Science.gov

Sample records for state payer mandates

  1. Mandated State-Level Open Government Training Programs

    ERIC Educational Resources Information Center

    Kimball, Michele Bush

    2011-01-01

    Although every state in the country has recognized the importance of government transparency by enacting open government provisions, few of those statutes require training programs to encourage records custodians to comply with the law. Ten states mandate training in how to legally respond to public records requests, and some mandates are stronger…

  2. Assessing early implementation of state autism insurance mandates.

    PubMed

    Baller, Julia Berlin; Barry, Colleen L; Shea, Kathleen; Walker, Megan M; Ouellette, Rachel; Mandell, David S

    2016-10-01

    In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined five states' experiences implementing autism insurance mandates. Semi-structured, key-informant interviews were conducted with 17 participants representing consumer advocacy organizations, provider organizations, and health insurance companies. Overall, participants thought that the mandates substantially affected the delivery of autism services. While access to autism treatment services has increased as a result of implementation of state mandates, states have struggled to keep up with the demand for services. Participants provided specific information about barriers and facilitators to meeting this demand. Understanding of key informants' perceptions about states' experiences implementing autism insurance mandates is useful for other states considering adopting or expanding mandates or other policies to expand access to autism treatment services.

  3. Assessing early implementation of state autism insurance mandates

    PubMed Central

    Baller, Julia Berlin; Barry, Colleen L; Shea, Kathleen; Walker, Megan M; Ouellette, Rachel; Mandell, David S

    2016-01-01

    In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined five states’ experiences implementing autism insurance mandates. Semi-structured, key-informant interviews were conducted with 17 participants representing consumer advocacy organizations, provider organizations, and health insurance companies. Overall, participants thought that the mandates substantially affected the delivery of autism services. While access to autism treatment services has increased as a result of implementation of state mandates, states have struggled to keep up with the demand for services. Participants provided specific information about barriers and facilitators to meeting this demand. Understanding of key informants’ perceptions about states’ experiences implementing autism insurance mandates is useful for other states considering adopting or expanding mandates or other policies to expand access to autism treatment services. PMID:26614401

  4. THE EFFECT OF STATE INSURANCE MANDATES ON INFANT IMMUNIZATION RATES.

    PubMed

    Chang, Lenisa V

    2016-03-01

    While US infant immunization rates have been increasing in the last 20 years, the cost of fully immunizing a child with all recommended vaccines has almost tripled. This is partly not only due to new additions in the list of recommended vaccines but also due to the use of new, safer, but more expensive technologies in vaccine production and distribution. In recent years, many states have mandated that recommended childhood vaccines be covered by private health insurance companies. Currently, there are 33 states with such a mandate. In this paper, I examine whether the introduction of mandates on private insurers affected immunization rates. Using state and time variation, I find that mandates increased the immunization rate for three vaccines--the diphtheria-tetanus-pertussis, polio, and measles-mumps-rubella vaccines--by about 1.8 percentage points. These results may provide a lower bound for the expected effect of the Affordable Care Act, which mandates coverage of childhood vaccines for all private insurers in the USA. I also find evidence that the mandates shifted a significant portion of vaccinations from publicly funded sources to private ones, with a decline in public health clinic visits and an increase in vaccinations at hospitals and doctor's offices. PMID:25773053

  5. Assessing Early Implementation of State Autism Insurance Mandates

    ERIC Educational Resources Information Center

    Baller, Julia Berlin; Barry, Colleen L.; Shea, Kathleen; Walker, Megan M.; Ouellette, Rachel; Mandell, David S.

    2016-01-01

    In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined…

  6. Certified School Nurse Perspectives on State-Mandated Hearing Screens

    ERIC Educational Resources Information Center

    Sekhar, Deepa L.; Beiler, Jessica S.; Schaefer, Eric W.; Henning, Antoinette; Dillon, Judith F.; Czarnecki, Beth; Zalewski, Thomas R.

    2016-01-01

    Background: Approximately 15% of children in the United States 6-19 years of age have hearing loss. Even mild, unilateral hearing loss may adversely affect educational success. In 2014, the Pennsylvania Department of Health (PA DOH) began updating the 2001 regulations on state-mandated school hearing screens. To inform the updates, a needs…

  7. Retention as a State Policy Mandate: IREAD in Indiana

    ERIC Educational Resources Information Center

    Stubbs, Velinda F.

    2013-01-01

    The interpretation of Indiana Public Law 109 and subsequent policy adopted by the Indiana Department of Education resulted in the Indiana State Board of Education mandating circumstances implemented during the 2011-2012 school year regarding grade level retention of Grade 3 students. IREAD-3, a standardized, gateway assessment, was administered to…

  8. Do States Have the Capacity to Meet the NCLB Mandates?

    ERIC Educational Resources Information Center

    Sunderman, Gail L.; Orfield, Gary

    2007-01-01

    The states have always been central to the American public school systems, and they have been sharply expanding their authority over local school districts since the 1980s, when they adopted education reforms that increased course requirements (especially in science and math), mandated uniform testing, and put in place higher teaching standards. A…

  9. New evidence on the effects of state mental health mandates.

    PubMed

    Busch, Susan H; Barry, Colleen L

    2008-01-01

    State mental health parity laws improve equity in private insurance coverage for mental and physical health services, but prior research shows no effect on service use. We study whether state parity differentially affects individuals by employer size since large firms are often exempt from state health mandates due to the Employee Retirement Income Security Act. We also examine whether state parity laws differentially affect use among individuals with low incomes or in poor mental health. We find that individuals in smaller firms are more likely to use services post-parity implementation and that this effect is concentrated among low-income individuals.

  10. The Little State That Couldn't Could? The Politics of "Single-Payer" Health Coverage in Vermont.

    PubMed

    Fox, Ashley M; Blanchet, Nathan J

    2015-06-01

    In May 2011, a year after the passage of the Affordable Care Act (ACA), Vermont became the first state to lay the groundwork for a single-payer health care system, known as Green Mountain Care. What can other states learn from the Vermont experience? This article summarizes the findings from interviews with nearly 120 stakeholders as part of a study to inform the design of the health reform legislation. Comparing Vermont's failed effort to adopt single-payer legislation in 1994 to present efforts, we find that Vermont faced similar challenges but greater opportunities in 2010 that enabled reform. A closely contested gubernatorial election and a progressive social movement opened a window of opportunity to advance legislation to design three comprehensive health reform options for legislative consideration. With a unified Democratic government under the leadership of a single-payer proponent, a high-profile policy proposal, and relatively weak opposition, a framework for a single-payer system was adopted by the legislature - though with many details and political battles to be fought in the future. Other states looking to reform their health systems more comprehensively than national reform can learn from Vermont's design and political strategy. PMID:25700374

  11. The Little State That Couldn't Could? The Politics of "Single-Payer" Health Coverage in Vermont.

    PubMed

    Fox, Ashley M; Blanchet, Nathan J

    2015-06-01

    In May 2011, a year after the passage of the Affordable Care Act (ACA), Vermont became the first state to lay the groundwork for a single-payer health care system, known as Green Mountain Care. What can other states learn from the Vermont experience? This article summarizes the findings from interviews with nearly 120 stakeholders as part of a study to inform the design of the health reform legislation. Comparing Vermont's failed effort to adopt single-payer legislation in 1994 to present efforts, we find that Vermont faced similar challenges but greater opportunities in 2010 that enabled reform. A closely contested gubernatorial election and a progressive social movement opened a window of opportunity to advance legislation to design three comprehensive health reform options for legislative consideration. With a unified Democratic government under the leadership of a single-payer proponent, a high-profile policy proposal, and relatively weak opposition, a framework for a single-payer system was adopted by the legislature - though with many details and political battles to be fought in the future. Other states looking to reform their health systems more comprehensively than national reform can learn from Vermont's design and political strategy.

  12. State Law Mandates for Reporting of Healthcare-Associated Clostridium difficile Infections in Hospitals

    PubMed Central

    Reagan, Julie; Herzig, Carolyn T.A.; Pogorzelska-Maziarz, Monika; Dick, Andrew W.; Stone, Patricia W.; Divya Srinath, JD

    2015-01-01

    US state and territorial laws were reviewed to identify Clostridium difficile infection reporting mandates. Twenty states require reporting either under state law or by incorporating federal Centers for Medicare & Medicaid Services' reporting requirements. Although state law mandates are more common, the incorporation of federal reporting requirements has been increasing. PMID:25695178

  13. State law mandates for reporting of healthcare-associated Clostridium difficile infections in hospitals.

    PubMed

    Reagan, Julie; Herzig, Carolyn T A; Pogorzelska-Maziarz, Monika; Dick, Andrew W; Stone, Patricia W; Divya Srinath, Jd

    2015-03-01

    US state and territorial laws were reviewed to identify Clostridium difficile infection reporting mandates. Twenty states require reporting either under state law or by incorporating federal Centers for Medicare & Medicaid Services' reporting requirements. Although state law mandates are more common, the incorporation of federal reporting requirements has been increasing.

  14. Effect of state-mandated insurance coverage on accrual to community cancer clinical trials.

    PubMed

    Ellis, Shellie D; Carpenter, William R; Minasian, Lori M; Weiner, Bryan J

    2012-09-01

    Thirty-five U.S. states and territories have implemented policies requiring insurers to cover patient care costs in the context of cancer clinical trials; however, evidence of the effectiveness of these policies is limited. This study assesses the impact of state insurance mandates on clinical trial accrual among community-based practices participating in the NCI Community Clinical Oncology Program (CCOP), which enrolls approximately one-third of all NCI cancer trial participants. We analyzed CCOP clinical trial enrollment over 17 years in 37 states, 14 of which implemented coverage policies, using fixed effects least squares regression to estimate the effect of state policies on trial accrual among community providers, controlling for state and CCOP differences in capacity to recruit. Of 91 CCOPs active during this time, 28 were directly affected by coverage mandates. Average recruitment per CCOP between 1991 and 2007 was 95.1 participants per year (SD=55.8). CCOPs in states with a mandate recruited similar numbers of participants compared to states without a mandate. In multivariable analysis, treatment trial accrual among CCOPs in states that had implemented a coverage mandate, was not statistically different than accrual among CCOPs in states that did not implement a coverage mandate (β=2.95, p=0.681). State mandates did not appear to confer a benefit in terms of CCOP clinical trial accrual. State policies vary in strength, which may have diluted their effect on accrual. Nonetheless, policy mandates alone may not have a meaningful impact on participation in clinical trials in these states.

  15. The impact of health insurance mandates on drug innovation: evidence from the United States.

    PubMed

    Chun, Natalie; Park, Minjung

    2013-04-01

    An important health policy issue is the low rate of patient enrollment into clinical trials, which may slow down the process of clinical trials and discourage their supply, leading to delays in innovative life-saving drug treatments reaching the general population. In the US, patients' cost of participating in a clinical trial is considered to be a major barrier to patient enrollment. In order to reduce this barrier, some states in the US have implemented policies requiring health insurers to cover routine care costs for patients enrolled in clinical trials. This paper evaluates empirically how effective these policies were in increasing the supply of clinical trials and speeding up their completion, using data on cancer clinical trials initiated in the US between 2001 and 2007. Our analysis indicates that the policies did not lead to an increased supply in the number of clinical trials conducted in mandate states compared to non-mandate states. However, we find some evidence that once clinical trials are initiated, they are more likely to finish their patient recruitment in a timely manner in mandate states than in non-mandate states. As a result, the overall length to completion was significantly shorter in mandate states than in non-mandate states for cancer clinical trials in certain phases. The findings hint at the possibility that these policies might encourage drug innovation in the long run.

  16. US state variation in autism insurance mandates: balancing access and fairness.

    PubMed

    Johnson, Rebecca A; Danis, Marion; Hafner-Eaton, Chris

    2014-10-01

    This article examines how nations split decision-making about health services between federal and sub-federal levels, creating variation between states or provinces. When is this variation ethically acceptable? We identify three sources of ethical acceptability-procedural fairness, value pluralism, and substantive fairness-and examine these sources with respect to a case study: the fact that only 30 out of 51 US states or territories passed mandates requiring private insurers to offer extensive coverage of autism behavioral therapies, creating variation for privately insured children living in different US states. Is this variation ethically acceptable? To address this question, we need to analyze whether mandates go to more or less needy states and whether the mandates reflect value pluralism between states regarding government's role in health care. Using time-series logistic regressions and data from National Survey of Children with Special Health Care Needs, Individual with Disabilities Education Act, legislature political composition, and American Board of Pediatrics workforce data, we find that the states in which mandates are passed are less needy than states in which mandates have not been passed, what we call a cumulative advantage outcome that increases between-state disparities rather than a compensatory outcome that decreases between-state disparities. Concluding, we discuss the implications of our analysis for broader discussions of variation in health services provision.

  17. US state variation in autism insurance mandates: balancing access and fairness.

    PubMed

    Johnson, Rebecca A; Danis, Marion; Hafner-Eaton, Chris

    2014-10-01

    This article examines how nations split decision-making about health services between federal and sub-federal levels, creating variation between states or provinces. When is this variation ethically acceptable? We identify three sources of ethical acceptability-procedural fairness, value pluralism, and substantive fairness-and examine these sources with respect to a case study: the fact that only 30 out of 51 US states or territories passed mandates requiring private insurers to offer extensive coverage of autism behavioral therapies, creating variation for privately insured children living in different US states. Is this variation ethically acceptable? To address this question, we need to analyze whether mandates go to more or less needy states and whether the mandates reflect value pluralism between states regarding government's role in health care. Using time-series logistic regressions and data from National Survey of Children with Special Health Care Needs, Individual with Disabilities Education Act, legislature political composition, and American Board of Pediatrics workforce data, we find that the states in which mandates are passed are less needy than states in which mandates have not been passed, what we call a cumulative advantage outcome that increases between-state disparities rather than a compensatory outcome that decreases between-state disparities. Concluding, we discuss the implications of our analysis for broader discussions of variation in health services provision. PMID:24789870

  18. Is State-Mandated Redesign an Effective and Sustainable Solution?

    ERIC Educational Resources Information Center

    Young, Michelle D.

