Eliminating the Individual Mandate: Effects on Premiums, Coverage, and Uncompensated Care

Outlines how removing the requirement to buy health insurance could affect coverage; government, employer, individual, and uncompensated spending; premiums; subsidies in the exchange; and Medicaid and Children's Health Insurance Program enrollment

Consider Savings as Well as Costs

Estimates 2014-19 state and federal spending and savings on Medicaid and Children's Health Insurance Programs as a result of the 2010 healthcare reform, including reductions in spending on uncompensated care. Considers factors in differences by state

Health Reform Across the States: Increased Insurance Coverage and Federal Spending on the Exchanges and Medicaid

Estimates state-by-state effects of healthcare reform, including variations by state in the impact on uninsurance rates, exchange subsidies, Medicaid enrollees, and federal spending. Analyzes state characteristics contributing to the variations

Assessment of Balance in Collegiate Cheerleaders: Is Implementing a Balance Training Program a Good Idea?

Cheerleading has evolved immensely over the years. Gone are the days of simply shaking pom poms and yelling GO TEAM! Flips, twists, and prime athletic ability are what can be seen on the sidelines of any collegiate football or basketball game. Cheerleaders in general are assumed to have an above average level of balance, due to the nature of their training and sport. However, with these new skills comes the increasing risk for injury, and this risk may differ according to a cheerleader\u27s position. As with any sport, cheerleading has specific positions. The cheerleaders that are put into the air are called flyers. Flyers (F) are responsible for standing in the hands of the cheerleaders below them while maintaining a tight, controlled posture. Bases (B) are responsible for lifting flyers into the air, supporting them, and returning them back to the ground safely. Collegiate cheerleaders are frequently exposed to lower limb injuries, such as ankle sprains, torn ligaments, etc. Since balance is an essential skill in cheerleading, balance performance may be an issue to consider for potential injury prevention programs of collegiate cheerleaders

Assessment of Balance in Collegiate Cheerleaders: Is Implementing a Balance Training Program a Good Idea?

Due to the nature of the activity, competitive cheerleaders are susceptible to falls, which can lead to injury. However, cheerleaders that get put into the air ( flyers ), may have better balance ability as compared to those that hold or support flyers ( bases ). However, no previous research could be located comparing balance ability and fall risk between these positions. The purpose of this study was to assess balance ability and fall risk in female, collegiate cheerleaders. It was found that within the past year, 63.6% of cheerleaders experienced a fall, while 45% reported lower extremity injuries due to participation in their sport. Our data indicate that both positions are at high risk for falls, despite flyers having significantly lower fall risk than bases. The data also indicate that fall risk is related to recent injury and indices of leg strength. This suggests that conditioning programs should also focus on balance ability along with muscle strength

Use of Assessments in Occupational Therapy Physical Disability Settings

Background: The aim of this study is to evaluate occupational therapists’ (OTs) perceptions and use of informal observation and formal assessments in order to understand if differences exist between acute care and non-acute care occupational therapy (OT) adult physical disability settings. Non-acute settings may include but are not limited to home health, inpatient rehabilitation, transitional care, outpatient rehabilitation, and long term care. Methods: Study design involved a nonexperimental survey. Qualtrics software was utilized to disseminate the survey across a five-state region to the population under study. Response rate included 88 OTs who answered consistently to the questions analyzed. Data analyses utilizing Statistical Package for the Social Sciences (SPSS) Statistics 23 was then conducted. Findings: OTs in both types of settings utilize informal observations more often compared to formal assessments. However, the acute care setting was found to have used informal assessments 17% more of the time. A positive relationship exists between increasing years of experience and feelings of validity and ease of use of informal observations. Trends were recognized in the number of years spent in OT practice regarding use of assessments. Conclusion: Findings enhance understanding of OT practice in acute care as compared to other adult physical disability settings in regards to the use of assessments. Implications involve the incorporation of teaching concepts of informal observations to the OT curriculum as well as enhancing future practitioners’ understandings of validity and reliability. The findings highlight the need for the development of formal assessments that consider the constraints of practice environments in order to enable their use. Implications for future study involve further investigation on the impact of years of experience in assessment use as well as additional studies to enhance understanding of occupational therapy in acute care

