Health: Public Health

Mental Health Status and Access to Health Care Services for Adults in Maine

Abstract: 

Maine people with poor mental health describe significant challenges with affordability and access to health care.  A new report released by the Maine Health Access Foundation (MeHAF) and the University of Southern Maine, Mental Health Status and Access to Health Care Service for Adults in Maine, describes how adults 18 and older in Maine who report depression and poor mental health have many barriers to getting health care. These results have important implications for planning in a time when major changes in health insurance coverage are expected.

Analyzing data from the ongoing federal/state public health survey, the Behavioral Risk Factor Surveillance System (BRFSS), Dr. Ziller found that adults in Maine experiencing 14 or more mental health bad days are less likely to have a regular health care provider and more likely to report delays in getting needed health care services (for reasons other than cost). Poorer mental health status was associated with higher rates of foregoing needed medical care because of costs; 25 percent those adults experiencing 14 or more mental health bad days reported they were unable to access needed care from a doctor due to cost compared to 7 percent of adults with no mental health bad days.

MeHAF support allows inclusion of additional questions about access to insurance and health care services in the state’s BRFSS, which surveys a random sample of Maine people throughout the year.  Results from the compiled 2012, 2013 and 2014 surveys are included in the report.

 

For more information on the study design and methodology, please contact Erika Ziller, PhD, (207) 780-4615.

Media contact: Barbara Leonard, President & CEO, (207) 620.8266 x102

Suggested Citation: Ziller EC, Leonard B. Mental Health Status and Access to Health Care Services for Adults in Maine. Augusta, ME: Maine Health Access Foundation and USM Muskie School; February, 2017.

The brief is also available for download on the Maine Health Access Foundation website.

Publication Type: 
Research and Policy Brief
Publish Date: 
February 2, 2017
Author: 
URL: 
http://www.mehaf.org/content/uploaded/images/reports-research/MeHAF_MH-Status-Access-Brief-Feb2017_FINAL.pdf

Innovations in Rural Health System Development

Unpublished
Abstract: 

cover photo for Innovations in Rural Health System Development

In an effort to inform and promote local discussions and strategic planning for transforming health and healthcare in rural communities, the Maine Health Access Foundation commissioned the Maine Rural Health Research Center to develop five issue briefs profiling innovative approaches to rural health. The briefs present innovative approaches from Maine and other parts of the United States to the provision of behavioral health services, recruitment and retention of health care workers, service delivery, governance, and health care payment and financing in rural areas. Examples of innovative approaches profiled in the briefs include: the use of new health workers such as community paramedics and community health workers, rural-focused medical education models, alternative models of emergency care, telehealth, care coordination initiatives, Accountable Care Organizations, and Medicaid Accountable Communities.

The aim of these briefs is to assist rural communities and regions to proactively envision and develop strategies for transforming rural health in the state. In preparing these briefs the Maine Rural Health Research Center consulted experts, interviewed key informants, and reviewed the professional and research literature to find robust and innovative models and strategies that could be replicated in rural Maine.

Suggested citations:

Burgess A, Coburn A. Innovations in Rural Health System Development: Maine’s Behavioral Health Services. Portland, ME: University of Southern Maine, Muskie School of Public Service, MaineRural Health Research Center; November 2016.

Burgess A, Coburn A. Innovations in Rural Health System Development: Recruiting and Retaining Maine’s Health Care Workforce. Portland, ME: University of Southern Maine,Muskie School of Public Service, Maine Rural Health Research Center; November 2016.

Burgess A, Coburn A. Innovations in Rural Health System Development: Service Delivery Advances in Care Coordination, Emergency Care, and Telehealth. Portland, ME: University of SouthernMaine. Muskie School of Public Service, Maine Rural Health Research Center; November 2016.

Kahn-Troster S, Coburn A. Innovations in Rural Health System Development: Governance. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine RuralHealth Research Center; November 2016.

Kahn-Troster S, Coburn A. Innovations in Rural Health System Development: Moving Rural Health Systems to Value-Based Payment. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; November 2016.

Publication Type: 
Report
Publish Date: 
November 10, 2016
URL: 
http://www.mehaf.org/learning-resources/reports-research/

Access to Health Care Services for Adults in Maine

Abstract: 

On October 17, 2016, the Maine Health Access Foundation (MeHAF) released a new research brief developed with the University of Southern Maine that found significant inequality in the ability of people in Maine to access quality health care. "Our research shows the devastating inequalities in whether people in Maine can get health care,” said Barbara Leonard, president and CEO of the MeHAF. “If you’re young, have a low-income, lack higher education or are a racial or ethnic minority, health care maybe a luxury that you struggle to afford. Many are just one health care crisis away from financial hardship. To make improvements that help people to live better, healthy and happier lives, we have to change the way we approach health care delivery, especially for those facing the greatest barriers to care.”