    2013-01-01

    There is a pervasive and ongoing perception that leadership preparation is a problem. Important questions remain about the intentions, capacity, and impact of state departments of education engaged in leadership preparation program redesign. In this essay, I take up several issues concerning this state policy work, including whether a one size…

  19. Implementing Curricular Change through State-Mandated Testing: Ethical Issues.

    ERIC Educational Resources Information Center

    Mathison, Sandra

    1991-01-01

    Explores the ethical issues involved in using standardized tests to implement a state-level policy. Examines the fourth grade science program evaluation test administered in New York State for the first time in 1989. A utilitarian view of ethics ignores the consequences of testing for different constituents, obviates caring behavior, and damages…

  20. States Stepping up Mandates for School Safety Drills

    ERIC Educational Resources Information Center

    Shah, Nirvi

    2013-01-01

    Hundreds of U.S. schools will supplement fire drills and tornado training next fall with simulations of school shootings. In response to the December shootings by an intruder at Sandy Hook Elementary School in Newtown, Connecticut, several states have enacted or are considering laws that require more and new types of school safety drills, more…

  1. The Financial Education Tool Kit: Helping Teachers Meet State- Mandated Personal Finance Requirements

    ERIC Educational Resources Information Center

    St. Pierre, Eileen; Richert, Charlotte; Routh, Susan; Lockwood, Rachel; Simpson, Mickey

    2012-01-01

    States are recognizing the need for personal financial education and have begun requiring it as a condition for high school graduation. Responding to teacher requests to help them meet state-mandated financial education requirements, FCS educators in the Oklahoma Cooperative Extension Service developed a financial education tool kit. This article…

  2. State mandated public reporting and outcomes of percutaneous coronary intervention in the United States.

    PubMed

    Cavender, Matthew A; Joynt, Karen E; Parzynski, Craig S; Resnic, Frederick S; Rumsfeld, John S; Moscucci, Mauro; Masoudi, Frederick A; Curtis, Jeptha P; Peterson, Eric D; Gurm, Hitinder S

    2015-06-01

    Public reporting has been proposed as a strategy to improve health care quality. Percutaneous coronary interventions (PCIs) performed in the United States from July 1, 2009, to June 30, 2011, included in the CathPCI Registry were identified (n = 1,340,213). Patient characteristics and predicted and observed in-hospital mortality were compared between patients treated with PCI in states with mandated public reporting (Massachusetts, New York, Pennsylvania) and states without mandated public reporting. Most PCIs occurred in states without mandatory public reporting (88%, n = 1,184,544). Relative to patients treated in nonpublic reporting states, those who underwent PCI in public reporting states had similar predicted in-hospital mortality (1.39% vs 1.37%, p = 0.17) but lower observed in-hospital mortality (1.19% vs 1.41%, adjusted odds ratio [ORadj] 0.80; 95% confidence interval [CI] 0.74, 0.88; p <0.001). In patients for whom outcomes were available at 180 days, the differences in mortality persisted (4.6% vs 5.4%, ORadj 0.85, 95% CI 0.79 to 0.92, p <0.001), whereas there was no difference in myocardial infarction (ORadj 0.97, 95% CI 0.89 to 1.07) or revascularization (ORadj 1.05, 95% CI 0.92 to 1.20). Hospital readmissions were increased at 180 days in patients who underwent PCI in public reporting states (ORadj 1.08, 95% CI 1.03 to 1.12, p = 0.001). In conclusion, patients who underwent PCI in states with mandated public reporting of outcomes had similar predicted risks but significantly lower observed risks of death during hospitalization and in the 6 months after PCI. These findings support considering public reporting as a potential strategy for improving outcomes of patients who underwent PCI although further studies are warranted to delineate the reasons for these differences.

  3. Dangerous Liaisons: Reflections on a Pilot Project for State-Mandated Outcomes Assessment of Written Communication

    ERIC Educational Resources Information Center

    Denny, Harry C.

    2008-01-01

    This study details the development and results of a campus-based writing assessment plan that was mandated by a state-wide university system in order to explore the ''value-added'' from a writing program curriculum to undergraduate students' competence with written expression. Four writing samples (two timed essays and two conventional essays)…

  4. A Study of the Relationship between Students' Anxiety and Test Performance on State-Mandated Assessments

    ERIC Educational Resources Information Center

    Hernandez, Rosalinda; Menchaca, Velma; Huerta, Jeffery

    2011-01-01

    This study examined whether relationships exist between Hispanic fourth-grade students' anxiety and test performance on a state-mandated writing assessment. Quantitative methodologies were employed by using test performance and survey data from 291 participants. While no significantly direct relationship exists between students' levels of anxiety…

  5. Linking Scholarship and Practice: Community College Leaders, State Mandates, and Leadership Competencies

    ERIC Educational Resources Information Center

    Hebert-Swartzer, Cathleen A.; McNair, Delores E.

    2010-01-01

    To be an effective leader in today's community college requires a sophisticated set of skills that are often learned through on the job training, mentoring, and professional development activities. Using case study methodology, this study examined how community college leaders in California use their skills to implement a state mandate related to…

  6. Social Studies Teachers' Attitudes Concerning Controversial Public Issues Instruction and State Mandated Tests

    ERIC Educational Resources Information Center

    Nance, Starlynn Raenae

    2012-01-01

    This transcendental phenomenological qualitative study examines attitudes toward Controversial Public Issue instruction by teachers who used mandated standards and state tests. After the interviews of 11 social studies teachers (high school, middle school and junior high) five distinct themes emerged in the study. Overall, participants execute…

  7. Tests Worth Teaching To: Constructing State-Mandated Tests that Emphasize Critical Thinking.

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2001-01-01

    Argues that state mandated tests should emphasize critical thinking, thus mitigating the concern that such tests encourage instructional focus on rote factual learning. Conceptualizing critical thinking as argumentation provides a way to focus instruction and assessment on types of critical thinking valued in the workplace. Illustrates how this…

  8. State-Mandated Principal Preparation Program Redesign: Impetus for Reform or Invitation to Chaos?

    ERIC Educational Resources Information Center

    Phillips, Joy C.

    2013-01-01

    Increasing criticism of practicing educational leaders has led to additional critiques of the university programs in which they are prepared. In response, many states have mandated statewide university preparation program redesign. The articles in this special issue describe five unique cases of principal preparation program redesign--including…

  9. Evaluation of Alabama Public School Wellness Policies and State School Mandate Implementation

    ERIC Educational Resources Information Center

    Gaines, Alisha B.; Lonis-Shumate, Steven R.; Gropper, Sareen S.

    2011-01-01

    Background: This study evaluated wellness policies created by Alabama public school districts and progress made in the implementation of Alabama State Department of Education (ALSDE) school food and nutrition mandates. Methods: Wellness policies from Alabama public school districts were compared to minimum requirements under the Child Nutrition…

  10. State-Mandated Hospital Infection Reporting Is Not Associated With Decreased Pediatric Healthcare-Associated Infections

    PubMed Central

    Rinke, Michael L.; Bundy, David G.; Abdullah, Fizan; Colantuoni, Elizabeth; Zhang, Yiyi; Miller, Marlene R.

    2014-01-01

    Objectives State governments increasingly mandate public reporting of central line-associated blood stream infections (CLABSIs). This study tests if hospitals located in states with state-mandated, facility-identified, pediatric-specific public CLABSI reporting have lower rates of CLABSIs as defined by the Agency for Healthcare Research and Quality’s Pediatric Quality Indicator 12 (PDI12). Methods Utilizing the Kids’ Inpatient Databases from 2000 to 2009, we compared changes in PDI12 rates across three groups of states: states with public CLABSI reporting begun by 2006, states with public reporting begun by 2009 and never-reporting states. In the baseline period (2000–2003), no states mandated public CLABSI reporting. A multivariable, hospital-level random intercept, logistic regression was performed comparing changes in PDI12 rates in states with public reporting to changes in PDI12 rates in never-reporting states. Results 4,705,857 discharge records were eligible for PDI12. PDI12 rates significantly decreased in all reporting groups, comparing baseline to the post-public reporting time period (2009): Never Reporters 88% decrease (95% CI: 86%, 89%), Reporting Begun by 2006 90% decrease (95% CI: 83%, 94%), and Reporting Begun by 2009 74% decrease (95% CI: 72%, 76%). The Never Reporting Group had comparable decreases in PDI12 rates to the Reporting Begun by 2006 group (p=0.4) and significantly larger decreases in PDI12 rates compared to the Reporting Begun by 2009 group (p<0.001), despite having no states with public reporting. Conclusions Public CLABSI reporting alone appears to be insufficient to affect administrative data-based measures of pediatric CLABSI rates or children may be inadequately targeted in current public reporting efforts. PMID:24681422

  11. State-Mandated Reporting of Health Care-Associated Infections in the United States: Trends Over Time

    PubMed Central

    Reagan, Julie; Pogorzelska-Maziarz, Monika; Srinath, Divya; Stone, Patricia W.

    2014-01-01

    Over the past decade, most US states and territories began mandating that acute care hospitals report healthcare-associated infections (HAI) to their departments of health. Trends in state HAI law enactment and data submission requirements were determined using systematic legal review; state HAI coordinators were contacted to confirm collected data. As of January 31, 2013, 37 US states and territories (71%) had adopted laws requiring HAI data submission; most were enacted and became effective in 2006 and 2007. Most states with HAI laws required reporting of central line-associated bloodstream infections in adult ICUs (92%), and about half required reporting of methicillin-resistant Staphylococcus aureus and Clostridium difficile infections (54% and 51%, respectively). Overall, data submission requirements were found to vary across states. Considering the facility and state resources needed to comply with HAI reporting mandates, future studies should focus on whether these laws have had the desired impact of reducing infection rates. PMID:24951104

  12. Do Fourteenth Amendment considerations outweigh a potential state interest in mandating cochlear implantation for deaf children?

    PubMed

    Bender, Denise G

    2004-01-01

    Currently, the decision concerning pediatric cochlear implantation for children remains a personal choice for parents to make. Economic factors, educational outcomes, and societal attitudes concerning deafness could result in an increased governmental interest in this choice. This article examines case law related to the issue of parental autonomy to determine whether the state, acting in the role of parens patriae, could use economic and social reasons to mandate the provision of cochlear implants for all eligible children. The author uses previous cases as a framework to develop an opinion on whether a constitutional protection for parents may exist. PMID:15304405

  13. Towards State-Mandated Testing in Germany: How Do Teachers Assess the Pedagogical Relevance of Performance Feedback Information?

    ERIC Educational Resources Information Center

    Maier, Uwe

    2009-01-01

    The paper analyses how teachers view state-mandated tests in Baden-Wurttemberg, a large state in the south-west of Germany. For the first time in 2006, public secondary schools were bound by law to administer "Vergleichsarbeiten" [state-wide tests] in up to three relevant subjects after Grade 6. Scholars in the field of school improvement…

  14. The use of technology assessment by hospitals, health maintenance organizations, and third-party payers in the United States.

    PubMed

    Luce, B R; Brown, R E

    1995-01-01

    A case study design was used to determine the reliance on technology assessment of decisionmakers in hospitals, health maintenance organizations (HMOs), and third-party payers. Thirty different organizations were contacted and semistructured interviews conducted. The study found that hospitals, HMOs, and insurers are conducting technology assessments, but the form and sophistication of these analyses range widely. Hospitals are particularly focused on traditional financial analyses ("prudent purchasing") with the exception of pharmacy committees, which generally conduct more sophisticated socio-economic analyses. HMOs and insurers conduct outcome assessments for coverage of expensive or controversial technologies but exclude economics. Technology assessment will become increasingly important in resource allocation decision making and it is in the interest of technology providers to foster better information, a more comprehensive assessment process, and a more efficient assessment system.

  15. West Virginia Physical Education Teacher Perceptions of State Mandated Fitnessgram® Testing and Application of Results

    ERIC Educational Resources Information Center

    Miller, William M.

    2013-01-01

    Background/Purpose: In response to concerns with increasing rates of childhood obesity, many states have enacted policies that affect physical education. A commonly used approach is state mandated fitness test administration in school-based settings. While this approach is widely debated throughout the literature, one area that lacks research is…

  16. Has the Shift to Managed Care Reduced Medicaid Expenditures? Evidence from State and Local-Level Mandates

    ERIC Educational Resources Information Center

    Duggan, Mark; Hayford, Tamara

    2013-01-01

    From 1991 to 2009, the fraction of Medicaid recipients enrolled in HMOs and other forms of Medicaid managed care (MMC) increased from 11 percent to 71 percent. This increase was largely driven by state and local mandates that required most Medicaid recipients to enroll in an MMC plan. Theoretically, it is ambiguous whether the shift from…

  17. Negotiating Dual Accountability Systems: Strategic Responses of Big Picture Schools to State-Mandated Standards and Assessment

    ERIC Educational Resources Information Center

    Suchman, Sara P.

