Early Implementation of Pre-Existing Condition Insurance Plans: Providing an Interim Safety Net for the Uninsurable

Outlines enrollment trends and enrollee traits in a temporary program designed to provide affordable coverage to the uninsured with preexisting conditions, changes to structures and premiums, and estimated out-of-pocket costs by utilization and plan type

The Lived Experiences of Black Women Tenured and Tenure-Track Faculty in Business Schools at Predominantly White Institutions

Changing college-student demographics and the diversification of higher education requires an understanding of Black women’s experiences. Their visibility adds value to all higher education stakeholders and mobilizes students of color beyond the margins (Hasnas, 2018; Vargas, 1999). Researchers reported that Black women faculty have trouble offering the academy their unique perspectives due to isolation and tokenism (Diggs, Garrison-Wade, Estrada, & Galindo, 2009; Niemann, 2016). As a result, a further exploration of their experiences and a further examination of their perspectives are necessary from their points of view. While an abundance of research is available on the lived experiences of Black women faculty at predominantly White institutions (Alfred, 2001; Gregory, 2001; Hinton, 2010; Jones, Hwang, & Bustamante, 2015), limited research has examined the business education context (Toubiana, 2014). The current study illuminated the voices of Black women tenured and tenure-track faculty in business schools at predominantly White institutions. This critical, phenomenological qualitative research study had a twofold purpose. First, it explored the lived experiences of Black women tenured and tenure-track faculty in business schools at predominantly White institutions through the framework of Black feminist thought. This lens captured study participants’ collective voice while acknowledging the diverse perspectives of individuals whose standpoints are not often illuminated (Collins, 1990, 2000, 2016). Secondly, this research offered institutional and business-education stakeholders—such as deans, department heads, and the Association to Advance Collegiate Schools of Business (AACSB)—greater awareness and recommendations to support Black women faculty’s recruitment, retention, and overall success. Keywords: Black, Black feminist thought, faculty, intersectionality, predominantly White institution, professor, tenured, tenure-track, woma

Improving Central Venous Catheter Infection Rates Through The Use of A Bundle: An Integrative Review

The role of Central Venous Catheters (CVC) is significant for the End-Stage Renal Disease (ESRD) population. The placement of the CVC for a HD (HD) patient is not only necessary, but life-sustaining. CVCs are usually placed for an emergent HD treatment, while awaiting a permanently placed arteriovenous fistula or graft (AVF/AVG), or when the permanent access becomes non-functioning. There are multiple risk factors related to having a CVC placed, the most predominant complication being catheter line-associated bloodstream infections (CLABSIs). Studies have shown that implementing a CVC prevention bundle was associated with a significant reduction in the CLABSI rates within the HD population. Implementing and examining the efficacy of best evidence-based practices to determine whether infection rates decrease in the ESRD population with a prevention bundle intervention, was the aim of this integrative review. Having the ability to control infection in ESRD patients is a challenging task for healthcare providers, especially because catheters are often manipulated during HD treatments, and ESRD patients are already immunocompromised

The Kansas Demonstration to Maintain Independence and Employment: Preventing or Forestalling Disability Among Participants in the Kansas High Risk Insurance Pool

Section 204 of TWWIIA authorized the development of another program targeted at disability prevention. Demonstrations to Maintain Independence and Employment (DMIEs) provide health care coverage to working people iwth potentially disabling conditions to test the hypothesis that providing health care and other supports can prevent or forestall the onset of full disability and eventual dependence on federal disability program

Historical Disability Outcomes of Enrollees in the Kansas High Risk Pool: A White Paper presented to CMS by the Kansas DMIE Project January, 2006

This white paper reports the historical rates of disability outcomes (e.g., transition to Social Security disability status) for people enrolled in Kansas' state high-risk health insurance pool.Centers for Medicare & Medicaid Services; Kansas Health Policy Authorit

