Analysis of HHS Final Rules on Reinsurance, Risk Corridors and Risk Adjustment

Summarizes final rules for states and health insurance plans for minimizing adverse selection under federal healthcare reform and highlights changes from proposed rules. Outlines implications for states and plans, as well as outstanding issues

Mobility and Equity for New York's Transit-Starved Neighborhoods: The Case for Full-Featured Bus Rapid Transit

New York City's public transportation system moves millions of people every day. But an increasing number who live in outer borough neighborhoods are stuck with unreliable transit options and long travel times tracked in hours, not minutes.It does not have to be this way.Developed by the Pratt Center for Community Development and funded by the Rockefeller Foundation, this report highlights the limitations of New York City's current public transit system, the adverse effects those limitations have on our economy and quality of life, and the role Bus Rapid Transit (BRT) can play in remedying these transit inequities.BRT has transformed cities across the world from Mexico City to Barcelona to Cleveland. At a fraction of the cost to build just a mile of subway rail, BRT gives riders a reliable way to get where they need to go.BRT is effective. It is innovative. And it could be the solution for New York's transit-starved neighborhoods

Bus Rapid Transit: A Handbook for Partners, MTI Report 06-02

In April 2005, the Caltrans Division of Research and Innovation (DRI) asked MTI to assist with the research for and publication of a guidebook for use by Caltrans employees who work with local transit agencies and jurisdictions in planning, designing, and operating Bus Rapid Transit (BRT) systems that involve state facilities. The guidebook was also to assist to transit operators, local governments, community residents, and other stakeholders dealing with the development of BRT systems. Several areas in the state have experienced such projects ( San Diego , Los Angeles , San Francisco , and Alameda County ) and DRI wished to use that experience to guide future efforts and identify needed changes in statutes, policies, and other state concerns. Caltrans convened a Task Team from the Divisions of Research and Innovation, Mass Transportation, and Operations, together with stakeholders representing many of those involved with the BRT activities around the state. Prior to MTI’s involvement, this group produced a white paper on the topic, a series of questions, and an outline of the guidebook that MTI was to write. The MTI team conducted case studies of the major efforts in California, along with less developed studies of some of the other BRT programs under development or in early implementation phases around the state. The purpose was to clarify those issues that need to be addressed in the guidebook, as well as to compile information that would identify items needing legislative or regulatory action and items that Caltrans will need to address through district directives or other internal measures. A literature scan was used to develop a bibliography for future reference. The MTI team also developed a draft Caltrans director’s policy document, which provides the basis for Caltrans’ actions. This ultimately developed to be a project within a project. MTI submitted a draft document to Caltrans as a final product from the Institute. Task team members and Caltrans staff and leadership provided extensive review of the draft Bus Rapid Transit: A Handbook for Partners. Caltrans adopted a new Director’s Policy and published the document, BRT Caltrans. The MTI “wraparound” report presented below discusses in more detail the process that was followed to produce the draft report. The process was in many ways as much a project as the report itself

Investing in America\u27s Surface Transportation Infrastructure: The Need for a Multi-Year Reauthorization Bill: Hearing Before the S. Comm. on Env\u27t & Pub. Works, 116th Cong., July 10, 2019

The Fourth National Climate Assessment, released in November 2018, described the serious impacts of climate change already being felt throughout the U.S., and made clear that the risks to communities all across the country are growing rapidly. These findings, along with those in the 2018 Intergovernmental Panel on Climate Change (IPCC) report should serve as an immediate call to action. Even if we manage to limit planetary warming to just 2 degrees Celsius, the world will still face increased chances of economic and social upheaval from more severe flooding, droughts, heatwaves, and other climate impacts as well as devastating environmental consequences, the IPCC report warns. The consensus from leading scientific research academies within the United States and internationally is clear: multiple lines of evidence indicate, and have indicated for years, that our atmosphere is warming, sea levels are rising, the magnitude and frequency of certain extreme weather events is increasing, and that human activity is the primary driver of climate change. As described in the IPCC Special Report, the consensus is that countries around the world must rapidly decarbonize their economies, cutting greenhouse gas emissions in half by 2030 and to near zero by 2050. The U.S. Department of Defense, and leaders within the defense and national security communities, have also recognized climate change as a “national security issue” that requires adapting military operations and planning to ensure readiness. Despite our understanding of the consequences we will face and the urgency to act, U.S. GHG emissions from fossil fuel combustion increased by 2.7 percent in 2018, according the Rhodium Group. Clearly more action is needed. While we all recognize the importance of transportation in our daily lives and for our economy, it is also important to recognize that the transportation sector is the largest contributor of GHG emissions in the United States, and is already facing significant impacts from climate change. There is an urgent need, therefore, to transition to a low-carbon and more resilient transportation system. Such a transition would not only reduce emissions and fight climate change, it also would bring additional important benefits, including protecting public health by reducing conventional air pollution, providing more mobility options, and driving innovation and economic growth through policy action and through public and private investment