    2012-01-01

    The No Child Left Behind Act of 2001 mandated that states implement standards and test-based accountability systems. In theory, local educators are free to select the means for teaching the standards so long as students achieve a predetermined proficiency level on the exams. What is unclear, however, is how this theory plays out in schools…

  18. Private payers and cancer care: land of opportunity.

    PubMed

    Klein, Ira; Kolodziej, Michael

    2014-01-01

    The costs of cancer care are unsustainable in the present US health care system. Private payers have taken a leading role in oncology payment reform. This benefits all payers, including the Center for Medicare and Medicaid Services (CMS). Private payers' ability to set up systems of measurement and quality improvement is a strategy to support pay-for-value contracting. This facilitates workflow changes in oncology office practice as a way to bend the cost trends while enhancing patient care. Oncology practitioners demand speed and flexibility in deploying customized information technology solutions in exchange for new contracting terms. Pathway and guideline support tools have been proven effective in validating the use of evidence-based medicine and in systematizing office operations to reduce avoidable costs. The future of oncology practice should see further enhancement of these capabilities. A common health information exchange pipeline will allow patients, physicians, and other health care providers to share structured information from multiple electronic medical record/electronic health record platforms. By allowing multiple payers, including CMS, to access commonly accepted clinical decision support rules, any payer can create contracts and relationships with oncology practices. In this manner, future changes in payment for oncology services mandated by CMS can be sustained within the infrastructures being built today through payer-provider collaborations. PMID:24084888

  19. The Association of State Legal Mandates for Data Submission of Central Line-associated Blood Stream Infections in Neonatal Intensive Care Units with Process and Outcome Measures

    PubMed Central

    Zachariah, Philip; Reagan, Julie; Furuya, E. Yoko; Dick, Andrew; Liu, Hangsheng; Herzig, Carolyn T.A; Pogorzelska-Maziarz, Monika; Stone, Patricia W.; Saiman, Lisa

    2014-01-01

    Objective To determine the association between state legal mandates for data submission of central line-associated blood stream infections (CLABSIs) in neonatal intensive care units (NICUs) with process/outcome measures. Design Cross-sectional study. Participants National sample of level II/III and III NICUs participating in National Healthcare Safety Network (NHSN) surveillance. Methods State mandates for data submission of CLABSIs in NICUs in place by 2011 were compiled and verified with state healthcare-associated infection coordinators. A web-based survey of infection control departments in October 2011 assessed CLABSI prevention practices i.e. compliance with checklist and bundle components (process measures) in ICUs including NICUs. Corresponding 2011 NHSN NICU CLABSI rates (outcome measures) were used to calculate Standardized Infection Ratios (SIR). The association between mandates and process/outcome measures was assessed by multivariable logistic regression. Results Among 190 study NICUs, 107 (56.3%) NICUs were located in states with mandates, with mandates in place for 3 or more years for half. More NICUs in states with mandates reported ≥95% compliance to at least one CLABSI prevention practice (52.3% – 66.4%) than NICUs in states without mandates (28.9% – 48.2%). Mandates were predictors of ≥95% compliance with all practices (OR 2.8; 95% CI 1.4–6.1). NICUs in states with mandates reported lower mean CLABSI rates in the <750gm birth-weight group (2.4 vs. 5.7 CLABSIs/1000 CL-days) but not in others. Mandates were not associated with SIR <1. Conclusions State mandates for NICU CLABSI data submission were significantly associated with ≥95% compliance with CLABSI prevention practices but not with lower CLABSI rates. PMID:25111921

  20. Managing benefits for diabetes: changing payer strategies for changing times.

    PubMed

    Tzeel, Albert

    2013-01-01

    Just as there are many ways to treat a condition such as diabetes, there are also many ways for payers to manage the diabetes benefit. Although none of these methods is specifically right or wrong, they are grounded in a payer's philosophy and created in response to the needs of the time. Yet, just as in any other business, new ideas and, for diabetes, new scientific discoveries will surely mandate new strategies to achieve goals. As payers find themselves adapting to new political realities and new partnerships, one cannot be sure if their new strategies will succeed or not. But, in actuality, this becomes moot as the 1 point we can be sure of is that benefit management will continue to evolve.

  1. Managing benefits for diabetes: changing payer strategies for changing times.

    PubMed

    Tzeel, Albert

    2013-01-01

    Just as there are many ways to treat a condition such as diabetes, there are also many ways for payers to manage the diabetes benefit. Although none of these methods is specifically right or wrong, they are grounded in a payer's philosophy and created in response to the needs of the time. Yet, just as in any other business, new ideas and, for diabetes, new scientific discoveries will surely mandate new strategies to achieve goals. As payers find themselves adapting to new political realities and new partnerships, one cannot be sure if their new strategies will succeed or not. But, in actuality, this becomes moot as the 1 point we can be sure of is that benefit management will continue to evolve. PMID:23725238

  2. Management of sacroiliac joint disruption and degenerative sacroiliitis with nonoperative care is medical resource-intensive and costly in a United States commercial payer population

    PubMed Central

    Ackerman, Stacey J; Polly, David W; Knight, Tyler; Holt, Tim; Cummings, John

    2014-01-01

    Introduction Low back pain is common and originates in the sacroiliac (SI) joint in 15%–30% of cases. Traditional SI joint disruption/degenerative sacroiliitis treatments include nonoperative care or open SI joint fusion. To evaluate the usefulness of newly developed minimally-invasive technologies, the costs of traditional treatments must be better understood. We assessed the costs of nonoperative care for SI joint disruption to commercial payers in the United States (US). Methods A retrospective study of claim-level medical resource use and associated costs used the MarketScan® Commercial Claims and Encounters as well as Medicare Supplemental Databases of Truven Healthcare. Patients with a primary ICD-9-CM diagnosis code for SI joint disruption (720.2, 724.6, 739.4, 846.9, or 847.3), an initial date of diagnosis from January 1, 2005 to December 31, 2007 (index date), and continuous enrollment for ≥1 year before and 3 years after the index date were included. Claims attributable to SI joint disruption with a primary or secondary ICD-9-CM diagnosis code of 71x.xx, 72x.xx, 73x.xx, or 84x.xx were identified; the 3-year medical resource use-associated reimbursement and outpatient pain medication costs (measured in 2011 US dollars) were tabulated across practice settings. A subgroup analysis was performed among patients with lumbar spinal fusion. Results The mean 3-year direct, attributable medical costs were $16,196 (standard deviation [SD] $28,592) per privately-insured patient (N=78,533). Among patients with lumbar spinal fusion (N=434), attributable 3-year mean costs were $91,720 (SD $75,502) per patient compared to $15,776 (SD $27,542) per patient among patients without lumbar spinal fusion (N=78,099). Overall, inpatient hospitalizations (19.4%), hospital outpatient visits and procedures (14.0%), and outpatient pain medications (9.6%) accounted for the largest proportion of costs. The estimated 3-year insurance payments attributable to SI joint disruption

  3. Do biofuel blending mandates reduce gasoline consumption? Implications of state-level renewable fuel standards for energy security

    NASA Astrophysics Data System (ADS)

    Lim, Shinling

    In an effort to keep America's addiction to oil under control, federal and state governments have implemented a variety of policy measures including those that determine the composition of motor gasoline sold at the pump. Biofuel blending mandates known as Renewable Fuel Standards (RFS) are designed to reduce the amount of foreign crude oil needed to be imported as well as to boost the local ethanol and corn industry. Yet beyond looking at changes in gasoline prices associated with increased ethanol production, there have been no empirical studies that examine effects of state-level RFS implementation on gasoline consumption. I estimate a Generalized Least Squares model for the gasoline demand for the 1993 to 2010 period with state and time fixed effects controlling for RFS. States with active RFS are Minnesota, Hawaii, Missouri, Florida, Washington, and Oregon. I find that, despite the onset of federal biofuel mandates across states in 2007 and the lower energy content of blended gasoline, being in a state that has implemented RFS is associated with 1.5% decrease in gasoline consumption (including blended gasoline). This is encouraging evidence for efforts to lessen dependence on gasoline and has positive implications for energy security.

  4. An (un)clear conscience clause: the causes and consequences of statutory ambiguity in state contraceptive mandates.

    PubMed

    VanSickle-Ward, Rachel; Hollis-Brusky, Amanda

    2013-08-01

    Since 1996, twenty-eight states have adopted legislation mandating insurance coverage of prescription contraceptives for women. Most of these policies include language that allows providers to opt out of the requirement because of religious or moral beliefs-conscience clause exemptions. There is striking variation in how these exemptions are defined. This article investigates the sources and consequences of ambiguous versus precise statutory language in conscience clauses. We find that some forms of political and institutional fragmentation (party polarization and gubernatorial appointment power) are correlated with the degree of policy specificity in state contraceptive mandates. This finding reinforces previous law and policy scholarship that has shown that greater fragmentation promotes ambiguous statutory language because broad wording acts as a vehicle for compromise when actors disagree. Interestingly, it is the more precisely worded statutes that have prompted court battles. We explain this with reference to the asymmetry of incentives and mobilizing costs between those disadvantaged by broad (primarily female employees) versus precisely worded statutes (primarily Catholic organizations). Our findings suggest that the impact of statutory ambiguity on court intervention is heavily contextualized by the resources and organization of affected stakeholders. PMID:23645878

  5. State Law, Policy, and Access to Information: The Case of Mandated Openness in Higher Education

    ERIC Educational Resources Information Center

    McLendon, Michael K.; Hearn, James C.

    2010-01-01

    Background/Context: Every state in the nation has legal requirements, state "sunshine laws," to ensure accountability and fairness in institutions receiving state funds and operating under state authority. These laws have come to significantly influence the ways in which the business of higher education is conducted. Purpose/Objective/Research…

  6. Can ship-to-classroom interactions aid in teaching state-mandated curricula to special needs students?

    NASA Astrophysics Data System (ADS)

    Haddad, A.; Turner, M.; Samuelson, L.; Scientific Team of IODP Expedition 336: Mid-Atlantic Ridge Microbiology

    2011-12-01

    Cutting edge science is so exciting to elementary-level students with special needs that they are constantly asking for more! We drew on this enthusiasm and developed an interaction between special needs students and scientists performing cutting edge research on and below the ocean floor with the goal of teaching them state-mandated curricula. While on board the JOIDES Resolution during IODP Expedition 336: Mid-Atlantic Ridge Microbiology (Fall 2011), scientists interacted with several special needs classrooms in the Phoenix, Arizona metro area via weekly activities, blogs, question-and-answer sessions and Skype calls revolving around ocean exploration. All interactions were developed to address Arizona Department of Education curriculum standards in reading, writing, math and science and tailored to the learning needs of the students. Since the usual modalities of teaching (lecturing, Powerpoint presentations, independent reading) are ineffective in teaching students with special needs, we employed as much hands-on, active student participation as possible. The interactions were also easily adaptable to include every student regardless of the nature of their special needs. The effectiveness of these interactions in teaching mandated standards was evaluated using pre- and post-assessments and are presented here. Our goal is to demonstrate that special needs students benefit from being exposed to real-time science applications.

  7. High school science teacher perceptions of the science proficiency testing as mandated by the State of Ohio Board of Education

    NASA Astrophysics Data System (ADS)

    Jeffery, Samuel Shird

    There is a correlation between the socioeconomic status of secondary schools and scores on the State of Ohio's mandated secondary science proficiency tests. In low scoring schools many reasons effectively explain the low test scores as a result of the low socioeconomics. For example, one reason may be that many students are working late hours after school to help with family finances; parents may simply be too busy providing family income to realize the consequences of the testing program. There are many other personal issues students face that may cause them to score poorly an the test. The perceptions of their teachers regarding the science proficiency test program may be one significant factor. These teacher perceptions are the topic of this study. Two sample groups ware established for this study. One group was science teachers from secondary schools scoring 85% or higher on the 12th grade proficiency test in the academic year 1998--1999. The other group consisted of science teachers from secondary schools scoring 35% or less in the same academic year. Each group of teachers responded to a survey instrument that listed several items used to determine teachers' perceptions of the secondary science proficiency test. A significant difference in the teacher' perceptions existed between the two groups. Some of the ranked items on the form include teachers' opinions of: (1) Teaching to the tests; (2) School administrators' priority placed on improving average test scores; (3) Teacher incentive for improving average test scores; (4) Teacher teaching style change as a result of the testing mandate; (5) Teacher knowledge of State curriculum model; (6) Student stress as a result of the high-stakes test; (7) Test cultural bias; (8) The tests in general.

  8. Learning Disabilities and the LRE Mandate: An Examination of National and State Trends

    ERIC Educational Resources Information Center

    McLeskey, James; Landers, Eric; Hoppey, David; Williamson, Pamela

    2011-01-01

    This study was conducted to examine changes in the identification rates and national and state placement practices for school age students with learning disabilities (LD) between 1990-1991 and 2008-2009. Findings revealed that while identification rates of students with LD declined by about 4 percent during this time, general education placements…

  9. Mandating Academic Excellence: High School Responses to State Curriculum Reform. Sociology of Education Series.

    ERIC Educational Resources Information Center

    Wilson, Bruce L.; Rossman, Gretchen B.

    In the past decade, states have taken an increasingly active role in designing new policies intended to reform America's high schools. This book offers a systematic, empirical look at the most widely adopted policy reform strategy--mandatory changes in high school graduation requirements. Maryland is used as a case study, exploring five…

  10. Retention of High School Economics Knowledge and the Effect of the California State Mandate

    ERIC Educational Resources Information Center

    Gill, Andrew M.; Gratton-Lavoie, Chiara

    2011-01-01

    The authors extend the literature on the efficacy of high school economics instruction in two directions. First, they assess how much economic knowledge that California students acquired in their compulsory high school course is retained on their entering college. Second, using as a control group some college students from the state of Washington,…

  11. US State Variation in Autism Insurance Mandates: Balancing Access and Fairness

    ERIC Educational Resources Information Center

    Johnson, Rebecca A.; Danis, Marion; Hafner-Eaton, Chris

    2014-01-01

    This article examines how nations split decision-making about health services between federal and sub-federal levels, creating variation between states or provinces. When is this variation ethically acceptable? We identify three sources of ethical acceptability--procedural fairness, value pluralism, and substantive fairness--and examine these…

  12. Controversies in vaccine mandates.

    PubMed

    Lantos, John D; Jackson, Mary Anne; Opel, Douglas J; Marcuse, Edgar K; Myers, Angela L; Connelly, Beverly L

    2010-03-01

    Policies that mandate immunization have always been controversial. The controversies take different forms in different contexts. For routine childhood immunizations, many parents have fears about both short- and long-term side effects. Parental worries change as the rate of vaccination in the community changes. When most children are vaccinated, parents worry more about side effects than they do about disease. Because of these worries, immunization rates go down. As immunization rates go down, disease rates go up, and parents worry less about side effects of vaccination and more about the complications of the diseases. Immunization rates then go up. For teenagers, controversies arise about the criteria that should guide policies that mandate, rather than merely recommend and encourage, certain immunizations. In particular, policy makers have questioned whether immunizations for human papillomavirus, or other diseases that are not contagious, should be required. For healthcare workers, debates have focused on the strength of institutional mandates. For years, experts have recommended that all healthcare workers be immunized against influenza. Immunizations for other infections including pertussis, measles, mumps, and hepatitis are encouraged but few hospitals have mandated such immunizations-instead, they rely on incentives and education. Pandemics present a different set of problems as people demand vaccines that are in short supply. These issues erupt into controversy on a regular basis. Physicians and policy makers must respond both in their individual practices and as advisory experts to national and state agencies. The articles in this volume will discuss the evolution of national immunization programs in these various settings. We will critically examine the role of vaccine mandates. We will discuss ways that practitioners and public health officials should deal with vaccine refusal. We will contrast responses of the population as a whole, within the

  13. An Investigation of Writing Strategies Used by High Ability Seventh Graders Responding to a State-Mandated Explanatory Writing Assessment Task. Draft.