House Republican Budget Plan: State-by-State Impact of Changes in Medicaid Financing

Estimates how the April 2011 Budget Plan passed by the House of Representatives would affect federal Medicaid funding for states between 2012 and 2021 and how in turn this would affect Medicaid spending and enrollment and hospitals under three scenarios

Recommendations for a ‘Wellbeing Curriculum’ to Mitigate Undergraduate Psychological Distress Associated with Lack of Careers Confidence and Poor University Engagement

To foster a ‘wellbeing curriculum’ in a climate with an increasingly competitive graduate jobs market, we believe it is critical to support undergraduate career development and to develop positive peer and educator relationships, particularly for non vocational degree programs. However, these relationships between undergraduate wellbeing and their career development or peer/educator relationships have not been specifically examined. This study used a mixed methods approach to examine if poor career development or university engagement (quality of relationships with peers or educators, use of the university careers and counselling services, time studying) were associated with psychological distress for students in non vocational degree programs. Undergraduates (biomedical science; n=1100) from five Australian universities participated in a survey to investigate relationships between psychological distress, as determined by their responses to the Depression, Anxiety and Stress Scales, and their career development or university engagement. Almost half of the students lacked confidence in their ‘future employment and job prospects’. Students’ psychological distress was significantly correlated with lack of confidence with their career development, poor relationships with their peers and educators and little use of the counselling service. Further exploration of these factors in student focus groups highlighted stress associated with academic competition between students and a critical need for undergraduate career development, especially industry placements. We provide pivotal recommendations to promote undergraduate and educator wellbeing, by developing a ‘wellbeing curriculum’ that supports career development and positive relationships between students and their peers and educators, particularly vital for non vocational degrees

Review: Delivering mental health support within schools and colleges – a thematic synthesis of barriers and facilitators to implementation of indicated psychological interventions for adolescents

Background: Increasing the role of schools and colleges in the provision of mental health services for young people has the potential to improve early intervention and access to treatment. We aimed to understand what factors influence the successful implementation of indicated psychological interventions within schools and colleges to help guide increased provision of mental health support within education settings. Methods: Systematic search for studies that have reported barriers or facilitators to the implementation of indicated interventions for adolescent emotional disorders delivered within schools and further education/sixth form colleges (CRD42018102830). Databases searched were EMBASE, MEDLINE, PsycINFO, CINAHL, British Nursing Index, ASSIA, ERIC and British Education Index. A thematic synthesis of factors reported to impact implementation was conducted. Results: Two thousand five hundred and sixty-nine records and 177 full texts were screened. Fifty studies were identified for inclusion, all of which were of school-based interventions. Eleven analytic themes were developed encompassing intervention characteristics, organisational capacity, training and technical assistance, provider characteristics and community-level factors. Findings indicate the need to select appropriate interventions, consider logistical challenges of the school context and provide training and supervision to enable staff to deliver interventions with fidelity. However, structural and environmental support is required for these facilitators to have the greatest impact on successful implementation. Conclusions: Implementing indicated school-based mental health interventions is challenging. Those involved in planning school-based mental health initiatives must be alert to the impact of factors on multiple interacting levels. There is a lack of research on implementing mental health support within further education and sixth form colleges

Vermont Hospitals\u27 Emergency Department Utilization Charges by Insurance Payer

Objective: To identify the differences in emergency department (ED) charges across all insurance payers and to evaluate ED charges for Medicaid beneficiaries over time. Methods: The Vermont Department of Health\u27s publicly-available Hospital Discharge Data Set (HDD) data for 2012, 2014 and 2016 was analyzed by insurance group and year, as predictor variables, with age and sex as covariates. The primary outcome variable was total charges as a binary variable. Results: Medicare cases had the greatest odds of high total charge visits. The odds of Medicare records having high total charges were 65.0% greater than the odds of Medicaid records having high total charges, holding age group and sex constant. For records representing Medicaid beneficiaries, the odds of high total charges in 2012 and 2014 were 41.1% and 22.3% lower, respectively, than the odds of high total charges in 2016, holding rurality, age, and sex constant. Conclusions: Medicare cases had the greatest odds of being classified as high total charge visits. The odds of Medicaid cases producing high total charges increased during each period from 2012 to 2016