Can Accountable Care Organizations Improve the Value of Health Care by Solving the Cost and Quality Quandaries?

Explores proposed models and configurations of accountable care organizations, which combine provider payment and delivery system reforms, and their potential to slow the rise of healthcare costs. Outlines key issues and program features under debate

Risk Adjustment Under the Affordable Care Act: A Guide for Federal and State Regulators

Summarizes discussions from a conference about the consequences of the 2010 healthcare reform's risk adjustment provisions, design and implementation challenges, and the merits of various risk adjustment strategies. Recommends diagnostic risk measures

Problems and prospects of non-motorized public transport integration in developing cities

The benefits and costs of the paid category of non-motorized public transport (NMPT) –especially three wheeler cycle rickshaws – have long been a major transport planning problem in many developing cities. Policy measures to restrict or eliminate non-motorized vehicles, especially NMPTs, from urban arterials and other feeder networks have already been implemented in developing cities as diverse as Delhi, Bangkok, Jakarta, Manila, Surabaya, Beijing and Bogotá. Over the last few years, the government of Bangladesh has implemented policies to phase out non-motorized transport, particularly rickshaws, from the major traffic spines of Dhaka City. The acceptability, rationality and implication of such ‘solutions’ are widely argued in Bangladesh, as well as internationally. The argument is severe in Dhaka, the case study of this research, considering social acceptability, economic response, fuel free eco-friendly characteristics and magnitude of role of rickshaw in sustaining the traffic and mobility needs of citizens. Therefore, rather than simply pursuing policies to eliminate NMPT, a better approach may be to integrate motorized and non-motorized vehicles as complementary rather than competitive forces in meeting the comprehensive demand of Dhaka’s transport. With the backdrop and given the international significance of the problem, this paper will delineate a preliminary framework for the future place of the NMPT-rickshaw and explore the problems as well as opportunities for its sustainable co-existence in a mixed mode transport stream that best meets the network performance needs of Dhaka

Anthropogenic Habitats Facilitate Dispersal of an Early Successional Obligate: Implications for Restoration of an Endangered Ecosystem

Landscape modification and habitat fragmentation disrupt the connectivity of natural landscapes, with major consequences for biodiversity. Species that require patchily distributed habitats, such as those that specialize on early successional ecosystems, must disperse through a landscape matrix with unsuitable habitat types. We evaluated landscape effects on dispersal of an early successional obligate, the New England cottontail (Sylvilagus transitionalis). Using a landscape genetics approach, we identified barriers and facilitators of gene flow and connectivity corridors for a population of cottontails in the northeastern United States. We modeled dispersal in relation to landscape structure and composition and tested hypotheses about the influence of habitat fragmentation on gene flow. Anthropogenic and natural shrubland habitats facilitated gene flow, while the remainder of the matrix, particularly development and forest, impeded gene flow. The relative influence of matrix habitats differed between study areas in relation to a fragmentation gradient. Barrier features had higher explanatory power in the more fragmented site, while facilitating features were important in the less fragmented site. Landscape models that included a simultaneous barrier and facilitating effect of roads had higher explanatory power than models that considered either effect separately, supporting the hypothesis that roads act as both barriers and facilitators at all spatial scales. The inclusion of LiDAR-identified shrubland habitat improved the fit of our facilitator models. Corridor analyses using circuit and least cost path approaches revealed the importance of anthropogenic, linear features for restoring connectivity between the study areas. In fragmented landscapes, human-modified habitats may enhance functional connectivity by providing suitable dispersal conduits for early successional specialists