    ERIC Educational Resources Information Center

    Lynch, William Mark

    A case study investigated the writing strategies use by high ability seventh graders (n=4) responding to explanatory tasks from the Maryland Writing Test (MWT), a state-mandated writing assessment. Central questions were: (1) what are the writing strategies elicited by the MWT?; (2) what evidence is revealed of participants' self-monitoring…

  14. Teachers' Perceptions of the Impact of State-Mandated Standardized Testing: The Michigan Educational Assessment Program (MEAP) as a Case Study of Consequences

    ERIC Educational Resources Information Center

    Segall, Avner

    2003-01-01

    In the last decade, the debate over state-mandated standardized testing has become one of the most heated, political debates in education. Situated within that debate and drawing from it, this paper examines the relationship among teachers, teaching, and standardized testing, using the Michigan Educational Assessment Program (MEAP) as a case study…

  15. The Implementation of State-Mandated Program Review: A Case Study of Governance and Decision Making in Community Colleges. ASHE Annual Meeting Paper.

    ERIC Educational Resources Information Center

    White, Kenneth B.

    A study examined the governing system in two Florida community colleges in order to better understand the dynamics of policymaking and policy implementation at the two-year college. The study focused on institutional characteristics, specifically communication, and how this may affect state-mandated program implementation. It was found that the…

  16. A School-University Partnership's Involvement in State Mandated Reform: The Impact of a Teacher-Based Professional Development Model on Teachers, or, "Caught in the Headlights!"

    ERIC Educational Resources Information Center

    Laguardia, Armando; Grisham, Dana; Gallucci, Chrysan; Jamison, Shelli; Brink, Beverly; Peck, Cap

    This study examined teachers' experiences in the Washington state-mandated educational reform process, their pedagogical responses to the reform initiatives, and the way in which these were mediated by professional development activities such as those initiated by the Goals 2000 project. Five Washington teachers participated in this case study.…

  17. Comparison of Height, Weight, and Body Mass Index Data from State-Mandated School Physical Fitness Testing and a Districtwide Surveillance Project

    ERIC Educational Resources Information Center

    Khaokham, Christina B.; Hillidge, Sharon; Serpas, Shaila; McDonald, Eric; Nader, Philip R.

    2015-01-01

    Background: Approximately one third of California school-age children are overweight or obese. Legislative approaches to assessing obesity have focused on school-based data collection. During 2010-2011, the Chula Vista Elementary School District conducted districtwide surveillance and state-mandated physical fitness testing (PFT) among fifth grade…

  18. A Study of the Impact of Transformative Professional Development on Hispanic Student Performance on State Mandated Assessments of Science in Elementary School

    ERIC Educational Resources Information Center

    Johnson, Carla C.; Fargo, Jamison D.

    2014-01-01

    This paper reports the findings of a study of the impact of the transformative professional development (TPD) model on student achievement on state-mandated assessments of science in elementary school. Two schools (one intervention and one control) participated in the case study where teachers from one school received the TPD intervention across a…

  19. Linguistic Discrimination in Writing Assessment: How Raters React to African American "Errors," ESL Errors, and Standard English Errors on a State-Mandated Writing Exam

    ERIC Educational Resources Information Center

    Johnson, David; VanBrackle, Lewis

    2012-01-01

    Raters of Georgia's (USA) state-mandated college-level writing exam, which is intended to ensure a minimal university-level writing competency, are trained to grade holistically when assessing these exams. A guiding principle in holistic grading is to not focus exclusively on any one aspect of writing but rather to give equal weight to style,…

  20. All-payer ratesetting: Down but not out

    PubMed Central

    Anderson, Gerard F.

    1992-01-01

    In the United States, when the cost-containment paradigm shifted from regulation to competition, all-payer hospital ratesetting went out of favor. After reviewing the published literature and supplementing the existing literature with more current information, the author concludes that all-payer ratesetting is able to meet its multiple objectives of cost containment, reduction of the amount of cost shifting, improvement of access to the uninsured, and increased productivity. At the same time, all-payer ratesetting has not stifled the diffusion of competitive health care systems or new technology, and any impact on length of stay, admissions, and quality of care is small, if it exists at all. PMID:25371975

  1. Money down the Drain: Mandated Professional Development

    ERIC Educational Resources Information Center

    Kragler, Sherry; Martin, Linda; Kroeger, Diane C.

    2008-01-01

    Federal, state, and district policy mandates are increasingly affecting primary grade teachers--especially, those in at-risk schools, given that they face more mandated curriculum and professional development. This study investigated K-3 teachers in two inner-city schools as they navigated through various mandates. Qualitative and quantitative…

  2. What Can US Single-Payer Supporters Learn From the Swiss Rejection of Single Payer?

    PubMed

    Chaufan, Claudia

    2016-01-01

    On September 27, 2014, Swiss voters rejected a proposal to replace their system of about 60 health insurance companies offering mandatory basic health coverage with a single public insurer, the state, which would offer taxpayer-funded coverage of all medically necessary care. The Swiss and the U.S. media, academia, and business sectors, from conservative and liberal camps, interpreted the results to mean a rejection of single payer and a preference for a privately run system, with important implications for health reform in the United States. While on the surface mainstream interpretations appear reasonable, I argue that they have little basis on fact because they rely on assumptions that, while untrue, are repeated as mantras that conveniently justify the continuation of a model of health insurance that is unraveling, less conspicuously in Switzerland, dramatically in the United States. To make my case, I describe the dominant narrative about Swiss health care and mainstream interpretations of the latest referendum on health reform, unpack the problem within these interpretations, and conclude by identifying what lessons the Swiss referendum contains for single payer advocates in the United States in particular and for those who struggle for social and economic rights more generally. PMID:26880092

  3. What Can US Single-Payer Supporters Learn From the Swiss Rejection of Single Payer?

    PubMed

    Chaufan, Claudia

    2016-01-01

    On September 27, 2014, Swiss voters rejected a proposal to replace their system of about 60 health insurance companies offering mandatory basic health coverage with a single public insurer, the state, which would offer taxpayer-funded coverage of all medically necessary care. The Swiss and the U.S. media, academia, and business sectors, from conservative and liberal camps, interpreted the results to mean a rejection of single payer and a preference for a privately run system, with important implications for health reform in the United States. While on the surface mainstream interpretations appear reasonable, I argue that they have little basis on fact because they rely on assumptions that, while untrue, are repeated as mantras that conveniently justify the continuation of a model of health insurance that is unraveling, less conspicuously in Switzerland, dramatically in the United States. To make my case, I describe the dominant narrative about Swiss health care and mainstream interpretations of the latest referendum on health reform, unpack the problem within these interpretations, and conclude by identifying what lessons the Swiss referendum contains for single payer advocates in the United States in particular and for those who struggle for social and economic rights more generally.

  4. Exploring barriers to payer utilization of genetic counselors.

    PubMed

    Doyle, Nan; Cirino, Allison; Trivedi, Amber; Flynn, Maureen

    2015-02-01

    Access to genetic counselors' services is neither universal nor automatic, due in part to the gatekeeper role of healthcare payers--the companies and agencies that purchase healthcare services on patients' behalf and control the bulk of healthcare spending. This pilot study surveyed and analyzed the relative importance of barriers to expanded payer coverage of genetic counselors' services. Surveys were mailed to 263 medical directors and quality assurance directors at health insurance carriers throughout the United States. Respondents provided demographic information and indicated the importance of nine possible barriers, plus an optional write-in "other." Twenty-two surveys were analyzed. "Evidence that use of genetic counselors improves health outcomes" led the list of factors having a significant/very significant influence on coverage policy. Sixteen respondents (73 %) rated this factor "4" or "5" on a Likert scale; it also received the most #1 rankings and the highest score using a weighted-mean analysis. Provider practice guidelines, CMS/Medicare regulations, and genetic counselor licensure-all of which are outside of payers' direct control-also ranked highly. The research demonstrates that although the potential barriers to expanded reimbursement for genetic counselors are numerous and complex, some are more consistently identified as important and therefore more deserving of legislative and advocacy resources to effect change. Future research should endeavor to increase survey response and include providers as well as payers. PMID:25138080

  5. A descriptive study of the reported effects of state-mandated testing on the instructional practices and beliefs of middle school science teachers

    NASA Astrophysics Data System (ADS)

    Font-Rivera, Miriam Josefa

    The purpose of this study was to investigate the effects of state-level testing on the instructional practices and beliefs of middle school science teachers. The study addressed four questions: (a) What are the beliefs of middle school science teachers regarding the pressure to improve their students' test scores? (b) What are the beliefs of middle school science teachers about how standardized tests influence their class time? (c) What are the attitudes of middle school science teachers toward state testing? and (d) What commonalities emerge from teachers' responses about the state tests? The sample was composed of 86 middle school science teachers from states that have state mandated testing programs in the area of science. Descriptive statistics and an inductive analysis were performed to answer the research questions. Teachers reported that they and their students were under a great amount of pressure to increase test scores from central office administrators and from the school principal. Teachers reported spending considerable time on certain test preparation activities throughout the school year. Teachers reported that the three strongest influences in instructional planning were reviewing the content and skills covered on the state tests prior to the test administration, having to prepare students for state tests, and adjusting the curriculum sequence based on the content tested by the state tests. Multiple-choice items were reported to be the most often used assessment strategy. Teachers reported that state-mandated tests were not very helpful because the test results presented an inaccurate picture of student learning. The categories formed from the teachers' written comments reflected the findings of the survey questions. Comments concentrated on the negative effects of the tests in the areas of pressure, overemphasis on the test, accountability, reduction of instructional time due to test preparation, and negative uses of state-mandated tests

  6. Multiple payers, commonality and free-riding in health care: Medicare and private payers.

    PubMed

    Glazer, Jacob; McGuire, Thomas G

    2002-11-01

    Managed health care plans and providers in the US and elsewhere sell their services to multiple payers. For example, the three largest groups of purchasers from health plans in the US are employers, Medicaid plans, and Medicare, with the first two accounting for over 90% of the total enrollees. In the case of hospitals, Medicare is the largest buyer, but it alone only accounts for 40% of the total payments. While payers have different objectives and use different contracting practices, the plans and providers set some elements of the quality in common for all payers. In this paper, we study the interactions between a public payer, modeled on Medicare, which sets a price and takes any willing provider, a private payer, which limits providers and pays a price on the basis of quality, and a provider/plan, in the presence of shared elements of quality. The provider compromises in response to divergent incentives from payers. The private sector dilutes Medicare payment initiatives, and may, under some circumstances, repair Medicare payment policy mistakes. If Medicare behaves strategically in the presence of private payers, it can free-ride on the private payer and set its prices too low. Our paper has many testable implications, including a new hypothesis for why Medicare has failed to gain acceptance of health plans in the US. PMID:12475125

  7. Changes in Payer Mix and Physician Reimbursement After the Affordable Care Act and Medicaid Expansion.

    PubMed

    Jones, Christine D; Scott, Serena J; Anoff, Debra L; Pierce, Read G; Glasheen, Jeffrey J

    2015-01-01

    Although uncompensated care for hospital-based care has fallen dramatically since the implementation of the Affordable Care Act and Medicaid expansion, the changes in hospital physician reimbursement are not known. We evaluated if payer mix and physician reimbursement by encounter changed between 2013 and 2014 in an academic hospitalist practice in a Medicaid expansion state. This was a retrospective cohort study of all general medicine inpatient admissions to an academic hospitalist group in 2013 and 2014. The proportion of encounters by payer and reimbursement/inpatient encounter were compared in 2013 versus 2014. A sensitivity analysis determined the relative contribution of different factors to the change in reimbursement/encounter. Among 37 540 and 40 397 general medicine inpatient encounters in 2013 and 2014, respectively, Medicaid encounters increased (17.3% to 30.0%, P < .001), uninsured encounters decreased (18.4% to 6.3%, P < 0.001), and private payer encounters also decreased (14.1% to 13.3%, P = .001). The median reimbursement/encounter increased 4.2% from $79.98/encounter in 2013 to $83.36/encounter in 2014 (P < .001). In a sensitivity analysis, changes in length of stay, proportions in encounter type by payer, payer mix, and reimbursement for encounter type by payer accounted for -0.7%, 0.8%, 2.0%, and 2.3% of the reimbursement change, respectively. From 2013 to 2014, Medicaid encounters increased, and uninsured and private payer encounters decreased within our hospitalist practice. Reimbursement/encounter also increased, much of which could be attributed to a change in payer mix. Further analyses of physician reimbursement in Medicaid expansion and non-expansion states would further delineate reimbursement changes that are directly attributable to Medicaid expansion.

  8. The single-payer option: a reconsideration.

    PubMed

    Oliver, Adam

    2009-08-01

    This article discusses some of the merits and demerits of the single-payer model of health care financing, with particular reference to the English National Health Service (NHS). Specifically, it is argued that the main merits are that the model can directly provide universal health care coverage, thus eradicating or at least alleviating market failure and equity concerns, and that it can achieve this with relatively low total health care expenditure in general and -- as compared to the commercial multiple insurance model -- low administrative costs in particular. A perceived demerit of the single-payer model is that it can lead to excessive health care rationing, particularly in terms of waiting times, although it is argued here that long waits are probably caused by insufficient funding rather than by the single-payer model per se. Moreover, rationing of one form or another occurs in all health care systems, and single-payer models may be the best option if the aim is to incorporate structured rationing such that an entire population is subject to the same rules and is thus treated equitably. A further perceived disadvantage of the single-payer model is that it offers limited choice, which is necessarily true with respect to choice of insurer, but choice of provider can be, and increasingly is, a feature of centrally tax-financed health care systems. No model of health care funding is perfect; trade-offs are inevitable. Whether the merits of the single-payer model are judged to outweigh the demerits will typically vary both across countries at any point in time and within a country over time.

  9. The Efficiency of a Group-Specific Mandated Benefit Revisited: The Effect of Infertility Mandates

    ERIC Educational Resources Information Center

    Lahey, Joanna N.

