Reporting on Pathways to Health Insurance Coverage: California's Experience

The Affordable Care Act opened new and expanded pathways to public health insurance coverage. Since 2014, many states have broadened their eligibility criteria for Medicaid, and have introduced new access points for Medicaid enrollment. During this time, publicly subsidized health insurance coverage also became available through state health insurance exchanges and through the federal health insurance marketplace. Recognizing there is a great deal to learn about who applies for and obtains these types of public coverage, the federal government and some states have established new data reporting efforts on how people use both new and existing pathways to health insurance coverage. In 2014 and 2015, Mathematica Policy Research supported the launch of such a reporting effort in California, with funding from the California Health Care Foundation. In this brief, we describe California's experience in reporting on applications, eligibility determinations, enrollments and coverage renewals for public insurance, highlight some of the practical implications of California's first few reports, and offer lessons for other states that are launching comparable reporting efforts. Key Findings: The open enrollment period drives enrollment growth for both qualified health plans and Medi-Cal, even though Medi-Cal enrollment remains open year-round. Insurance coverage was more stable over time than expected. During the second open enrollment period, 92 percent of individuals enrolled in qualified health plans in California renewed their coverage from the previous year. During that same period about 80 percent of Medi-Cal beneficiaries remained eligible for coverage. California's experience with reporting on public insurance coverage suggests that significant effort is needed to carefully define measures, produce data that are meaningful to multiple audiences, and communicate findings clearly. Public data reporting can be a powerful tool for advancing transparency and identifying areas for improvement. State officials in California now have an opportunity to examine local variation in application and enrollment measures to identify policy or process differences that might be driving different outcomes across the state

Achieving Foundation Accountability and Transparency: Lessons From the Robert Wood Johnson Foundation’s \u3ci\u3eScorecard\u3c/i\u3e

· The purpose of this article is to help foundations in their accountability and transparency efforts by sharing lessons from one foundation’s journey to develop a scorecard. · A commitment to funding and sharing the results from rigorous evaluations set the tone for Robert Wood Johnson Foundation (RWJF) accountability. · The Scorecard is a powerful tool for RWJF to set goals, track organizational effectiveness, and motivate responses to shortcomings. · Foundations can tailor their scorecard to include what best serves their needs. · With its Scorecard, RWJF found that comparative and quantitative measures are the most powerful forces to motivate change. · Setting targets motivates staff to focus their efforts on certain areas and make improvements

A case report of vanishing bile duct syndrome after exposure to pexidartinib (PLX3397) and paclitaxel.

Pexidartinib (PLX3397) is a small molecule tyrosine kinase and colony-stimulating factor-1 inhibitor with FDA breakthrough therapy designation for tenosynovial giant-cell tumor, and currently under study in several other tumor types, including breast cancer, non-Hodgkin's lymphoma, and glioblastoma. Here, we report a case of severe drug-induced liver injury requiring liver transplantation due to vanishing bile duct syndrome (VBDS) after exposure to pexidartinib in the I-SPY 2 Trial, a phase 2 multicenter randomized neoadjuvant chemotherapy trial in patients with Stage II-III breast cancer. We also review the current literature on this rare, idiosyncratic, and potentially life-threatening entity

Effects of a short-term freeze on Sphagnum girgensohnii grown under different light-temperature regimes

During the short, snow-free growing seasons in the Arctic, sudden “cold snaps” or freeze thaw events (FTE) frequently occur when temperatures fall subzero for 24 to 72 h. Vascular plants exposed to FTE are often irreversibly damaged, but despite their importance, the responses of nonvascular plants to FTE have been little studied. I grew plants of Sphagnum girgensonhii under high and low light and temperature conditions to investigate whether pre-freeze conditions influence damage and recovery of this important moss species. Plants grown at low light and high temperature showed the greatest growth. Upon freezing they also showed irreversible physiological damage and the greatest reduction in growth. Furthermore, some growing conditions resulted in increased production of new branches that were lost during freezing. The findings of this study suggest that the responses of Sphagnum species to climate variation may be important for the structure of arctic plant communities