The authors, Barbara Leonard from MeHAF and Erika Ziller from the USM Muskie School, found that income, age and education are all closely associated with Maine people’s ability to receive appropriate and timely health care. Specifically, they found that among Maine adults 18 and older, those with family incomes less than $25,000 a year, young adults, racial and ethnic minorities, and people with less education are much more likely to:

  • Delay seeking health care even when sick;
  • Be unable to afford prescription medication;
  • Lack access to preventative check-ups and screenings or have a regular health care provider.

In addition, their analysis also found that Maine people, of all income groups, have reported difficulties in paying medical costs.

The brief is available for download on the Maine Health Access Foundation website.

FMI: Barbara Leonard, (207) 620-8266, ext. 102 or Erika Ziller, (207) 780-4615

Suggested Citation: Ziller E, Leonard B. Access to Health Care Services for Adults in Maine. Augusta, ME: Maine Health Access Foundation and USM Muskie School; October, 2016.

Publication Type: 
Report
Publish Date: 
October 17, 2016
URL: 
http://www.mehaf.org/content/uploaded/images/reports-research/Access%20to%20Health%20Care%20Brief_Oct%202016.pdf

First Steps Phase III Initiative: Improving Oral Health and Healthy Weight in Children

Unpublished
Abstract: 

This is the final evaluation report of the First STEPS (Strengthening Together Early Preventive Services) Phase III Improving Oral Health and Healthy Weight in Children learning initiative. The evaluation assessed changes in rates of oral health and healthy weight preventive services and evidence-based office processes among practices that participated in the initiative, as well as related systems changes. This report presents key findings, summarizes lessons learned in implementing practice changes, and describes challenges in using CHIPRA, HEDIS and other oral health and healthy weight measures at the practice-level to inform quality improvement.

This report was written by Carolyn Gray and Kimberley Fox at the Cutler Institute of Health and Social Policy, Muskie School of Public Service at the University of Southern Maine. The work was conducted under a Cooperative Agreement between the Maine Department of Health and Human Services and the Muskie School of Public Service at the University of Southern Maine and is funded under grant CFDA 93.767 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) authorized by Section 401(d) of the Child Health Insurance Program Reauthorization Act (CHIPRA).

These contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and one should not assume endorsement by the Federal Government. The views expressed are those of the authors and do not necessarily represent the views of either the Department or the School. For further information regarding this report, or the broader evaluation of the local IHOC initiative, please contact Kim Fox at kfox@usm.maine.edu.

Suggested Citation:Gray, C., & Fox, K. (2015). First STEPS Phase III initiative: Improving oral health and healthy weight in children. (Final Evaluation Report). Portland, ME: University of Southern Maine, Muskie School of Public Service.

Publication Type: 
Report
Publish Date: 
June 10, 2015
URL: 
http://www.maine.gov/dhhs/oms/provider/ihoc.shtml

Early Lessons Learned in Implementing MaineCare Health Homes

Unpublished
Abstract: 

This Issue Brief, authored by researchers at the University of Southern Maine's Muskie School, highlights key lessons learned from the first year of implementation of the MaineCare Health Homes Initiative.

Key Findings:

  • MaineCare's Health Homes Initiative has expanded Maine's capacity for chronic care management in primary care practices and community care teams (CCTs);
  • CCTs provide valuable additional support to patients of Health Homes, including home visits and social supports in the community;
  • Flexibility in program design allowed for wide variation of service delivery models within CCTs;
  • Three percent of Health Home members were referred to CCTs by the end of the first year, but overall practice referral rates varied by CCT--from 1% to 7% of Health Home members within their associated practices.

To view or download the full study, click here

To view or download the Issue Brief on enrollment in the first year of MaineCare Health Homes implementation, click here

Suggested Citation: Fox K, Gray C, Rosingana K. Early Lessons Learned in Implementing MaineCare Health Homes. Portland, ME: University of Southern Maine, Muskie School of Public Service; September, 2014.

Publication Type: 
Research and Policy Brief
Publish Date: 
September 30, 2014
URL: 
http://muskie.usm.maine.edu/Publications/PHHP/MaineCare-HealthHomes-Implementation.pdf

MaineCare Health Homes Enrollment in the First Year of Implementation

Unpublished
Abstract: 

This Issue Brief, authored by researchers at the University of Southern Maine's Muskie School, highlights enrollment trends and characteristics of MaineCare's Health Homes initiative during the first year of implementation.

Key Findings:

  • MaineCare initially estimated 42,000 members were Health Home eligible; 48,000 members were enrolled by December 2013;
  • Health Homes practices increased referrals to Community Care Team (CCT) services over the course of the first year of the initiative, increasing from 60 members enrolled in CCTs in January 2013 to 1,392 in Decmber (3% of Health Home members);
  • Health Home members had an average of three chronic conditions.  Two out of the five most common conditions were behavioral health related.