    2012-01-01

    This paper examines the labor market effects of state health insurance mandates that increase the cost of employing a demographically identifiable group. State mandates requiring that health insurance plans cover infertility treatment raise the relative cost of insuring older women of child-bearing age. Empirically, wages in this group are…

  10. Payer Negotiations in the New Healthcare Environment: How to Prepare for and Succeed in a Value-Based World.

    PubMed

    Howrigon, Ron

    2016-01-01

    Because of their involvement with the Affordable Care exchanges, the national insurance companies have reported significant financial losses. As a result, there will soon be significant payer pressure to reduce medical expenses. To succeed in future negotiations with the payers, medical practices must understand the needs of the payers and then play to those needs. The author is a former managed care executive with more than 25 years of experience managing provider networks and implementing payer strategies for some of the largest payers in the United States. In this article, he outlines important things medical practices should be doing to prepare for the new world of value-based contracting. Medical practices that embrace this change and work hard to evolve with the future are the ones that are going to survive and succeed. PMID:27443057

  11. Impact of the New Jersey all-payer rate-setting system: an analysis of financial ratios.

    PubMed

    Rosko, M D

    1989-01-01

    Although prospective payment may contain costs, many analysts are concerned about the unintended consequences of rate regulation. This article presents the results of a case-study analysis of the New Jersey rate-setting programs during the period 1977-1985. Using measures of profitability, liquidity, and leverage, data for New Jersey, the Northeast, and the United States as a whole are used to contrast the impact of two forms of prospective payment. After attempting alternative cost-containment methods, the New Jersey Department of Health implemented an all-payer system in which prospective rates of compensation were established for DRGs. The new rate-setting system was designed to control costs, improve access to care, maintain quality of services, ensure financial viability of efficient providers, and limit the payment differentials associated with cost shifting. The results of this study have a number of implications for the evaluation of all-payer rate regulation. First, although the New Jersey all-payer system was more successful than the partial-payer program in restraining the rate of increase in cost per case, savings were achieved without adversely affecting the viability of regulated hospitals. Second, the large differentials among payers that were associated with the partial-payer program were reduced dramatically by the all-payer program. Third, using the financial position of inner-city hospitals relative to suburban hospitals as a measure of equity, the all-payer system appeared to be a fairer method of regulating rates.

  12. Managing Mandated Educational Change

    ERIC Educational Resources Information Center

    Clement, Jennifer

    2014-01-01

    This paper explores teachers' perspectives on the management of mandated educational change in order to understand how it may be managed more effectively. A case study of teachers' responses to the introduction of a quality teaching initiative in two New South Wales schools found that while some teachers described the strong negative…

  13. Perceived Effects of State-Mandated Testing Programs on Teaching and Learning: Findings from a National Survey of Teachers.

    ERIC Educational Resources Information Center

    Pedulla, Joseph J.; Abrams, Lisa M.; Madaus, George F.; Russell, Michael K.; Ramos, Miguel A.; Miao, Jing

    Results from a national survey of teachers are reported for five types of state testing programs, those with: (1) high stakes for districts, schools, or teachers, and students; (2) high stakes for districts, schools, and teachers, and moderate stakes for students; (3) high stakes for districts, schools, and teachers, and low stakes for students;…

  14. Mandating better buildings: a global review of building codes and prospects for improvement in the United States

    DOE PAGES

    Sun, Xiaojing; Brown, Marilyn A.; Cox, Matt; Jackson, Roderick

    2015-03-11

    This paper provides a global overview of the design, implementation, and evolution of building energy codes. Reflecting alternative policy goals, building energy codes differ significantly across the United States, the European Union, and China. This review uncovers numerous innovative practices including greenhouse gas emissions caps per square meter of building space, energy performance certificates with retrofit recommendations, and inclusion of renewable energy to achieve “nearly zero-energy buildings”. These innovations motivated an assessment of an aggressive commercial building code applied to all US states, requiring both new construction and buildings with major modifications to comply with the latest version of themore » ASHRAE 90.1 Standards. Using the National Energy Modeling System (NEMS), we estimate that by 2035, such building codes in the United States could reduce energy for space heating, cooling, water heating and lighting in commercial buildings by 16%, 15%, 20% and 5%, respectively. Impacts on different fuels and building types, energy rates and bills as well as pollution emission reductions are also examined.« less

  15. Mandating better buildings: a global review of building codes and prospects for improvement in the United States

    SciTech Connect

    Sun, Xiaojing; Brown, Marilyn A.; Cox, Matt; Jackson, Roderick

    2015-03-11

    This paper provides a global overview of the design, implementation, and evolution of building energy codes. Reflecting alternative policy goals, building energy codes differ significantly across the United States, the European Union, and China. This review uncovers numerous innovative practices including greenhouse gas emissions caps per square meter of building space, energy performance certificates with retrofit recommendations, and inclusion of renewable energy to achieve “nearly zero-energy buildings”. These innovations motivated an assessment of an aggressive commercial building code applied to all US states, requiring both new construction and buildings with major modifications to comply with the latest version of the ASHRAE 90.1 Standards. Using the National Energy Modeling System (NEMS), we estimate that by 2035, such building codes in the United States could reduce energy for space heating, cooling, water heating and lighting in commercial buildings by 16%, 15%, 20% and 5%, respectively. Impacts on different fuels and building types, energy rates and bills as well as pollution emission reductions are also examined.

  16. 42 CFR 411.22 - Reimbursement obligations of primary payers and entities that received payment from primary payers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Reimbursement obligations of primary payers and entities that received payment from primary payers. 411.22 Section 411.22 Public Health CENTERS FOR... Provisions § 411.22 Reimbursement obligations of primary payers and entities that received payment...

  17. 42 CFR 411.22 - Reimbursement obligations of primary payers and entities that received payment from primary payers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Reimbursement obligations of primary payers and entities that received payment from primary payers. 411.22 Section 411.22 Public Health CENTERS FOR... Provisions § 411.22 Reimbursement obligations of primary payers and entities that received payment...

  18. Pharmacogenomics, Evidence, and the Role of Payers

    PubMed Central

    Deverka, P.A.

    2009-01-01

    Initial enthusiasm for the potential of pharmacogenomics (PGx) to transform medical practice has been tempered by the reality that the process of biomarker discovery, validation, and clinical qualification has been disappointingly slow, with a limited number of PGx tests entering the marketplace since the initial publication of the human genome sequence. Reasons for the delays include the complexity of the underlying science as well as clinical, economic, and organizational barriers to the effective delivery of personalized health care. Nevertheless, payers are interested in using PGx services to ensure that drug use is safer and more effective, particularly in the settings of medications that are widely used, have significant risks of serious adverse events, have poor or highly variable drug response, or are very expensive. However, public and private payers have specific evidence requirements for new health care technologies that must be met prior to obtaining favorable coverage and reimbursement status. These evaluation criteria are frequently more rigorous than the current level of evidence required for regulatory approval of new PGx tests or PGx-related drug labeling. To support payer decision-making, researchers will need to measure the impact of PGx testing on clinical and economic outcomes and demonstrate the net benefit of PGx testing as compared to usual care. By linking payer information needs with the current PGx research agenda, there is the opportunity to develop the data required for informed decision-making. This strategy will increase the likelihood that PGx services will be both reimbursed and used appropriately in clinical practice. PMID:19204417

  19. Spina bifida and anencephaly before and after folic acid mandate--United States, 1995-1996 and 1999-2000.

    PubMed

    2004-05-01

    Neural tube defects (NTDs) are serious birth defects of the spine (e.g., spina bifida) and the brain (e.g., anencephaly) that occur during early pregnancy, often before a woman knows she is pregnant; 50%-70% of these defects can be prevented if a woman consumes sufficient folic acid daily before conception and throughout the first trimester of her pregnancy. In 1992, to reduce the number of cases of spina bifida and other NTDs, the U.S. Public Health Service (USPHS) recommended that all women capable of becoming pregnant consume 400 microg of folic acid daily. Three approaches to increase folic acid consumption were cited: 1) improve dietary habits, 2) fortify foods with folic acid, and 3) use dietary supplements containing folic acid. Mandatory fortification of cereal grain products went into effect in January 1998; during October 1998-December 1999, the reported prevalence of spina bifida declined 31%, and the prevalence of anencephaly declined 16%. Other studies have indicated similar trends. To update the estimated numbers of NTD-affected pregnancies and births, CDC recently analyzed data from 23 population-based surveillance systems that include prenatal ascertainment of these birth defects. This report summarizes the results of that analysis, which indicate that the estimated number of NTD-affected pregnancies in the United States declined from 4,000 in 1995-1996 to 3,000 in 1999-2000. This decline in NTD-affected pregnancies highlights the partial success of the U.S. folic acid fortification program as a public health strategy. To reduce further the number of NTD-affected pregnancies, all women capable of becoming pregnant should follow the USPHS recommendation and consume 400 microg of folic acid every day. PMID:15129193

  20. A Study of the Impact of Transformative Professional Development on Hispanic Student Performance on State Mandated Assessments of Science in Elementary School

    NASA Astrophysics Data System (ADS)

    Johnson, Carla C.; Fargo, Jamison D.

    2014-11-01

    This paper reports the findings of a study of the impact of the transformative professional development (TPD) model on student achievement on state-mandated assessments of science in elementary school. Two schools (one intervention and one control) participated in the case study where teachers from one school received the TPD intervention across a 2-year period while teachers at the other school received no program and continued business as usual. The TPD program includes a focus on the core conceptual framework for effective professional development (Desimone in Educ Res 38:181-199, 2009) as well as an emphasis on culturally relevant pedagogy (CRP) and other effective science instructional strategies. Findings revealed that participation in TPD had a significant impact on student achievement for Burns Elementary with the percentage of proficient students growing from 25 % at baseline to 67 % at the end of the 2-year program, while the comparison school did not experience similar growth. Implications for future research and implementation of professional development programs to meet the needs of teachers in the realm of CRP in science are discussed.

  1. The role of value in provider-patient-payer relationships.

    PubMed

    Benson, Keith J; Weech-Maldonado, Robert; Gamm, Larry D

    2003-01-01

    Value is becoming a topic of interest to 3 key players in the healthcare field-patients, payers, and providers. This article examines various value definitions and puts forth a composite value definition incorporating cost, quality, and worth elements. A value triad is created to demonstrate how value can be a linking mechanism between patient, payers and providers. Examples are then provided to assist managers in examining the value associated with payers and patients. PMID:15141848

  2. Partnering with payers? Key lessons to keep in mind.

    PubMed

    Eggbeer, Bill; Sears, Kevin; Homer, Kenneth

    2014-01-01

    Key factors healthcare leaders might wish to consider when evaluating potential partnerships with payers include: Use of safeguards to prevent a payer from using benefit design to shift expected volume from high-revenue service lines or channels. Right to participate in narrow networks. Use of segment-specific language, which protects providers from payers that may try to extend a rate decrease from one patient segment to another. Exclusive co-branding. Automatic price increases if volume is not achieved.

  3. Bilingual Mandate Challenges Chicago's Public Preschools

    ERIC Educational Resources Information Center

    Zehr, Mary Ann

    2010-01-01

    Administrators in the Chicago public schools are seeking to strike the right balance between providing guidance and permitting flexibility as they put in place the nation's first state mandate for providing bilingual education to preschoolers. New rules approved by the Illinois state board of education in June flesh out a January 2009 change that…

  4. Maryland's Global Hospital Budgets--Preliminary Results from an All-Payer Model.

    PubMed

    Patel, Ankit; Rajkumar, Rahul; Colmers, John M; Kinzer, Donna; Conway, Patrick H; Sharfstein, Joshua M

    2015-11-12

    In the first year of Maryland's experiment in setting all-payer rates for hospital services, costs were contained and the quality of care improved, though the state still has high rates of hospital admissions and per capita spending for Medicare patients.

  5. 32 CFR 220.2 - Statutory obligation of third party payer to pay.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... is the reasonable charge for the care provided less the appropriate deductible or copayment amount... claimant's statement or coordination of benefits form. (e) Preemption of conflicting State laws. Any..., for any health care services for which payment by the third party payer under 10 U.S.C. 1095 or...

  6. Primary Payer Status is Associated with Mortality and Resource Utilization for Coronary Artery Bypass Grafting

    PubMed Central

    LaPar, Damien J.; Stukenborg, George J.; Guyer, Richard A.; Stone, Matthew L.; Bhamidipati, Castigliano M.; Lau, Christine L.; Kron, Irving L.; Ailawadi, Gorav

    2012-01-01

    Background Medicaid and Uninsured populations are a significant focus of current healthcare reform. We hypothesized that outcomes following coronary artery bypass grafting (CABG) in the United States is dependent upon primary payer status. Methods From 2003–2007, 1,250,619 isolated CABG operations were evaluated using the Nationwide Inpatient Sample (NIS) database. Patients were stratified by primary payer status: Medicare, Medicaid, Uninsured, and Private Insurance. Hierarchical multiple regression models were applied to assess the effect of primary payer status on postoperative outcomes. Results Unadjusted mortality for Medicare (3.3%), Medicaid (2.4%) and Uninsured (1.9%) patients were higher compared to Private Insurance patients (1.1%, p<0.001). Unadjusted length of stay was longest for Medicaid patients (10.9±0.04 days) and shortest for Private Insurance patients (8.0±0.01 days, p<0.001). Medicaid patients accrued the highest unadjusted total costs ($113,380±386, p<0.001). Importantly, after controlling for patient risk factors, income, hospital features, and operative volume, Medicaid (OR=1.82, p<0.001) and Uninsured (OR=1.62, p<0.001) payer status independently conferred the highest adjusted odds of in-hospital mortality. In addition, Medicaid payer status was associated with the longest adjusted length of stay and highest adjusted total costs (p<0.001). Conclusions Medicaid and Uninsured payer status confers increased risk adjusted in-hospital mortality for patients undergoing coronary artery bypass grafting operations. Medicaid was further associated with the greatest adjusted length of stay and total costs despite risk factors. Possible explanations include delays in access to care or disparate differences in health maintenance. PMID:22965973

  7. Perceived Effects of State-Mandated Testing Programs on Teaching and Learning: Findings from Interviews with Educators in Low-, Medium-, and High-Stakes States.

