flexibility to avoid time away from work and family. Plus, a trip to a retail clinic costs about one-third less than a visit to a doctor’s office, and is far cheaper than an emergency room. Retail clinics usually accept private insurance, Medicare, and, in many cases, Medicaid; yet people without insurance or a personal physician also are using them for treatment of routine illnesses, basic health screenings, and low-level acute problems like cuts, sprains, and rashes.
New shopping list: Pick up milk, breakfast cereal, and toilet paper; get a flu shot and that weird rash checked out.
View full post
Feb 5, 2015, 9:00 AM, Posted by
Tara Oakman
Tara Oakman, PhD, is a senior program officer at the Robert Wood Johnson Foundation focusing on strengthening vulnerable children and families and working to improve the value of national investments in health and health care. Read her full bio
Apr 11, 2014, 11:34 AM, Posted by
Tara Oakman
View full post
Feb 27, 2014, 5:27 PM, Posted by
Tara Oakman
View full post
Sep 6, 2013, 4:30 PM, Posted by
Tara Oakman
View full post