Modernizing Certificate of Need Laws to Match the Post-Affordable Care Act Landscape: Using Mississippi As a Case Study for Reform in Healthcare Costs and Access to Rural Care

2019 ◽  
Author(s):  
Katelin Davis
Keyword(s):  
Affordable Care Act ◽  
Healthcare Costs ◽  
Certificate Of Need ◽  
Rural Care

Introduction

2017 ◽  
Author(s):  
David K. Jones
Keyword(s):  
Affordable Care Act ◽  
Institutional Design ◽  
Tea Party ◽  
Policy Outcomes ◽  
State Control ◽  
Reform Legislation ◽  
Core Elements ◽  
Insurance Exchanges ◽  
Significant Health

The Affordable Care Act (ACA) is the most significant health reform legislation enacted in generations. However, politics does not end after a bill is signed into law. This chapter outlines why states were given such a prominent role in the implementation of core elements of the ACA, including the health insurance exchanges. This sets the stage for the question of this book: given that state leaders say they want flexibility and that Republicans say they prefer market-oriented reforms, why did so many states reject state control over exchanges? I outline the four main insights from the case study chapters: (1) the importance of governors, (2) the power of the Tea Party, (3) the ways in which differences in institutional design and procedures shaped policy outcomes, and (4) the importance of leadership. I ask whether this episode supports or undermines the federalism notion of states as laboratories of learning.

scholarly journals Narrow Networks on the Health Insurance Exchanges: What Do They Look Like and How Do They Affect Pricing? A Case Study of Texas

2015 ◽  
Vol 105 (5) ◽  
pp. 110-114 ◽  
Author(s):  
Leemore Dafny ◽  
Igal Hendel ◽  
Nathan Wilson
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
First Year ◽  
Narrow Gap ◽  
Limited Evidence ◽  
Hospital Networks ◽  
Using Data ◽  
Narrow Networks ◽  
Insurance Exchanges

The Affordable Care Act has engendered significant changes in the design of health insurance products. We examine the “narrowness” of hospital networks affiliated with plans offered in the first year of the marketplaces. Using data from Texas, we find limited evidence of a tight link between pricing and a simple measure of network breadth, or a more complex measure of network value derived from a logit model of hospital choice. The state's largest insurer priced its narrow networks at a fairly constant discount relative to its broad networks, notwithstanding significant variation in its broad-narrow gap across geographic markets in Texas.

scholarly journals EXPLORING PATENT ACTIVITY AND ITS POTENTIAL ASSOCIATION WITH HEALTHCARE OUTCOMES: A CASE STUDY OF OSTOMY PRODUCTS IN SWEDEN

2017 ◽  
Vol 33 (2) ◽  
pp. 168-175
Author(s):  
Paul Samuel Calara ◽  
Rikard Althin ◽  
Gary Inglese ◽  
Thomas Nichols
Keyword(s):  
Patient Outcomes ◽  
Healthcare Costs ◽  
Healthcare Expenditure ◽  
Medical Innovation ◽  
Healthcare Outcomes ◽  
Patent Activity ◽  
Potential Association ◽  
The Impact ◽  
Cost Differences

Objectives:The aim of this study was to evaluate whether ostomy industry patent activity (PA) is associated with patient outcomes and healthcare costs.Methods:Two groups of ostomy pouch users based on manufacturer PA (low or high) were compared in terms of ostomy-related wear patterns, adverse events, and healthcare expenditure. Using Swedish registry data, all patients with newly formed stomas were divided between each group and were followed during a 2-year period (2011–12). Propensity score matching and parametric duration analysis were used to compare outcomes between patients of similar characteristics such as sex, age, and ostomy surgery type.Results:In both one- and two-piece systems, the high PA group had significantly lower monthly ostomy-related expenditure than the low PA group (one-piece: 197.47 EUR versus 233.34 EUR; two-piece: 164.00 EUR versus 278.98 EUR). Fewer pouch and skin wafer purchases per month were an important driver of cost differences. Both groups had similar likelihood of purchasing dermatological products for skin complications over time.Conclusions:PA in the ostomy care industry was associated with reduced healthcare costs, but not necessarily with fewer skin complications. It suggests that there is a health economic benefit from products made by patent intensive companies which may differentiate them from generic comparators, but more research is needed to understand the impact of activities conducive to medical innovation on health outcomes.

scholarly journals Assessing a Coalition for Outreach and Enrollment in Minnesota’s Health Insurance Exchange

