How Care Is Managed: A Descriptive Study of Current and Future Trends in Care and Cost Management Practices Under Private Sector Employee Benefit Plans

In the fall of 2001, the United States Department of Health and Human Services\u27 Office of the Assistant Secretary for Planning and Evaluation (ASPE) asked the Center for Health Services Research and Policy in the School of Public Health and Health Services, The George Washington University Medical Center, to undertake a descriptive study of the current and future trends in cost and care management techniques used in the employment-based health insurance marketplace. The purpose of this study was to identify and report on (1) the cost and care management techniques currently in use in the private sector by health plans and employers, and (2) what, in the view of experts, were the likely future trends. The research team was asked to perform this descriptive study by interviewing experts in field. As part of the study, the Center was also asked to conduct a review of the literature concerning current cost and care management approaches used by managed care plans and employers in the private sector, with a focus on non-peer reviewed articles in trade journals and the popular press. Since the focus of this study was private sector purchasers, we were asked to exclude literature regarding cost and care management techniques used in the Medicaid and Medicare programs

Health Coverage in Massachusetts: Far to Go, Farther to Fall

This analysis has been prepared to highlight the state\u27s experience in health reform and describe the challenges that it now faces. It recommends a renewed commitment to maintaining and strengthening the reforms that have made Massachusetts one of the nation\u27s health policy leaders. This analysis does not focus on comprehensive health reform, although we believe that the cost and coverage problems that plague the Massachusetts health system (as well as that of every other state) would be most effectively addressed through broader restructuring aimed at achieving universal coverage and more decisive control over expenditures. In this report, we instead focus on shorter term reforms that can be achieved both politically and financially, which would offer important protections to the residents who most need the help

Mothering on crack cocaine: A grounded theory analysis

Mothers who use crack cocaine are commonly believed to be selfish, uncaring, and neglectful of their children. For this paper, the grounded theory method was used to analyze 68 semi-structured depth interviews with cocaine-using mothers. These women's views of motherhood, the strategies they used to manage mothering on cocaine, and the contextual influences on mothering outcomes were explored. Contrary to popular assumptions, the women highly valued motherhood and held firm standards for childrearing. Mothers were concerned about the possible risks to their children and used a process of defensive compensation to protect both their children and their maternal identities from the negative influences of crack cocaine. When unable to fulfil their maternal responsibilities by other means, some mothers placed their children with family members, and others lost custody involuntarily. When children were forcibly removed, mothers often increased their drug use to cope with the loss. Social and economic conditions influenced the outcomes of mothering on crack.women crack cocaine mothering grounded theory