To view or download the full study click here

To view or download the Issue Brief on implementation in the first year of MaineCare's Health Home Initiative click here

Suggested Citation: Fox K, Gray C, Rosingana K. MaineCare Health Homes Enrollment in the First Year of Implementation. Portland, ME: University of Southern Maine, Muskie School of Public Service; September, 2014.

Publication Type: 
Research and Policy Brief
Publish Date: 
September 30, 2014
URL: 
http://muskie.usm.maine.edu/Publications/PHHP/MaineCare-HealthHomes-Enrollment.pdf

Rural and Remote Food Environments and Obesity

Unpublished
Abstract: 

Researchers at the Maine Rural Health Research Center Rural have published a review in the January 2015 issue of Current Obesity Reports describing the rural community, home, and individual food environments and what is known about their roles in healthy eating.

Abstract: Rural residents are more likely to be obese and overweight compared to their urban counterparts. Studies of specific rural communities have found that the limited availability of healthy foods in the community and home as well as individual characteristics and preferences contribute to poor diet and overweight. The rural food environment is varied and may be affected by climate, regional and cultural preferences, transportation access, and remoteness among other factors. Given this diversity and the vulnerabilities of rural residents, who are more likely to have low-income, substandard housing or low educational attainment compared to their urban counterparts, policy and programmatic interventions should target specific needs and communities.

Suggested Citation: Lenardson, J. D., Hansen, A. Y., & Hartley, D. (2015). Rural and remote food environments and obesity. Current Obesity Reports. doi: 10.1007/s13679-014-0136-5

Publication Type: 
Journal Article
Publish Date: 
January 30, 2015
URL: 
http://link.springer.com/article/10.1007%2Fs13679-014-0136-5#page-1

Transforming Public Health Practice Through Accreditation (A User Guide for the Special Accreditation Issue)

Unpublished
Abstract: 

This editorial highlights the progress of public health accreditation efforts as discussed by the articles in this special issue. This issue represents an important step toward establishing a stronger evidence base for the national accreditation program, and the articles within this issue address many of the research agenda topics, including technical assistance, connections with public health categorical programs, readiness, and the impact of accreditation on public health departments of many sizes, types, and structures.

Publication Type: 
Journal Article
Publish Date: 
January 1, 2014
URL: 
http://journals.lww.com/jphmp/Fulltext/2014/01000/Transforming_Public_Health_Practice_Through.2.aspx

Introduction to Case Reports: One Goal - Many Journeys

Unpublished
Abstract: 

This article describes case reports that highlight the journey of accreditation through the lens of 11 health departments at various stages in the process. These case reports call attention to the link between accreditation and quality improvement.

Suggested Citation: Joly, B., & Davis, M. V. (2014). Introduction to case reports: One goal-many journeys. Journal of Public Health Management and Practice, 20(1), 64-65. doi: 10.1097/PHH.0b013e3182a958da

Publication Type: 
Journal Article
Publish Date: 
January 1, 2014
URL: 
http://journals.lww.com/jphmp/Fulltext/2014/01000/Introduction_to_Case_Reports___One_Goal_Many.17.aspx

First Steps Phase II Initiative: Improving Developmental, Autism, and Lead Screening for Children

Unpublished
Abstract: 

First STEPS (Strengthening Together Early Preventive Services) is a learning initiative supported by Maine's CHIPRA quality demonstration grant to support measure-driven practice improvement in pediatric and family practices across the state on improving developmental, autism, and lead screening for children. This report, authored by research staff at the USM Muskie School, evaluates the impact of Phase II of Maine's First STEPS initiative, which was implemented from May to December 2012 and included 12 practices serving more than 20,000 children on MaineCare (Maine's Medicaid system). The authors assess changes in developmental, autism, and lead screening rates and evidence-based office processes in participating practices before and after the initiative, as well as related systems changes. They also summarize lessons learned in implementing changes in practices and challenges in using CHIPRA and IHOC developmental, autism, and lead screening measures at the practice-level to inform quality improvement.

Suggested Citation: Fox K, Gray C, Elbaum-Williamson M. First STEPS Phase II Initiative: Improving Developmental, Autism, and Lead Screening for Children. Portland, ME: University of Southern Maine, Muskie School of Public Service; August, 2013. Improving Health Outcomes for Children (IHOC) Final Evaluation Report.

Publication Type: 
Report
Publish Date: 
August 30, 2013
URL: 
http://muskie.usm.maine.edu/Publications/PHHP/FirstSTEPS-PhaseII-Developmental-Austism-Lead-Screening.pdf

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