How Much Does Churning in Medi-Cal Cost?

Looks at how the instability of children's enrollment in Medi-Cal affects the quality of health care they receive. Explores the cost inefficiencies involved with processing and re-processing the same eligible children

Stability and Churning in Medi-Cal and Healthy Families

This report examines enrollment patterns and gaps overall and for specific groups within Medi-Cal and Healthy Families, as well as medical costs after a gap. We use this information to examine the possible effect of the Governor's plan to reinstate Quarterly Status Reports in Medi-Cal. Highlights include:Overall, approximately 50% of newly enrolled children "survive" after 21 months of enrollment in both Medi-Cal and Healthy Families;The sharpest drop in enrollment is seen at the 12-month renewal point, especially for children in Healthy Families and those in the 1931(B) and children's percent programs in Medi-Cal;For children in other Medi-Cal -- especially those who are also receiving food stamps or cash assistance -- the drop is more gradual over time. These families need to renew more frequently to maintain the other social supports and thus, stay in closer touch with county assistance agencies.More frequent renewals will hit hardest children in the 1931(b) and percent programs of Medi-Cal. It is likely that half the children in these programs will be dropped at every renewal period.These families are teetering on the brink of poverty, are likely to be affected by an economic downturn, and may need the support health coverage offers for their children.Costs of medical care are substantially higher immediately after a gap. The longer the gap, the higher the cost afterwards.In Medi-Cal, it is likely that costs saved in the short-term by reducing enrollment using Quarterly Status Reports will be offset by pent up needs later on (or transferred to the safety net in the shorter term)

Problem-driven scenario generation: an analytical approach for stochastic programs with tail risk measure

Scenario generation is the construction of a discrete random vector to represent parameters of uncertain values in a stochastic program. Most approaches to scenario generation are distribution-driven, that is, they attempt to construct a random vector which captures well in a probabilistic sense the uncertainty. On the other hand, a problem-driven approach may be able to exploit the structure of a problem to provide a more concise representation of the uncertainty. In this paper we propose an analytic approach to problem-driven scenario generation. This approach applies to stochastic programs where a tail risk measure, such as conditional value-at-risk, is applied to a loss function. Since tail risk measures only depend on the upper tail of a distribution, standard methods of scenario generation, which typically spread their scenarios evenly across the support of the random vector, struggle to adequately represent tail risk. Our scenario generation approach works by targeting the construction of scenarios in areas of the distribution corresponding to the tails of the loss distributions. We provide conditions under which our approach is consistent with sampling, and as proof-of-concept demonstrate how our approach could be applied to two classes of problem, namely network design and portfolio selection. Numerical tests on the portfolio selection problem demonstrate that our approach yields better and more stable solutions compared to standard Monte Carlo sampling

Implementation Choices for the Children's Health Insurance Program Reauthorization Act of 2009

Synthesizes policy analyses and discussions with experts of provisions in the Children's Health Insurance Program Reauthorization Act to strengthen outreach and enrollment and improve quality of care. Recommends steps to ensure effective implementation

When Will People Pay to Pollute? Environmental Taxes, Political Trust, and Experimental Evidence from Britain

Previous studies have argued that political trust shapes public opinion with respect to policies for environmental protection, but this paper provides the first evidence that the relationship is causal. The paper presents results from survey experiments investigating conditions under which Britons are willing to pay taxes on polluting activities. Public willingness to pay increases sharply if new environmental taxes are offset by cuts to other kinds of taxes, but political distrust undermines much of the effect of this revenue-neutrality. People are also no more willing if revenues are hypothecated for spending on environmental protection, while making such taxes more tangible to people—by naming petrol and electricity as specific products to which they will apply—has a modestly negative effect

Success for pacific learners : the impact of tertiary education strategies

This project examined the impact of the 3 successive tertiary education strategies (2002-2007; 2007-2012 and 2010-2015) on how tertiary education institutions have developed their support for Pacific learners. Findings show that the Pasifika objectives within each of the 3 strategies are considered to be an important signal to Tertiary Education Institutions (TEIs) that success for Pasifika learners is a significant and continuing government priority and that the strategies are seen as an important enabler of change. These objectives have raised the priority for action to support Pasifika learners, unlocked resources for Pasifika initiatives and promoted the inclusion of Pasifika priorities on the strategic agendas of TEIs. It was noted however, this influence is only one of a number of internal and external, and local and national influences on enhancing success for Pasifika learners

The Spontaneous Decomposition of Ammonium Chlorate

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