    ERIC Educational Resources Information Center

    Clarke, Marguerite; Shore, Arnold; Rhoades, Kathleen; Abrams, Lisa; Miao, Jing; Li, Jie

    The goal of this study was to identify the effects of state-level standards-based reform on teaching and learning, paying particular attention to the state test and associated stakes. On-site interviews were conducted with 360 educators (elementary, middle, and high school teachers) in 3 states (120 in each state) attaching different stakes to the…

  8. The efficiency of a group-specific mandated benefit revisited: the effect of infertility mandates.

    PubMed

    Lahey, Joanna N

    2012-01-01

    This paper examines the labor market effects of state health insurance mandates that increase the cost of employing a demographically identifiable group. State mandates requiring that health insurance plans cover infertility treatment raise the relative cost of insuring older women of child-bearing age. Empirically, wages in this group are unaffected, but their total labor input decreases. Workers do not value infertility mandates at cost, and so will not take wage cuts in exchange, leading employers to decrease their demand for this affected and identifiable group. Differences in the empirical effects of mandates found in the literature are explained by a model including variations in the elasticity of demand, moral hazard, ability to identify a group, and adverse selection. PMID:22180892

  9. 42 CFR 422.108 - Medicare secondary payer (MSP) procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... payer. The MA organization will exercise the same rights to recover from a primary plan, entity, or individual that the Secretary exercises under the MSP regulations in subparts B through D of part 411 of this... 42 Public Health 3 2013-10-01 2013-10-01 false Medicare secondary payer (MSP) procedures....

  10. 42 CFR 422.108 - Medicare secondary payer (MSP) procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... payer. The MA organization will exercise the same rights to recover from a primary plan, entity, or individual that the Secretary exercises under the MSP regulations in subparts B through D of part 411 of this... 42 Public Health 3 2014-10-01 2014-10-01 false Medicare secondary payer (MSP) procedures....

  11. 32 CFR 220.6 - Certain payers excluded.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE SERVICES § 220.6 Certain...) Supplemental plans. CHAMPUS (see 32 CFR part 199) supplemental plans and income supplemental plans are excluded... documentation provided by the third party payer, that the policy or plan clearly excludes payment for...

  12. 32 CFR 220.6 - Certain payers excluded.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE SERVICES § 220.6 Certain...) Supplemental plans. CHAMPUS (see 32 CFR part 199) supplemental plans and income supplemental plans are excluded... documentation provided by the third party payer, that the policy or plan clearly excludes payment for...

  13. 32 CFR 220.6 - Certain payers excluded.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE SERVICES § 220.6 Certain...) Supplemental plans. CHAMPUS (see 32 CFR part 199) supplemental plans and income supplemental plans are excluded... documentation provided by the third party payer, that the policy or plan clearly excludes payment for...

  14. 32 CFR 220.6 - Certain payers excluded.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE SERVICES § 220.6 Certain...) Supplemental plans. CHAMPUS (see 32 CFR part 199) supplemental plans and income supplemental plans are excluded... documentation provided by the third party payer, that the policy or plan clearly excludes payment for...

  15. Child Abuse and Mandated Reporting

    ERIC Educational Resources Information Center

    Woika, Shirley; Bowersox, Carissa

    2013-01-01

    Teachers and teachers-in-training are mandated reporters; they are legally required to report any suspected child abuse or neglect. This article describes: (1) How to file a report; (2) How prevalent child abuse is; (3) What abuse is; (4) What it means to be a mandated reporter; (5) When the report should be made; and (6) What to do if abuse is…

  16. Redefining payer-provider relationships in an era of pay for performance: a social capital perspective.

    PubMed

    Young, Gary J

    2013-01-01

    Pay for performance (P4P) has become a leading initiative for improving the quality of care in numerous countries around the world, most notably the United States and United Kingdom. However, the scientific evidence regarding the effectiveness of P4P for improving quality is quite thin. Applying a social capital perspective to the US experience with P4P, this article offers a conceptual analysis of the relationship between payers and providers relative to the prospect for improving the effectiveness of P4P as applied to quality of care. From this perspective, a key barrier to improving the effectiveness of P4P has been that payers and providers have not worked cooperatively in the design and implementation of these financial incentive programs. However, recent developments in the US health care system, namely, the formation of quality improvement collaboratives and global payment arrangements, are helping to redefine relationships between payers and providers that support innovative payment arrangements. These relationships are being redefined in ways that are in accordance with social capital concepts such as trust, commitment, and shared purpose. As such, the US experience offers lessons for improving the effectiveness of P4P in any context in which better cooperation between payers and providers is needed.

  17. Redefining payer-provider relationships in an era of pay for performance: a social capital perspective.

    PubMed

    Young, Gary J

    2013-01-01

    Pay for performance (P4P) has become a leading initiative for improving the quality of care in numerous countries around the world, most notably the United States and United Kingdom. However, the scientific evidence regarding the effectiveness of P4P for improving quality is quite thin. Applying a social capital perspective to the US experience with P4P, this article offers a conceptual analysis of the relationship between payers and providers relative to the prospect for improving the effectiveness of P4P as applied to quality of care. From this perspective, a key barrier to improving the effectiveness of P4P has been that payers and providers have not worked cooperatively in the design and implementation of these financial incentive programs. However, recent developments in the US health care system, namely, the formation of quality improvement collaboratives and global payment arrangements, are helping to redefine relationships between payers and providers that support innovative payment arrangements. These relationships are being redefined in ways that are in accordance with social capital concepts such as trust, commitment, and shared purpose. As such, the US experience offers lessons for improving the effectiveness of P4P in any context in which better cooperation between payers and providers is needed. PMID:23807131

  18. Use of Diagnosis-Related Groups by Non-Medicare Payers

    PubMed Central

    Carter, Grace M.; Jacobson, Peter D.; Kominski, Gerald F.; Perry, Mark J.

    1994-01-01

    Medicare's prospective payment system (PPS) for hospital cases is based on diagnosis-related groups (DRGs). A wide variety of other third-party payers for hospital care have adapted elements of this system for their own use. The extent of DRG use varies considerably both by type of payer and by geographical area. Users include: 21 State Medicaid programs, 3 workers' compensation systems, the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), more than one-half of the Blue Cross and Blue Shield Association (BCBSA) member plans, several self-insured employers, and a few employer coalitions. We describe how each of these payers use DRGs. No single approach is dominant. Some payers negotiate specific prices for so many combinations of DRG and hospital that the paradigm that payment equals rate times weight does not apply. What has emerged appears to be a very flexible payment system in which the only constant is the use of DRGs as a measure of output. PMID:10142368

  19. Comparison of the costs of nonoperative care to minimally invasive surgery for sacroiliac joint disruption and degenerative sacroiliitis in a United States commercial payer population: potential economic implications of a new minimally invasive technology

    PubMed Central

    Ackerman, Stacey J; Polly, David W; Knight, Tyler; Schneider, Karen; Holt, Tim; Cummings, John

    2014-01-01

    Introduction Low back pain is common and treatment costly with substantial lost productivity and lost wages in the working-age population. Chronic low back pain originating in the sacroiliac (SI) joint (15%–30% of cases) is commonly treated with nonoperative care, but new minimally invasive surgery (MIS) options are also effective in treating SI joint disruption. We assessed whether the higher initial MIS SI joint fusion procedure costs were offset by decreased nonoperative care costs from a US commercial payer perspective. Methods An economic model compared the costs of treating SI joint disruption with either MIS SI joint fusion or continued nonoperative care. Nonoperative care costs (diagnostic testing, treatment, follow-up, and retail pharmacy pain medication) were from a retrospective study of Truven Health MarketScan® data. MIS fusion costs were based on the Premier’s Perspective™ Comparative Database and professional fees on 2012 Medicare payment for Current Procedural Terminology code 27280. Results The cumulative 3-year (base-case analysis) and 5-year (sensitivity analysis) differentials in commercial insurance payments (cost of nonoperative care minus cost of MIS) were $14,545 and $6,137 per patient, respectively (2012 US dollars). Cost neutrality was achieved at 6 years; MIS costs accrued largely in year 1 whereas nonoperative care costs accrued over time with 92% of up front MIS procedure costs offset by year 5. For patients with lumbar spinal fusion, cost neutrality was achieved in year 1. Conclusion Cost offsets from new interventions for chronic conditions such as MIS SI joint fusion accrue over time. Higher initial procedure costs for MIS were largely offset by decreased nonoperative care costs over a 5-year time horizon. Optimizing effective resource use in both nonoperative and operative patients will facilitate cost-effective health care delivery. The impact of SI joint disruption on direct and indirect costs to commercial insurers, health

  20. Biosimilars: Opportunities to Promote Optimization Through Payer and Provider Collaboration.

    PubMed

    Manolis, Chronis H; Rajasenan, Kiran; Harwin, William; McClelland, Scott; Lopes, Maria; Farnum, Carolyn

    2016-09-01

    A panel was convened that consisted of 1 medical director, 2 pharmacy directors, and 2 oncologists, who represented the University of Pittsburgh Medical Center Health Plan, an integrated delivery network, and Florida Blue, a progressive regional health plan. This panel met in order to share ideas, discuss challenges, and develop practical solutions to promote optimal utilization in order to encourage collaboration between payers and providers to help ensure the success of biosimilar entrants into the marketplace. Live meetings were conducted in Orlando, Florida, and Pittsburgh, Pennsylvania, and were followed by virtual meetings to solidify ideas and concepts for this supplement. It is important for biosimilar manufacturers to identify potential payer, provider, and patient obstacles in order to develop strategic and tactical plans to preemptively address these potential obstacles. Gathering payer and provider insights will shed light on various issues such as access and reimbursement. Biosimilar manufacturers must be proactive in the education of payers, providers, and patients to ensure access to biosimilars. A strong factor emphasized among this group was that the assumption surrounding biosimilar development and use is the potential for health care cost savings. According to the panel, payers and providers must carefully consider economic implications and potential cost-effectiveness in order to increase the acceptance or understanding of biosimilars in clinical practice. The group identified 3 major challenges surrounding biosimilar adoption: (1) provider confidence in biosimilar education and clinical value, (2) provider confidence in reimbursement for new biosimilars, and (3) creating shared payer and provider cost-savings. After identification of the 3 challenges, the group posed potential solutions to help with biosimilar adoption. PMID:27579939

  1. Contraception Use, Abortions, and Births: The Effect of Insurance Mandates.

    PubMed

    Mulligan, Karen

    2015-08-01

    Beginning August, 2012, the U.S. Patient Protection and Affordable Care Act (ACA) required new private health insurance plans to cover contraceptive methods and counseling without requiring an insured's copay. The ACA represents the first instance of federally mandated contraception insurance coverage, but 30 U.S. states had already mandated contraceptive insurance coverage through state-level legislation prior to the ACA. This study examines whether mandated insurance coverage of contraception affects contraception use, abortions, and births. I find that mandates increase the likelihood of contraception use by 2.1 percentage points, decrease the abortion rate by 3 %, and have an insignificant impact on the birth rate. The results imply a lower-bound estimate that the ACA will result in approximately 25,000 fewer abortions. PMID:26153735

  2. 32 CFR 220.6 - Certain payers excluded.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... or Medicaid programs (titles XVIII and XIX of the Social Security Act) are not authorized. (b) Supplemental plans. CHAMPUS (see 32 CFR part 199) supplemental plans and income supplemental plans are excluded... documentation provided by the third party payer, that the policy or plan clearly excludes payment for...

  3. 42 CFR 422.108 - Medicare secondary payer (MSP) procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Medicare secondary payer (MSP) procedures. 422.108 Section 422.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections §...

  4. 42 CFR 423.462 - Medicare secondary payer procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Medicare secondary payer procedures. 423.462 Section 423.462 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part...

  5. State-Level Mandates for Financial Literacy Education, JA Finance Park, and the Impact on Eighth-Grade Students in Colorado

    ERIC Educational Resources Information Center

    Mitchell, Sherri L.

    2013-01-01

    In 2008, the Colorado General Assembly passed legislation requiring the adoption of personal financial literacy (PFL) education standards for kindergarten through 12th-grade students. Beginning in 2014, the state plans to conduct standardized testing to determine financial literacy of 3rd- through 12th-grade students. The state did not allocate…

  6. 32 CFR 728.35 - Coordination of benefits-third party payers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... to third-party payers for the cost of such care. Admission office personnel must obtain insurance, medical service, or health plan (third-party payer) information from retirees and dependents upon.... 1095 directs the services to collect from third-party payers the reasonable costs of inpatient...

  7. 42 CFR 411.25 - Primary payer's notice of primary payment responsibility.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Primary payer's notice of primary payment... Insurance Coverage That Limits Medicare Payment: General Provisions § 411.25 Primary payer's notice of primary payment responsibility. (a) If it is demonstrated to a primary payer that CMS has made a...

  8. 42 CFR 411.25 - Primary payer's notice of primary payment responsibility.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Primary payer's notice of primary payment... Insurance Coverage That Limits Medicare Payment: General Provisions § 411.25 Primary payer's notice of primary payment responsibility. (a) If it is demonstrated to a primary payer that CMS has made a...

  9. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Payment when Medicare is not primary payer. 417.528... Medicare is not primary payer. (a) Limits on payments and charges. (1) CMS may not pay for services to the extent that Medicare is not the primary payer under section 1862(b) of the Act and part 411 of...

  10. 40 CFR 1500.3 - Mandate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Mandate. 1500.3 Section 1500.3 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY PURPOSE, POLICY, AND MANDATE § 1500.3 Mandate... significant impact (when such a finding will result in action affecting the environment), or takes action...

  11. 40 CFR 1500.3 - Mandate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Mandate. 1500.3 Section 1500.3 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY PURPOSE, POLICY, AND MANDATE § 1500.3 Mandate... significant impact (when such a finding will result in action affecting the environment), or takes action...

  12. 40 CFR 1500.3 - Mandate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Mandate. 1500.3 Section 1500.3 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY PURPOSE, POLICY, AND MANDATE § 1500.3 Mandate. Parts 1500 through 1508 of this title provide regulations applicable to and binding on all...

  13. Predictors of Payer Mix and Financial Performance Among Safety Net Hospitals Prior to the Affordable Care Act.

    PubMed

    Sommers, Benjamin D; Stone, Juliana; Kane, Nancy

    2016-01-01

    The objective of this study was to use audited hospital financial statements to identify predictors of payer mix and financial performance in safety net hospitals prior to the Affordable Care Act. We analyzed the 2010 financial statements of 98 large, urban safety net hospital systems in 34 states, supplemented with data on population demographics, hospital features, and state policies. We used multivariate regression to identify independent predictors of three outcomes: 1) Medicaid-reliant payer mix (hospitals for which at least 25% of hospital days are paid for by Medicaid); 2) safety net revenue-to-cost ratio (Medicaid and Medicare Disproportionate Share Hospital payments and local government transfers, divided by charity care costs and Medicaid payment shortfall); and 3) operating margin. Medicaid-reliant payer mix was positively associated with more inclusive state Medicaid eligibility criteria and more minority patients. More inclusive Medicaid eligibility and higher Medicaid reimbursement rates positively predicted safety net revenue-to-cost ratio. University governance was the strongest positive predictor of operating margin. Safety net hospital financial performance varied considerably. Academic hospitals had higher operating margins, while more generous Medicaid eligibility and reimbursement policies improved hospitals' ability to recoup costs. Institutional and state policies may outweigh patient demographics in the financial health of safety net hospitals.

