Cutler Institute for Health and Social Policy

Population Health and Health Policy

Tiered Provider Networks

Duration: 
1/1/2004 - 1/31/2006
Principal Investigator: 
Andrew Coburn
Collaborators: 
Bill Thomas, Ph.D.
Abstract: 

The purpose of this project is to determine where and how tiered provider networks are utilized, to describe the characteristics of these networks, and to develop insights into strategies used by health plans when implementing and operating tiered provider networks. The concept underlying tiered networks is that health plans may be able to reduce costs and/or improve quality by directing consumers to certain providers and to avoid others. Unlike traditional HMO arrangements, tiered network plans typically allow members to access all providers, not just a subset. Through a variety of tactics, such as the disclosure of provider ?scores? as well as differential cost sharing arrangements, consumers are encouraged to shop for health care services among select and non-select providers.
In collaboration with Mercer Human Resource Consulting, a set of questions will be included in this firm?s 2005 web-based Survey of Employer Sponsored Health Plans. To answer questions that cannot be addressed with a structured response survey, site visits will be conducted, including personal interviews and focus groups, in five case study communities in which tiered provider networks are operational. Finally, to assess the direction and magnitude of changes occurring in tiered network programs, information derived from the analyses of 2005 survey results and site visits will be used to develop a refined set of tiered network questions for the 2006 Mercer survey.

Start Date: 
Thu, 2004-01-01
End Date: 
Tue, 2006-01-31
Legacy Muskie ID: 
2391

Cutler Institute awarded $600,000 to help youth raised in foster system

Marty Zanghi

USM's Cutler Institute for Health and Social Policy has been awarded a $600,000 grant to help young people raised in Maine's foster system to prepare for college and the workforce.

The money comes from the Annie E. Casey Foundation as part of a $5.4 million national effort aimed at youth who are homeless or in either the foster care or juvenile justice systems.

"Many of these young people have suffered abuse or trauma and were raised in poverty and neglect," said Marty Zanghi, the Cutler Center's youth development director.

The money -- including an expected $400,000 more in matching funds -- will pay for contracted work with agencies in the target areas, starting with the greater Portland area and Penobscot, Kennebec and Somerset counties.

Nationally and in Maine, only about 3 percent of people who grow up in the foster care system achieve a college degree, he said.

"It's dramatically lower than the rate for the general population," Zanghi said. "It's a horrible outcome."

It doesn't have to be that way, though.

"There are young people that overcome these circumstances," he said. "I know people who have master's degrees and Ph.Ds."

The Casey Foundation's national effort is being called the "Learn and Earn to Achieve Potential" (LEAP) initiative.

The initiative is working on partnerships in Maine and nine other areas: Alaska, Arizona, California, Massachusetts, Michigan, Minnesota, Nebraska and New York. In each case, people will adapt two evidence-based models to meet the needs of these youth, including support to address the trauma they may have experienced in their lives.

In Maine, the work will include a pair of successful programs, Jobs for Maine Graduates (JMG) and Jobs for the Future. Results will be carefully tracked, Zanghi said.

After the first year, the program is expected to grow.

"Eventually, the additional help will be available to all children, 14 and over, in the foster care system in the state of Maine," Zanghi said.

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