An Alternative Explanation for the Equality of Male and Female Unemployment Rates in the U.S. Labor Market in the Late 1980s

Given demographic trends, public policies in the future may be aimed at stimulating the availability of nursing home care in the U.S. This paper estimates how certificate of need laws, Medicaid reimbursement rates, and state corporate income tax rates affect the availability of nursing home care in markets throughout the U.S. The results indicate that the Medicaid reimbursement rate directly affects the availability of nursing home care. The findings also suggest that the state corporate tax rate inversely influences the provision of nursing care. Finally, the availability of nursing care is not affected by the presence of certificate of need laws.Female; Unemployment Rate; Unemployment

The Effects of Medicaid Reimbursement Rates on Access to Dental Care

Compares efforts to improve Medicaid access to dental care in California with those in Alabama, Michigan, South Carolina, Tennessee, Virginia, and Washington, and assesses the extent to which raising dentists' Medicaid reimbursement rates improved access

A Decomposition of the Elasticity of Medicaid Nursing Home Expenditures Into Price, Quality, and Quantity Effects

Nursing home expenditures have become a public policy concern primarily because the Medicaid program payes for approximately 50 percent. Medicaid makes health care available to individuals who otherwise could not afford it, by directly reimbursing nursing homes for Medicaid patient care. Typically, Medicaid reimbursement rates are set by a cost plus method, where the reimbursement per patient is equal to average cost plus some return referred to as the Medicaid "plus" factor. This paper estimates the elasticity of Medicaid expenditures with respect to a change in the Medicaid "plus" factor,and decomposes that elasticity into price, quality, and quantity components. The decomposition is derived from a model of nursing home behavior, which shows that an increase in the Medicaid "plus" factor causes nursing homes to admit more Medicaid patients and reduce quality.Total expenditures are the Medicaid reimbursement rate times the number of Medicaid patients receiving care. An increase in the Medicaid "plus" factor affects the Medicaid reimbursement by directly raising the Medicaid "plus" factor, and by indirectly decreasing average cost through a reduction in quality. These are the price and quality effects, respectively. The quantity effect is change in the number of Medicaid patients. The elasticities are estimated separately for proprietary and "not for profit" nursing homes using a 1980 sample of New York nursing homes. Uniformly, the proprietary elasticities are approximately twice as large as the "not for profit" elasticities. As expected the price and quantity effects are positive, and the quality effects are negative. In the decomposition, the quality effect is quite important. In fact, ignoring it would lead to a fifty-three percent overestimate of the Medicaid expenditure elasticity.

State Variation in Primary Care Physician Supply: Implications for Health Reform Medicaid Expansions

Examines regional and state variations in primary care supply, physicians' acceptance of new patients, and capacity to meet increased demand from Medicaid's expansion. Considers policy implications, including reimbursement and scope-of-practice issues

Nursing home bed capacity in the States, 1978-86.

Trends in nursing home bed supply in the States show large variations in beds per population and a gradual decline in supply per aged population. A cross-sectional time-series regression analysis was used to examine some factors associated with nursing home bed supply. Variation was accounted for by economic factors, supply of alternative services, and climate. State Medicaid reimbursement rates had negative coefficients, with supply suggesting States may be increasing rates to improve access where supply is limited. Medicaid waiver policy was not found to be significant

Medicaid Policies for Alcohol SBI Reimbursement

The purpose of this report was to review existing reimbursement policies by state Medicaid agency, including the District of Columbia (D.C.), in order to understand similarities and differences associated with financial compensation for alcohol screening and brief intervention (SBI) services. Alcohol SBI is an evidence-based practice known to help reduce atrisk alcohol consumption among patients who drink too much. 1 Although alcohol SBI was designed to be a population-based approach to address unhealthy alcohol consumption, its current utilization is limited. 2 Implementation of the practice into routine clinical care remains a challenge at the health system level even with support from federal resources (e.g., SBIRT: Screening, Brief Intervention, and Referral to Treatment). One way to encourage the uptake of alcohol SBI/SBIRT among providers is to ensure that the service is reimbursable by third-party payers. However, reimbursement opportunities vary by state and payer, and in some locations are non-existent. Information about the current status of policies will assist in the development of policies and incentives to encourage healthcare providers and systems to submit claims for alcohol SBI/SBIRT and potentially increase the routine uptake of the service in clinical careCenters for Disease Control and Prevention Cooperative Agreement Number DD00114

On the Uneasy Relationship Between Medicaid and Charity Care

Medicaid and charity care have a lengthy relationship fraught with complications. These complications will remain and in some respects become even more acute following the implementation of the Patient Protection and Affordable Care Act. This article focuses on the uneasy relationship between Medicaid and charity care, one that becomes particularly acute in the context of Medicaid reimbursement. It traces the lineage of Medicaid in charity, and uses Medicaid reimbursement and supplemental payments as lenses through which to examine the relationship between Medicaid and charity care. The tension that we uncover will need to be resolved if Medicaid is to come closer to achieving its arguable aim of placing the poor on the same footing in our health care system as enjoyed by wealthier, privately-insured Americans

On the Uneasy Relationship between Medicaid and Charity Care

Medicaid and charity care have a lengthy relationship fraught with complications. These complications will remain and in some respects become even more acute following the implementation of the Patient Protection and Affordable Care Act. This article focuses on the uneasy relationship between Medicaid and charity care, one that becomes particularly acute in the context of Medicaid reimbursement. It traces the lineage of Medicaid in charity, and uses Medicaid reimbursement and supplemental payments as lenses through which to examine the relationship between Medicaid and charity care. The tension that we uncover will need to be resolved if Medicaid is to come closer to achieving its arguable aim of placing the poor on the same footing in our health care system as enjoyed by wealthier, privately-insured Americans

It Takes a Team: How New Dental Providers Can Benefit Patients and Practices

Examines how dental therapists and hygienist-therapists, licensed to provide primary care to underserved patients, and dental hygienists would affect private practices' capacity, productivity, and revenues under three scenarios. Recommends policy options