Qualitative exploration of the nature of grief-related beliefs and expectations

Societal expectations of grief impact the experience of bereavement. The congruence of societal expectations with current scientific understanding of grief is unknown. Therefore two qualitative studies explored community perceptions of grief. In study one, three small focus groups (N = 9) examined grief-related expectations associated with hypothetical scenarios of bereavement. In study two, the impact of grief-related perceptions on the lived experience of bereavement for 11 individuals was explored through semi-structured interviews. Across both studies, elements of a traditional stage model view of grief were evident, with participants viewing emotional expression of grief as important. An avoidant coping style in the bereaved was considered problematic. Findings of study two suggested that grief-related beliefs may impact the bereavement experience via appraisal of the grief response and willingness to support bereaved individuals. The studies suggested that stage model assumptions in the beliefs of the general population persist, although there was a recognition of diversity in the grief response.<br /

Transition to Medicare Part D: An Early Snapshot of Barriers Experienced by Younger Dual Eligibles With Disabilities

Transition to Medicare Part D affected not only 35.4 million elderly enrollees but also 6.4 million younger enrollees with disabilities, 2.5 million of whom have low incomes and previously obtained medications through Medicaid. Because Part D was conceived primarily as a benefit for elders, we sought to examine its effects on a dually eligible, younger group of beneficiaries who have significantly different, more expensive, and often unstable health conditions

Health Care Behaviors and Decision-Making Processes Among Enrollees In A State High Risk Insurance Pool: Focus Group Findings

Purpose-To better understand the relationship between health insurance coverage and health care behaviors of persons with potentially disabling conditions enrolled in a state high risk insurance pool. Approach or Design-Six focus groups with risk pool enrollees in two sites. Setting-Suburban areas in the state of Kansas. Participants-Forty-two individuals ages 29 to 62 years, all with potentially disabling physical or mental health conditions. Method-Qualitative analysis of focus group transcripts using pile sorting and theme identification. Results-High premiums and deductibles limit participants’ ability to afford basic health services and access to prescription medications despite their middle-class socioeconomic status. Participants report delaying or forgoing needed medical care due to lack of coverage and/or out-of-pocket costs. They employ numerous and potentially dangerous strategies to minimize costs, especially for prescription medications. Some report “saving up” needed procedures until their total costs will exceed that year’s deductible. Conclusion-Individuals in the risk pool were making medical decisions on the basis of cost rather than need. Many shared stories of medical complications as a result of delayed care and most expressed stress related to the difficulty of making decisions about their care and use of prescribed medications. The individual, nongroup insurance market, with its higher out-of-pocket costs, may not meet the needs of people with chronic health conditions.Kansas Health Policy Authority, U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (11-P-92389/7-01

Unintended Consequences: The Potential Impact of Medicare Part D on Dual Eligibles with Disabilities in Medicaid Work Incentive Programs

Common sense suggests that a safety net is required for situations in which enrollees are unable to obtain critical or life-sustaining medications. Such situations can arise when either the drug is not on formulary and/or is being used off-label and the appeals process has been exhausted, or when patients cannot afford the co-payments for the numerous medications they need. Given the vulnerability of this population, immediate action is needed to address these issues in the short time remaining before Part D is implemented

Preventing Disability Among Working Participants in Kansas’ High-risk Insurance Pool: Implications for Health Reform

Health conditions that prevent individuals from working full time can restrict their access to health insurance. For people living in the 35 states that offer high-risk pools, coverage is available but premiums are 125–200% of standard rates. Additionally, high cost-sharing means enrollees often defer needed care because they must pay large amounts out of pocket. Lack of access may lead to poor health outcomes and disability. The Kansas DMIE investigated whether improving insurance coverage for such a group would improve their health status and reduce their risk of transition to full Social Security disability. Half of the 508 participants received enhanced benefits and nurse case management, the other half received usual risk pool coverage. Outcomes were measured through telephone surveys, focus groups, and claims analysis. Utilization of services increased and health status stabilized for the intervention group, while health status of the control group significantly declined. These findings have broad implications because some plans to be offered under the Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) have similarly high out-of-pocket costs. Considering the long-term cost of full disability, providing adequate health insurance benefits for individuals at high risk of disability may be cost effective.Kansas Health Policy Authority, U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (no. 11-P-92389/7-01)