This study will examine the impact of program cost sharing features on the access to care for low income persons and populations who face particular barriers to care due to pre-existing health conditions. The Muskie School is seeking the cooperation of the states of Vermont, Maine, and New Hampshire in making this study feasible. Such cooperation would require assisting the research team in accessing claims and administrative databases for persons enrolled in the state access initiatives.
Health Services Access, Quality, and Financing
Patient safety standards and systems have been developed and conducted in large, urban hospitals and the relevance of such standards and systems for smaller, rural hospitals has not been established. The purpose of this project is to test the feasibility, cost, and impact of implementing patient safety standards in small, rural hospitals. Working with 8 hospitals in Tennessee, this project will create a sustainable infrastructure for assisting rural hospitals to implement critical safety improvements and to more toward a universal culture of safety. The resulting materials and tools will allow for broader replication in Tennessee and other states.
The Office of MaineCare Services and the New Hampshire Medicaid Program have observed a trend in the conversion of physicians from private practice to other practice arrangements including Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), hospital-owned practices, and hospital outpatient departments. The extent and consequences of these changes are largely unknown; however, reimbursement is higher for Medicaid patients when care is provided within these facilities rather than physician offices. This project will result in an understanding of changes to the organization and finance of physician practice in Maine and New Hampshire, the contribution of the federal process for approving FQHCs / RHCs on these trends, and potential policy options for mitigating the impact to Medicaid.
The project includes a literature review, interviews with state Medicaid officials and practice administrators, and analysis of claims data.
The Maine CDC's Health Workforce Forum provided an informed and coordinated effort to identify and address current and projected health occupation shortages, pipeline/workforce development issues and systemic gaps/barriers to inform state policy and support planning decisions to ensure the effective delivery of health services in the state. The Maine CDC and Muskie School staff continued the Forum's work sessions to address infrastructure and system level initiatives.
State Solutions is a national program office for the Robert Wood Johnson Foundation focused on maximizing enrollment in Medicare Savings Programs (e.g. QMB, SLMB, and QI1). This project provides technical assistance and policy analyses to State Solutions to identify and evaluate incentives created for increasing enrollment in the Medicare Savings Programs as a result of the implementation of the Medicare Part D drug benefit and low-income subsidies. The project will produce a series of issue briefs and develop and implement the agenda for a national invitational summit on this topic.