  14. Predictors of Payer Mix and Financial Performance Among Safety Net Hospitals Prior to the Affordable Care Act.

    PubMed

    Sommers, Benjamin D; Stone, Juliana; Kane, Nancy

    2016-01-01

    The objective of this study was to use audited hospital financial statements to identify predictors of payer mix and financial performance in safety net hospitals prior to the Affordable Care Act. We analyzed the 2010 financial statements of 98 large, urban safety net hospital systems in 34 states, supplemented with data on population demographics, hospital features, and state policies. We used multivariate regression to identify independent predictors of three outcomes: 1) Medicaid-reliant payer mix (hospitals for which at least 25% of hospital days are paid for by Medicaid); 2) safety net revenue-to-cost ratio (Medicaid and Medicare Disproportionate Share Hospital payments and local government transfers, divided by charity care costs and Medicaid payment shortfall); and 3) operating margin. Medicaid-reliant payer mix was positively associated with more inclusive state Medicaid eligibility criteria and more minority patients. More inclusive Medicaid eligibility and higher Medicaid reimbursement rates positively predicted safety net revenue-to-cost ratio. University governance was the strongest positive predictor of operating margin. Safety net hospital financial performance varied considerably. Academic hospitals had higher operating margins, while more generous Medicaid eligibility and reimbursement policies improved hospitals' ability to recoup costs. Institutional and state policies may outweigh patient demographics in the financial health of safety net hospitals. PMID:25995304

  15. Cost-Effectiveness of Global Endometrial Ablation vs. Hysterectomy for Treatment of Abnormal Uterine Bleeding: US Commercial and Medicaid Payer Perspectives

    PubMed Central

    Lenhart, Gregory M.; Bonafede, Machaon M.; Lukes, Andrea S.; Laughlin-Tommaso, Shannon K.

    2015-01-01

    Abstract Cost-effectiveness modeling studies of global endometrial ablation (GEA) for treatment of abnormal uterine bleeding (AUB) from a US perspective are lacking. The objective of this study was to model the cost-effectiveness of GEA vs. hysterectomy for treatment of AUB in the United States from both commercial and Medicaid payer perspectives. The study team developed a 1-, 3-, and 5-year semi-Markov decision-analytic model to simulate 2 hypothetical patient cohorts of women with AUB—1 treated with GEA and the other with hysterectomy. Clinical and economic data (including treatment patterns, health care resource utilization, direct costs, and productivity costs) came from analyses of commercial and Medicaid claims databases. Analysis results show that cost savings with simultaneous reduction in treatment complications and fewer days lost from work are achieved with GEA versus hysterectomy over almost all time horizons and under both the commercial payer and Medicaid perspectives. Cost-effectiveness metrics also favor GEA over hysterectomy from both the commercial payer and Medicaid payer perspectives—evidence strongly supporting the clinical-economic value about GEA versus hysterectomy. Results will interest clinicians, health care payers, and self-insured employers striving for cost-effective AUB treatments. (Population Health Management 2015;18:373–382) PMID:25714906

  16. Cost-Effectiveness of Global Endometrial Ablation vs. Hysterectomy for Treatment of Abnormal Uterine Bleeding: US Commercial and Medicaid Payer Perspectives.

    PubMed

    Miller, Jeffrey D; Lenhart, Gregory M; Bonafede, Machaon M; Lukes, Andrea S; Laughlin-Tommaso, Shannon K

    2015-10-01

    Cost-effectiveness modeling studies of global endometrial ablation (GEA) for treatment of abnormal uterine bleeding (AUB) from a US perspective are lacking. The objective of this study was to model the cost-effectiveness of GEA vs. hysterectomy for treatment of AUB in the United States from both commercial and Medicaid payer perspectives. The study team developed a 1-, 3-, and 5-year semi-Markov decision-analytic model to simulate 2 hypothetical patient cohorts of women with AUB-1 treated with GEA and the other with hysterectomy. Clinical and economic data (including treatment patterns, health care resource utilization, direct costs, and productivity costs) came from analyses of commercial and Medicaid claims databases. Analysis results show that cost savings with simultaneous reduction in treatment complications and fewer days lost from work are achieved with GEA versus hysterectomy over almost all time horizons and under both the commercial payer and Medicaid perspectives. Cost-effectiveness metrics also favor GEA over hysterectomy from both the commercial payer and Medicaid payer perspectives-evidence strongly supporting the clinical-economic value about GEA versus hysterectomy. Results will interest clinicians, health care payers, and self-insured employers striving for cost-effective AUB treatments.

  17. States Address Civics with Mandated Task Forces

    ERIC Educational Resources Information Center

    Delander, Brady

    2014-01-01

    By coincidence or not, Massachusetts, Illinois and Virginia created civic education task forces not long after national test results showed a dismal understanding of the subject matter across all grade levels. Results of the 2010 National Assessment of Educational Progress showed just 25 percent of all testtakers in grades 4, 8 and 12 demonstrated…

  18. Mandated Mental Health Insurance: A Complex Case of Pros and Cons. Human Resources Series.

    ERIC Educational Resources Information Center

    Paterson, Andrea

    1986-01-01

    The pros and cons of state laws mandating mental health insurance are discussed in this report. The history of a 1985 Supreme Court case which held that states could mandate mental health benefits introduces the report. In an overview of the issue, the long-standing argument between the insurance industry and the mental health establishment is…

  19. Are Teachers Prepared? Predictors of Teachers' Readiness to Serve as Mandated Reporters of Child Abuse

    ERIC Educational Resources Information Center

    Greytak, Emily A.

    2009-01-01

    The Child Abuse Prevention and Treatment Act (1974) requires that states receiving U.S. federal funds directed at child abuse implement mandated reporting laws. As a result, all states have adopted legislation requiring teachers and other professionals who deal with children to report suspicions of child abuse. The federal mandate for such…

  20. Print News Coverage of School-Based HPV Vaccine Mandate

    PubMed Central

    Casciotti, Dana; Smith, Katherine C.; Andon, Lindsay; Vernick, Jon; Tsui, Amy; Klassen, Ann C.

    2015-01-01

    BACKGROUND In 2007, legislation was proposed in 24 states and the District of Columbia for school-based HPV vaccine mandates, and mandates were enacted in Texas, Virginia, and the District of Columbia. Media coverage of these events was extensive, and media messages both reflected and contributed to controversy surrounding these legislative activities. Messages communicated through the media are an important influence on adolescent and parent understanding of school-based vaccine mandates. METHODS We conducted structured text analysis of newspaper coverage, including quantitative analysis of 169 articles published in mandate jurisdictions from 2005-2009, and qualitative analysis of 63 articles from 2007. Our structured analysis identified topics, key stakeholders and sources, tone, and the presence of conflict. Qualitative thematic analysis identified key messages and issues. RESULTS Media coverage was often incomplete, providing little context about cervical cancer or screening. Skepticism and autonomy concerns were common. Messages reflected conflict and distrust of government activities, which could negatively impact this and other youth-focused public health initiatives. CONCLUSIONS If school health professionals are aware of the potential issues raised in media coverage of school-based health mandates, they will be more able to convey appropriate health education messages, and promote informed decision-making by parents and students. PMID:25099421

  1. Gene therapy, fundamental rights, and the mandates of public health.

    PubMed

    Lynch, John

    2004-01-01

    Recent and near-future developments in the field of molecular biology will make possible the treatment of genetic disease on an unprecedented scale. The potential applications of these developments implicate important public policy considerations. Among the questions that may arise is the constitutionality of a state-mandated program of gene therapy for the purpose of eradicating certain genetic diseases. Though controversial, precedents of public health jurisprudence suggest that such a program could survive constitutional scrutiny. This article provides an overview of gene therapy in the context of fundamental rights and the mandates of public health. PMID:15255004

  2. External Mandates and Instructional Leadership: School Leaders as Mediating Agents

    ERIC Educational Resources Information Center

    Louis, Karen Seashore; Robinson, Viviane M.

    2012-01-01

    Purpose: The purpose of this paper is to examine how US school leaders make sense of external mandates, and the way in which their understanding of state and district accountability policies affects their work. It is posited that school leaders' responses to external accountability are likely to reflect a complex interaction between their…

  3. The Mandate: To Identify Children with Handicapping Conditions.

    ERIC Educational Resources Information Center

    Mazzullo, Mariann C.

    Reviewed are 10 Child Find projects to locate possibly handicapped children as mandated by Public Law 94-142 with particular emphasis on Child Find activities in New York State. Noted are efforts of Colorado, and Idaho including public awareness campaigns, and screening programs. It is reported that more than 30 projects have been funded in New…

  4. Using External Accountability Mandates to Create Internal Change

    ERIC Educational Resources Information Center

    Petrides, Lisa A.; McClelland, Sara I.; Nodine, Thad R.

    2004-01-01

    In light of a new state-mandated performance-based funding mechanism for community colleges in California, this article discusses how one district sought to implement new internal evaluation procedures to improve student outcomes in line with systemwide goals outlined in the performance-based funding. These efforts introduced an evaluative …

  5. Intergovernmental Mandates in Federal Legislation. Economic and Budget Issue Brief

    ERIC Educational Resources Information Center

    Lex, Leo

    2009-01-01

    Federal law sometimes requires state, local, or tribal governments to spend money to achieve certain goals. In some cases, a requirement is imposed as a condition for receiving federal aid; in others, requirements can be imposed through the exercise of the federal government's sovereign power. The Unfunded Mandates Reform Act of 1995 (UMRA)…

  6. Parallel payers, privatization and two-tier healthcare in Canada.

    PubMed

    Davidson, Alan

    2008-01-01

    The commissioning of care by Workers' Compensation Boards alongside provincial healthcare insurance plans functions in Canada in much the same way as parallel private insurance functions in countries like England and Australia. Parallel payers introduce policy conflict, undermine equity and promote privatization. WCB demands for expedited care for injured workers create challenges for the efficiency and fairness of the healthcare system. Unfortunately, the legitimate policy of goals of WCB and universal healthcare insurance are difficult to reconcile in the real world of Canadian healthcare policy. PMID:18493171

  7. Mandated Reporting Thresholds for Community Professionals

    ERIC Educational Resources Information Center

    Crowell, Kathryn; Levi, Benjamin H.

    2012-01-01

    This study examines how community-based mandated reporters understand and interpret "reasonable suspicion", the standard threshold for mandated reporting of suspected child abuse. Respondents were asked to identify the probability necessary for "suspicion of child abuse" to constitute "reasonable suspicion". Data were analyzed for internal…

  8. Learning from the Aloha State.

    PubMed

    Dukakis, M S; Roseman, C

    1992-01-01

    Since 1974, Hawaii has required its employers to provide health insurance to all employees working at least 20 hours a week. More recently, the state created a new program to cover the "gap group" of 50,000 uninsured residents, along with a new program to create a "seamless system of health care" for all Aloha State residents. And Hawaii has managed to insure nearly all of its citizens while keeping the annual price of health insurance at nearly half of that paid in many mainland states ($1,300 per person and $4,000 per family). At the same time, life expectancy is the highest in the nation and infant mortality is among the lowest. In seeking to reform a dysfunctional national insurance system, policymakers should learn from the Hawaiian experience, which shows that small business can live with an employer mandate, universal coverage can cut costs by encouraging early preventive care, and a dominant payer can reduce administrative expenses.

  9. Biosimilars: How Can Payers Get Long-Term Savings?

    PubMed

    Mestre-Ferrandiz, Jorge; Towse, Adrian; Berdud, Mikel

    2016-06-01

    The term 'biosimilar' refers to an alternative similar version of an off-patent innovative originator biotechnology product (the 'reference product'). Several biosimilars have been approved in Europe, and a number of top-selling biological medicines have lost, or will lose, patent protection over the next 5 years. We look at the experience in Europe so far. The USA has finally implemented a regulatory route for biosimilar approval. We recommend that European and US governments and payers take a strategic approach to get value for money from the use of biosimilars by (1) supporting and incentivising generation of high-quality comprehensive outcomes data on the effectiveness and safety of biosimilars and originator products; and (2) ensuring that incentives are in place for budget holders to benefit from price competition. This may create greater willingness on the part of budget holders and clinicians to use biosimilar and originator products with comparable outcomes interchangeably, and may drive down prices. Other options, such as direct price cuts for originator products or substitution rules without outcomes data, are likely to discourage biosimilar entry. With such approaches, governments may achieve a one-off cut in originator prices but may put at risk the creation of a more competitive market that would, in time, produce much greater savings. It was the creation of competitive markets for chemical generic drugs-notably, in the USA, the UK and Germany-rather than price control, that enabled payers to achieve the high discounts now taken for granted. PMID:26792791

  10. Parent Involvement in the Special Education Eligibility Process: Implementation of Legal Mandates and Best Practices

    ERIC Educational Resources Information Center

    McEvoy, Cathleen K.

    2013-01-01

    School psychologists throughout New York State were surveyed regarding their schools' policies to include parents in the special education eligibility process related to legal mandates and best practices. Differences were found in the implementation of legal mandates compared to implementation of best practices. Location differences were…

  11. Adolescent Abortion and Mandated Parental Involvement: The Impact of Back Alley Laws on Young Women.

    ERIC Educational Resources Information Center

    Flinn, Susan; And Others

    This document notes that many states have passed, or are considering, laws that would mandate parental consent for, or notification of, a young woman's decision to obtain an abortion. Constructed in a question-and-answer format, the document then examines a number of issues concerned with such mandated parental involvement. It examines who is…

  12. Print News Coverage of School-Based Human Papillomavirus Vaccine Mandates

    ERIC Educational Resources Information Center

    Casciotti, Dana M.; Smith, Katherine C.; Andon, Lindsay; Vernick, Jon; Tsui, Amy; Klassen, Ann C.