2015 ◽  
Author(s):  
Kim Dauner
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Contextual Factors ◽  
Community Outreach ◽  
Community Level ◽  
Case Study Approach ◽  
Study Approach ◽  
Unintended Effect ◽  
Technical Challenges

Using a case-study approach, representatives of the Insure Duluth coalition were interviewed in order to evaluate processes, strengths, challenges and outcomes associated with using a coalition approach to community outreach and enrollment in health insurance via the new state marketplace, which is part of the implementation of the Affordable Care Act. Overall, interview participants cited numerous strengths to the coalition approach as well as technical challenges with enrolling persons in health insurance. They also felt such challenges had the unintended effect of strengthening the relationships between coalition organizations. Community level outcomes were identified as being associated with the coalition’s work. Participants also discussed key contextual factors supporting the coalition. The coalition approach appears to be a promising tactic to increase health insurance access. States can provide funding for and foster policies to assist coalitions expand health insurance access.

scholarly journals Measuring the Impact of the Affordable Care Act: A Ryan White Clinic Case Study

2015 ◽  
Vol 2 (suppl_1) ◽  
Author(s):  
Amy Downs ◽  
Jana Collins ◽  
Katina Marchione ◽  
Timothy Crawford ◽  
Alice Thornton
Keyword(s):  
Affordable Care Act ◽  
Ryan White ◽  
The Affordable Care Act ◽  
The Impact

scholarly journals Affordable Care Act: A review and discussion of its impact on healthcare today, and a primer for pharmacists

2013 ◽  
Vol 4 (1) ◽  
Author(s):  
Leo Lai Ho Lui ◽  
Albert Wertheimer
Keyword(s):  
United States ◽  
Patient Care ◽  
Affordable Care Act ◽  
Healthcare Costs ◽  
Healthcare Professionals ◽  
The United States ◽  
Patient Protection ◽  
The Future ◽  
The Impact

In the midst of countless healthcare debates, the Patient Protection and Affordable Care Act is written into legislation as a possible solution to the United States's rising healthcare costs. Individualized into nine titles, the act sought to provide additional coverage to millions of Americans while cutting down healthcare costs through numerous provisions effective into 2020. While the act has been challenged publicly and privately by the states, many healthcare professionals today, let alone the average American, are unaware and uneducated of what comprises the act, as well as the impact in which it has on the future of healthcare in the United States. With an increasing role of patient care placed upon pharmacists today, an understanding of the PPACA allows us to provide extensive answers to questions in which our patients may have.   Type: Student Project

scholarly journals The Challenges and Strategies of Affordable Care Act Navigators and In-Person Assisters with Enrolling Uninsured, Violently Injured Young Black Men into Healthcare Insurance Coverage

2021 ◽  
Vol 15 (2) ◽  
pp. 155798832110055
Author(s):  
Joseph B. Richardson ◽  
William Wical ◽  
Nipun Kottage ◽  
Mihir Chaudhary ◽  
Nicholas Galloway ◽  
...  
Keyword(s):  
Black Men ◽  
Affordable Care Act ◽  
Low Income ◽  
Qualitative Case Study ◽  
Insurance Coverage ◽  
Violent Injury ◽  
Study Approach ◽  
Healthcare Insurance ◽  
Insurance Enrollment

Low-income young Black men experience a disproportionate burden of violent injury in the United States. These men face significant disparities in healthcare insurance coverage and access to care. The Affordable Care Act (ACA) created a new healthcare workforce, Navigators and In-Person Assisters (IPAs), to support low-income minority populations with insurance enrollment. Using a longitudinal qualitative case study approach with Navigators and IPAs at the two busiest urban trauma centers in Maryland, this study identifies the culturally and structurally responsive enrollment strategies used by three Navigators/IPAs as they enrolled violently injured young Black men in healthcare insurance coverage. These approaches included gaining their trust and building rapport and engaging female caregivers during enrollment. Navigators and IPAs faced significant barriers, including identity verification, health literacy, privacy and confidentiality, and technological issues. These findings offer novel insight into the vital work performed by Navigators and IPAs, as they attempt to decrease health disparities for young Black male survivors of violence. Despite high rates of victimization due to violent firearm injury, little is known about how this population gains access to healthcare insurance. Although the generalizability of this research may be limited due to the small sample size of participants, the qualitative case study approach offers critical exploratory data suggesting the importance of trauma-informed care in insurance enrollment by Navigators and IPAs. They also emphasize the need to further address structural issues, which affect insurance enrollment and thus undermine the well-being of young Black men who have survived violent injury.

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