Medicaid-the need for reform

Recent administration proposals to address the rising cost of Medicaid will do little to contain costs or truly reform the program. The primary issues are the large differences among state Medicaid programs in coverage and benefits and the programs high and rising costs. In this paper, we describe and develop several options for Medicaid reform that would expand coverage, provide fiscal relief to states, shift responsibility for some or all of the cost of dual eligibles to the federal government, and eliminate or restructure the disproportionate share programs. A number of other issues are addressed, including Medicaid cost containment and the federal matching rate structure.Health care reform ; Medicaid

Supporting State Policymakers' Implementation of Federal Health Reform

Outlines the capacities states will need to implement federal healthcare reform in the areas of information and analysis, strategic implementation and planning, topic-specific technical assistance, communications, and coordination and integration

States' Roles in Shaping High Performance Health Systems

Analyzes results from the State Health Policies Aimed at Promoting Excellent Systems survey and a review of current research on efforts to improve state healthcare systems, with a focus on coverage; quality, safety, and value; and infrastructure

The annuitization of Americans' resources: a cohort analysis

An analysis of the changes since 1960 in the share of Americans' resources that are annuitized, which has declined slightly for younger Americans but has risen dramatically for the elderly, with important implications for the national saving rate and income inequality.Saving and investment

A State Policymakers' Guide to Federal Health Reform: Part I: Anticipating How Federal Health Reform Will Affect State Roles

Examines how federal healthcare reform will affect states' tools and roles in connecting people to services, promoting coordination and integration, improving care for those with complex needs, being results-oriented, and increasing efficiencies

State Health Policies Aimed at Promoting Excellent Systems: A Report on States’ Roles in Health Systems Performance

States shape the health system in many ways: as purchasers, regulators, and conveners. Despite these various roles, there is little systematic effort to monitor state choices, learn from the choices states make, and purposefully spread one state’s innovations to other states. Coordination between states and the federal government on approaches to improving the health care system is often lacking, limiting our nation’s ability to address critical problems. In an effort to improve health system performance and increase the spread of innovation, the National Academy for State Health Policy (NASHP), with support from the Commonwealth Fund, prepared this report on a broad array of state health policies and practices. This report describes a tremendous amount of activity at the state level and which has implications for how well the health care system performs

Re-examining the role of Drosophila Sas-4 in centrosome assembly using two-colour-3D-SIM FRAP.

Centrosomes have many important functions and comprise a 'mother' and 'daughter' centriole surrounded by pericentriolar material (PCM). The mother centriole recruits and organises the PCM and templates the formation of the daughter centriole. It has been reported that several important Drosophila PCM-organising proteins are recruited to centrioles from the cytosol as part of large cytoplasmic 'S-CAP' complexes that contain the centriole protein Sas-4. In a previous paper (Conduit et al., 2014b) we showed that one of these proteins, Cnn, and another key PCM-organising protein, Spd-2, are recruited around the mother centriole before spreading outwards to form a scaffold that supports mitotic PCM assembly; the recruitment of Cnn and Spd-2 is dependent on another S-CAP protein, Asl. We show here, however, that Cnn, Spd-2 and Asl are not recruited to the mother centriole as part of a complex with Sas-4. Thus, PCM recruitment in fly embryos does not appear to require cytosolic S-CAP complexes.PTC was supported by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (105653/Z/14/Z) and by an Issac Newton Trust Research Grant from the University of Cambridge awarded to TTW (RG78799). AW, ZN and JWR were supported by a Senior Investigator Award awarded to JWR and funded by the Wellcome Trust (104575/Z/14/Z). The OMX microscope used in this study is part of the Oxford Micron Advanced Bioimaging Unit supported by a Wellcome Trust Strategic Award (091911).This is the final version of the article. It first appeared from eLife via http://dx.doi.org/10.7554/eLife.0848

The Annuitization of Americans' Resources: A Cohort Analysis

This paper constructs a unique cohort data set to study the changes since 1960 in the share of Americans' resources that are annuitized. Understanding these changes is important because the larger this share, the more cohorts are likely to consume and the less they are likely to bequeath. Hence, the degree of annuitization affects national saving as well as the transmission of inequality over time. Our findings are striking. Although the annuitized share of resources of younger Americans declined slightly between 1960 and 1990, it increased dramatically for older Americans. It doubled for older men and quadrupled for older women. Since the elderly have much higher mortality probabilities than do the young, their degree of annuitization is much more important for aggregate bequests and saving. According to our estimates, aggregate U.S. bequests would now be 66 percent larger had the post-1960 increase in annuitization not occurred. In addition, U.S. national saving would likely be substantially larger than is currently the case.

The Increasing Annuitization of the Elderly- Estimates and Implications for Intergenerational Tranfers, Inequality, and National Saving

This paper examines changes over time in the degree to which the resources (human plus nonhuman wealth) of the elderly have been annuitized. Using data from the 1962 and 1983 Federal Reserve Surveys of Consumer Finances we find evidence of an increase in annuitization which is particularly pronounced among the older elderly (those over 75) and among women. The estimated 1983 flow of aggregate bequests to children and grandchildren would have been 20% larger were it not for this increase in annuitization. The change in annuitization may have contributed significantly to the recent decline of the U.S. national saving rate.

Digital pathways in community museums

This research was supported by the European Commission, grant agreement number 693669In this article, we investigate the positive impact recent developments in digital technologies have on the relations between museums, their collections and the communities they serve. Our work indicates that sustainable benefit is produced with the use of existing digital literacies and infrastructures. We have analysed and evaluated the potential of emergent 3D and spherical technologies on the relationships between community and museum, participation in the formation of heritage, the ‘visit’ to the museum, and connection with remote audiences. The evaluation arises from our long term experience in working with community museums and through a series of workshops developed for the project entitled ‘Museums and Community: Concepts, experiences, and sustainability in Europe, Latin America and the Caribbean’ (‐‐). Firstly, we contextualise the work presented by examining community museums, trends in emergent technologies and the advancements in digital heritage. Secondly, we analyse the methodologies used to design and execute the elements of the workshops, along with assess case studies to demonstrate distinctive experiences and outcomes particular to each workshop. We also describe how we constructed and implemented a novel design for a cost effective Virtual Museum Infrastructure (), which makes it simpler for communities to create a virtual museum and connect it with global museum networks. Our aim is to communicate our findings in relation to methodologies, workflows and technologies that will be of value in understanding how to overcome the challenges emergent technologies present but yet have the potential to strengthen both community and museum.Publisher PDFPeer reviewe