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Quality Disparities exist between Payers

by Nii Darko, DO, MBA in Medicaid

Although providing health insurance to Americans who didn’t have prior coverage sounds like a good thing; not all insurance provides equal quality of care. Disparities [...]


Quality of Care

Continuity of Care

Health care costs

Access to Care

  • Source: Allen Skyy (Flickr/cc)

    Medicaid crowd out: hype or reality?

    With Medicaid expansion underway, questions about whether Medicaid coverage “crowds out” private coverage have reemerged. Critics of Medicaid expansion contend that public health insurance causes individuals to forego private coverage. A recent study published in Inquiry sought to quantify this phenomenon—specifically, to determine how many new Medicaid enrollees had private insurance at the time of Medicaid enrollment and, of those new Medicaid recipients, how many dropped their private [...]
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    Carrying the Big Stick in Health Policy

    In 2004, the Centers for Medicaid and Medicare (CMS) launched the CMS Hospital Inpatient Quality Reporting program, which would publicly report quality of care delivered by US hospitals. A recent study investigated quality of care measures and racial/ethnic performance rates among and within hospitals from 2005 – 2010. The study found that in addition to an overall increase in quality of care in heart attacks, heart failure, and pneumonia, there was greater equality in care among white, [...]
  • Source: Flickr/CC

    Preventing Suicides with Sensible Gun Laws

    In 2013, suicides were the 10th leading cause of death in the United States. Of the over 40,000 suicides, about half were carried out by firearms. Source: Flickr/CC A study published in the American Journal of Public Health this year found that firearm access is associated with the risk for completed suicide. Child access prevention laws and practices can protect adolescents from suicides as well as unintentional injuries, but working with older adults on gun safety is especially important [...]
  • Source: DIBP images

    Mid-level providers are moving on up

    Over the past several decades, there has been a dire need for primary care services across the United States, especially in rural and poor urban settings. This need has increased dramatically with more citizens insured through the Affordable Care Act. Mid-level providers such as nurse practitioners (NPs) and physician assistants (PAs) have been utilized more recently within the past several decades to address the immediate and critical shortage of primary care providers. Over the past decade, [...]
  • Source: Adriano Agulló (Flickr/CC)

    Support for Private Gun Sale Regulations

    The country has been mourning victims of another mass shooting. This time in Charleston, South Carolina. Though this particular act stands out for its racist and terrorist overtones, it should be noted that the suspect allegedly obtained his gun through a private transaction. Source: Adriano Agulló (Flickr/CC) Currently, federal law requires federally licensed gun dealers to run background checks on individuals purchasing firearms. However, background checks are not required for private sales [...]
  • Source: felixtsao (Flickr/CC)

    PCMH falls flat in New Orleans

    With the expansion of Medicaid provided by the Affordable Care Act, models like the patient-centered medical home (PCMH) should be analyzed for their potential positive impact on Medicaid populations. A PCMH is a team-based health care delivery model led by a primary care physician that emphasizes specific elements of quality care. Though prior researchers found that the adoption of more PCMH characteristics was associated with higher patient ratings of care coordination, it was not associated [...]
  • Source: Bob the Lomond (Flickr/CC)

    The Dynamics of Health Insurance Post-ACA

    We know that the number of uninsured in the United States has decreased significantly (by 16.9 million) since the Affordable Care Act (ACA), but how are people moving between different types of insurance coverage? Source: Bob the Lomond (Flickr/CC) Despite intense focus on Medicaid expansion and the health care Marketplaces as key elements of the ACA, employer-sponsored insurance, which 9.6 million uninsured Americans obtained between September 2013 and February 2015, was responsible for the [...]
  • Source: Robbie Shade (Flickr/CC)

    Looking to Massachusetts for Answers

    Massachusetts’ health reform in 2006 served as a model for the Affordable Care Act (ACA), and many policy experts are closely following the state to estimate what we can expect with the ACA. One important question to policymakers and the public is whether the ACA will decrease emergency department (ED) visits. Source: Robbie Shade (Flickr/CC) A new study published in Medical Care this year specifically focused on ED use by people who gained Commonwealth Care (CommCare) after health reform in [...]
  • Source: Carol Von Canon (Flickr/CC)

    The Doctor will see you Now (For $160)

    Although the Affordable Care Act sought to expand health insurance to near universal levels, this has not occurred. In the Supreme Court case National Federation of Independent Business v Sebelius, the court ruled Medicaid expansion to be optional. Subsequently, 20 states opted not to participate in expansion. What was left were significant questions regarding access to care for those left out of Medicaid expansion. Source: Carol Von Canon (Flickr/CC) In an article recently published in Health [...]
  • Source: lunar caustic (Flickr/CC)

    Protecting Babies and Women’s Rights

    Does protecting abortion rights paradoxically lower infant mortality rates? A new study from Health Affairs examined trends in US infant death rates between1960–1980, and though the hypothesis is provocative, the study’s level of evidence is limited due to its descriptive analysis. Source: lunar caustic (Flickr/CC) Several states have introduced hundreds of abortion bills in the past few years. Often referred to as targeted regulation of abortion providers (TRAP), the laws have affected [...]

Health IT

Public Health

Lessons from Abroad

Affordable Care Act

  • No Picture

    Will the Affordable Care Act kill jobs?

    October 22, 2012 // 5 Comments

    Many public policy decisions have impacts distant from their original intent. Public expansion of health insurance has often been associated with alterations in the labor [...]
  • Source: Time Green (Flickr/CC)
    Several countries have implemented healthcare systems that seek to attain universal health insurance through private markets. Germany, the Netherlands, and Switzerland have [...]
  • Source: DonkeyHotey (Flickr/CC)

    Are mandates constitutional?

    October 1, 2009 // 2 Comments

    We have reviewed other materials from the Robert Wood Johnson Foundation in regards to medical malpractice. This current review discusses the important legal basis for and [...]
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    The Math of Medicaid Expansion

    July 31, 2013 // 0 Comments

    The following 2 minute video is excerpted from the RAND Corporation. It explains the effects on states that opt-out of the Medicaid expansion scheduled for [...]
  • Image: Don DeBold (Creative Commons / Flickr)

    Is the Affordable Care Act toxic to workers?

    June 23, 2014 // 0 Comments

    Image: Don DeBold (Creative Commons / Flickr) The Impact of the Affordable Care Act on the Health Care Workforce is a nurse-authored paper that appeared in a recent Heritage [...]
  • Source: Moresheth (Flickr / Creative Commons)

    Maybe we don’t need the employer mandate

    July 31, 2014 // 1 Comment

    Source: Moresheth (Flickr / Creative Commons) Although written into law in March 2010, the Affordable Care Act’s requirement for employers to provide health insurance has [...]

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