2016 ASC Bidding Competition – Commercial Building

Our group traveled to Reno Nevada to participate in the Associated Schools of Construction (ASC) annual bidding competition which took place from February 10th- 14th. The competition included teams from all over the western United States with many different categories for groups to participate in. The category that our group decided to participate in for our senior design project was commercial bidding. The commercial bidding category had a total of 12 teams competing on a bid estimate for Mortenson construction. The project, which we did not know anything about until arrival, was a multi-million dollar sporting complex addition that we only had 16 hours to prepare the bid for. Once the bid estimate and any documentation that was required was completed and turned in our group had to prepare a presentation for the judges who were all Mortenson employees that knew the project extremely well. In order to prepare for the completion we met weekly and worked on a practice bid estimate that we though would be similar to what we would be exposed to in Reno. The competition was a valuable experience to all group member as it gave us all practice for problems and scenarios that we may come across when we are out working in industry

Detecting Body Mass Index from a Facial Photograph in Lifestyle Intervention

This study aimed to identify whether a research participant’s body-mass index (BMI) can be correctly identified from their facial image (photograph) in order to improve data capturing in dissemination and implementation research. Facial BMI (fBMI) was measured using an algorithm formulated to identify points on each enrolled participant’s face from a photograph. Once facial landmarks were detected, distances and ratios between them were computed to characterize facial fatness. A regression function was then used to represent the relationship between facial measures and BMI values to then calculate fBMI from each photo image. Simultaneously, BMI was physically measured (mBMI) by trained researchers, calculated as weight in kilograms divided by height in meters squared (adult BMI). Correlation analysis of fBMI to mBMI (n = 1210) showed significant correlation between fBMI and BMIs in normal and overweight categories (p \u3c 0.0001). Further analysis indicated fBMI to be less accurate in underweight and obese participants. Matched pair data for each individual indicated that fBMI identified participant BMI an average of 0.4212 less than mBMI (p \u3c 0.0007). Contingency table analysis found 109 participants in the ‘obese’ category of mBMI were positioned into a lower category for fBMI. Facial imagery is a viable measure for dissemination of human research; however, further testing to sensitize fBMI measures for underweight and obese individuals are necessary

Patellar Tendonopathy in Collegiate Volleyball Athletes

Purpose: The first purpose was to identify the prevalence of patellar tendon abnormality in female collegiate volleyball players. The second purpose was to identify a potential association between kinetic measures during the drop vertical jump between those with tendon abnormality and those without in female collegiate volleyball athlete

Benefits, barriers, self-efficacy and knowledge regarding healthy foods; perception of African Americans living in eastern North Carolina

African Americans in the United States suffer from many health disparities such as obesity, diabetes or hypertension. Lifestyle factors including diet and physical activity play an important role in prevention of these health conditions. The purpose of this research project was to assess beliefs, barriers and self-efficacy of eating a healthy diet and self efficacy of shopping for foods such as whole grains or foods designated as low fat or low sodium. Additionally, the objective was to assess beliefs about healthfulness, appropriate consumption, and protective aspect of specific foods including fruits, vegetables, and whole grains. The assessment was done using a survey instrument developed for this study. Data collection took place at two church locations. Data were obtained from 57 African Americans, mean age 50 years old (SD 12.70) completed the survey. The majority of respondents (58.1%) were females and most (75%) had at least some college education. Generally, benefits of eating healthy foods received considerably higher scores compared to barriers of eating healthy. A belief that healthy foods would help to take care of one's body received the highest mean score while a belief that healthy foods are too expensive had the highest score from all barriers. The results showed high self-efficacy of eating and purchasing healthy foods, high awareness of knowledge regarding foods associated with disease prevention but low awareness of recommendations for fruits and vegetables. The high scores for benefits, self-efficacy and knowledge regarding eating healthy foods did not translate into the perception of intake of such foods. Most participants believed that they do not eat enough of healthy foods. Interventions design to help African Americans make dietary changes should be culturally relevant and should involved working on a community level utilizing messages that are familiar and relevant to African Americans

Can Preseason Performance Tests Discriminate Injury Risk in Female Collegiate Volleyball Players

Purpose: Prior research has demonstrated a 4-fold greater risk of a non-contact time-loss lower quadrant injury in collegiate female VB players (3). The purpose of this study was to validate effectiveness of functional performance tests to discriminate injury risk in female collegiate volleyball players