    2014-01-01

    Background: In 2007, legislation was proposed in 24 states and the District of Columbia for school-based human papillomavirus (HPV) vaccine mandates, and mandates were enacted in Texas, Virginia, and the District of Columbia. Media coverage of these events was extensive, and media messages both reflected and contributed to controversy surrounding…

  13. A Review of CBO's Activities in 2008 under the Unfunded Mandates Reform Act. A CBO Report

    ERIC Educational Resources Information Center

    Lex, Leo

    2009-01-01

    In this report, part of an annual series that began in 1997, the Congressional Budget Office (CBO) reviews its activities under the Unfunded Mandates Reform Act of 1995. The report covers public laws enacted and legislation considered by the Congress in 2008 that would impose federal mandates on state, local, or tribal governments or on the…

  14. Modified mandated choice for organ procurement

    PubMed Central

    Chouhan, P; Draper, H

    2003-01-01

    Presumed consent to organ donation looks increasingly unlikely to be a palatable option for increasing organ procurement in the UK following the publication of the report into events at Alder Hey and elsewhere. Yet, given that the alternative to increasing the number of cadaveric organs available is either to accept a greater number of live donations, or accept that people will continue to die for the want of an organ, public policy makers remain obliged to consider other means of increasing the procurement rate. In this paper, we meet the main objections to mandated choice (namely that it undermines autonomy and that mandated donation is preferable). We have modified the traditional approach to mandated choice to take into account the force of the objection that mandated donation is preferable, by accepting that people can and do make bad decisions about organ donation and proposing that all accompanying public education and information about cadaveric donation should be directed in favour of donation. PMID:12796435

  15. 42 CFR 411.31 - Authority to bill primary payers for full charges.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Authority to bill primary payers for full charges... Coverage That Limits Medicare Payment: General Provisions § 411.31 Authority to bill primary payers for... plans, a provider or supplier may bill its full charges and expect those charges to be paid unless...

  16. 42 CFR 411.31 - Authority to bill primary payers for full charges.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Authority to bill primary payers for full charges... Coverage That Limits Medicare Payment: General Provisions § 411.31 Authority to bill primary payers for... plans, a provider or supplier may bill its full charges and expect those charges to be paid unless...

  17. 42 CFR 411.31 - Authority to bill primary payers for full charges.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Authority to bill primary payers for full charges... Coverage That Limits Medicare Payment: General Provisions § 411.31 Authority to bill primary payers for... plans, a provider or supplier may bill its full charges and expect those charges to be paid unless...

  18. 78 FR 57800 - Medicare Program; Obtaining Final Medicare Secondary Payer Conditional Payment Amounts via Web...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-20

    ...; Obtaining Final Medicare Secondary Payer Conditional Payment Amounts via Web Portal AGENCY: Centers for... Medicare Secondary Payer (MSP) Web portal to conform to section 201 of the Medicare IVIG and Strengthening... MSP Web portal. It also requires that we add functionality to the existing MSP Web portal that...

  19. 32 CFR 728.35 - Coordination of benefits-third party payers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Coordination of benefits-third party payers. 728... MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Retired Members and Dependents of the Uniformed Services § 728.35 Coordination of benefits—third party payers. Title 10...

  20. Medicaid Expansion In 2014 Did Not Increase Emergency Department Use But Did Change Insurance Payer Mix.

    PubMed

    Pines, Jesse M; Zocchi, Mark; Moghtaderi, Ali; Black, Bernard; Farmer, Steven A; Hufstetler, Greg; Klauer, Kevin; Pilgrim, Randy

    2016-08-01

    In 2014 twenty-eight states and the District of Columbia had expanded Medicaid eligibility while federal and state-based Marketplaces in every state made subsidized private health insurance available to qualified individuals. As a result, about seventeen million previously uninsured Americans gained health insurance in 2014. Many policy makers had predicted that Medicaid expansion would lead to greatly increased use of hospital emergency departments (EDs). We examined the effect of insurance expansion on ED use in 478 hospitals in 36 states during the first year of expansion (2014). In difference-in-differences analyses, Medicaid expansion increased Medicaid-paid ED visits in those states by 27.1 percent, decreased uninsured visits by 31.4 percent, and decreased privately insured visits by 6.7 percent during the first year of expansion compared to nonexpansion states. Overall, however, total ED visits grew by less than 3 percent in 2014 compared to 2012-13, with no significant difference between expansion and nonexpansion states. Thus, the expansion of Medicaid coverage strongly affected payer mix but did not significantly affect overall ED use, even though more people gained insurance coverage in expansion states than in nonexpansion states. This suggests that expanding Medicaid did not significantly increase or decrease overall ED visit volume. PMID:27503974

  1. Medicaid Expansion In 2014 Did Not Increase Emergency Department Use But Did Change Insurance Payer Mix.

    PubMed

    Pines, Jesse M; Zocchi, Mark; Moghtaderi, Ali; Black, Bernard; Farmer, Steven A; Hufstetler, Greg; Klauer, Kevin; Pilgrim, Randy

    2016-08-01

    In 2014 twenty-eight states and the District of Columbia had expanded Medicaid eligibility while federal and state-based Marketplaces in every state made subsidized private health insurance available to qualified individuals. As a result, about seventeen million previously uninsured Americans gained health insurance in 2014. Many policy makers had predicted that Medicaid expansion would lead to greatly increased use of hospital emergency departments (EDs). We examined the effect of insurance expansion on ED use in 478 hospitals in 36 states during the first year of expansion (2014). In difference-in-differences analyses, Medicaid expansion increased Medicaid-paid ED visits in those states by 27.1 percent, decreased uninsured visits by 31.4 percent, and decreased privately insured visits by 6.7 percent during the first year of expansion compared to nonexpansion states. Overall, however, total ED visits grew by less than 3 percent in 2014 compared to 2012-13, with no significant difference between expansion and nonexpansion states. Thus, the expansion of Medicaid coverage strongly affected payer mix but did not significantly affect overall ED use, even though more people gained insurance coverage in expansion states than in nonexpansion states. This suggests that expanding Medicaid did not significantly increase or decrease overall ED visit volume.

  2. Guidelines and Value-Based Decision Making: An Evolving Role for Payers.

    PubMed

    McCauley, Janet L

    2015-01-01

    Payers use evidence-based guidelines to promote effective health diagnoses and treatments for their members and to ensure that members are not subject to harmful or wasteful care. Payer guidelines inform coverage, but the content of these guidelines relies on the same evidentiary base as clinical treatment guidelines. Recent strategies to foster value through benefit design and alternative reimbursement methodologies illustrate emerging applications for evidence-based guidelines. The current focus on cost effectiveness within health technology assessment, comparative effectiveness research in collaboration with payers, and transparency around payer evidence assessment could better align payers' interests in evidence-based care with those of other stakeholders. The move to value in health care will depend upon credible clinical evidence to enable informed decision making. PMID:26509518

  3. Legislative Mandates and Financial Reporting.

    ERIC Educational Resources Information Center

    Bock, Almon C., II

    1983-01-01

    Asserts the importance of each school business official's responsibility to accurately report the school's financial situation to the state legislature. Uses Minnesota's 33 area vocational technical institutes to illustrate the application of statewide uniform financial accounting and reporting standards to Minnesota public school districts. (JBM)

  4. Differences in utilization of drug-eluting stents by race and payer.

    PubMed

    Hannan, Edward L; Racz, Michael; Walford, Gary; Clark, Luther T; Holmes, David R; King, Spencer B; Sharma, Samin

    2007-10-15

    Numerous disparities in access to health care by race and gender have been identified in the literature. This study examines differences in the use of drug-eluting stents (DES) versus bare-metal stents (BMS) by race, payer, and income level. Data from New York State's Percutaneous Coronary Intervention Reporting System from July 2003 to December 2004 were used to examine use of DES (20,165 patients) relative to BMS (4,547 patients) by race, payer, and annual income level, controlling for a variety of patient and hospital characteristics. African-Americans were found to be less likely to receive DES than other races between July 2003 and March 2004 (adjusted odds ratio [OR] 0.56, 95% confidence interval [CI] 0.50 to 0.65) and between April 2004 and December 2004 (adjusted OR 0.74, 95% CI 0.61 to 0.90). These disparities were reduced (respective adjusted ORs 0.67, 95% CI 0.58 to 0.77 and 0.81, 95% CI 0.66 to 0.91) when controlling for admitting hospital and hospital volume, but were still significant. Medicaid/self-pay patients, and patients living in zip codes with median annual incomes between $20,000 and $30,000 were also less likely to receive DES in the first time period (adjusted respective ORs 0.80, 95% CI 0.68 to 0.93) and 0.85, 95% CI 0.75 to 0.96). In conclusion, African-Americans and low income groups receive DES less frequently than their counterparts compared with BMS. This is related to the hospitals where they are admitted, but not entirely.

  5. State Test Programs Mushroom as NCLB Mandate Kicks in: Nearly Half of States Are Expanding Their Testing Programs to Additional Grades This School Year to Comply with the Federal No Child Left Behind Act

    ERIC Educational Resources Information Center

    Olson, Lynn

    2005-01-01

    Twenty-three states are expanding their testing programs to additional grades this school year to comply with the federal No Child Left Behind Act. In devising the new tests, most states have defied predictions and chosen to go beyond multiple-choice items, by including questions that ask students to construct their own responses. But many state…

  6. Ethanol mandate thrown out by appeals court

    SciTech Connect

    Begley, R.

    1995-05-10

    In a victory for the oil industry, a federal appeals court has overturned EPA`s mandate for ethanol use in reformulated gasoline (REG), saying the agency lacks authority to require 30% of the oxygenate market be reserved for ethanol. EPA says the ruling does not prevent ethanols use in RFG - {open_quotes}It only says that EPA cannot dictate the recipe.{close_quotes} Charles DiBona, president of the American Petroleum Institute (API), says {open_quotes}API and its member companies are not opposed to the use of ethanol as an oxygenate. We oppose this illegal mandate.{close_quotes} Urvan Sternfels, president of the National Petroleum Refiners Association, says, {open_quotes}Mandating market shares for any product is unsound economic policy.{close_quotes} The two trade groups led the legal battle against the ethanol requirement.

  7. Mandating Father Involvement: Implications for Special Educators.

    ERIC Educational Resources Information Center

    Lillie, Timothy

    This paper examines issues concerning mandated father involvement with their children, especially as this involvement affects children with special needs. The paper examines four points: (1) the history of the status of fathers, how it has changed, and why father involvement is an issue; (2) current regulations at the federal level which…

  8. Understanding Teacher Relationships during a Mandated Reform.

    ERIC Educational Resources Information Center

    Gremillion, Joan; Cody, Caroline B.

    This study explored the social world of one school, looked at the web of relationships, and documented the social interactions that occurred in the context of a mandated reform. The study was designed to describe and understand the relationships of teachers in one school as they planned and developed a school-wide strategy for change as required…

  9. Single-payer health insurance systems: national myths and immovable mountains.

    PubMed Central

    Lightfoote, J. B.; Ragland, K. D.

    1996-01-01

    Leaders in both government and the health-care industry have strong and varied opinions regarding the present US health-care system, but concur that health-care financing and organization need restructuring. The single-payer system offers the best framework for improving health-care universality, delivery, quality, access, choice, and cost effectiveness. However, the single-payer alternative often is dismissed early in debates on health-care reform. Popular aversion to collective governmental funding of health-care costs and the economic interests of the management, insurance, information, and profit sectors of the health-care industry are the critical impediments to adoption of single-payer insurance systems. This article examines the psychosocial and economic obstacles that prevent development of an efficient and effective health-care system and preclude recognition of the single-payer system as the best answer to health-care reform. PMID:8648657

  10. Does Payer Type Influence Pediatric Burn Outcomes? A National Study Using the Healthcare Cost and Utilization Project Kids' Inpatient Database.

    PubMed

    Duquette, Stephen; Soleimani, Tahereh; Hartman, Brett; Tahiri, Youssef; Sood, Rajiv; Tholpady, Sunil

    2016-01-01

    Pediatric burns are a considerable source of injury in the United States. Socioeconomic status has been demonstrated to influence other disease outcomes. The goal of this study was to analyze national pediatric burn outcomes based on payer type. A retrospective study was designed using the Kids' Inpatient Database (KID), years 2000 to 2009. Patients 18 years of age and under with Major Diagnostic code number 22 for burn were included. A total of 22,965 patients were identified, estimating 37,856 discharges. Descriptive and bivariate statistics were performed. Multiple regression analysis was used to assess correlation of payer type with complications and length of stay (LOS). The majority of patients were Medicaid (52.3%). Medicaid patients were younger (4.25, P < .05), had a higher rate of being in the first quartile of their zipcode's income (46.26%, P < .05), and contained a higher proportion of African-Americans (30.01%, P < .05). Overall complication rate was higher among Medicaid patients than private insurance and self-pay patients (6.64 vs 5.51 and 4.35%, respectively, P = .11). Logistic regression analysis of complications showed that Medicaid coverage (P < .001) was associated with complications. The geometric mean LOS among Medicaid patients was 3.7 days compared with private insurance (3.5 days) and self-pay patients (3.1 days). Medicaid patients had longer LOS and more complications. Regression analysis revealed that payer type was a factor in LOS and overall complication rate. Identifying dissimilar outcomes based on patient and injury characteristics is critical in providing information on how to improve those outcomes.

  11. Effectiveness of an Electronic Booster Session Delivered to Mandated Students.

    PubMed

    Linowski, Sally A; DiFulvio, Gloria T; Fedorchak, Diane; Puleo, Elaine

    2016-01-01

    College student drinking continues to be a problem in the United States. Students who have violated campus alcohol policy are at particularly high risk for dangerous drinking. While Brief Alcohol Screening and Intervention for College Students (BASICS) has been found to be an effective strategy in reducing high-risk drinking and associated consequences, questions remain about ways to further reduce risk or sustain changes associated with a face-to face intervention. The purpose of this study was to assess the effectiveness of a computer-delivered personalized feedback (electronic booster) delivered to policy violators who completed a mandated BASICS program. At 3-month post-intervention, 346 participants (60.4% male and 39.6% female) were randomized to one of two conditions: assessment only (n = 171) or electronic booster feedback (n = 175). Follow-up assessments were given to all participants at 3, 6, and 12-month post-initial intervention. Both groups showed reductions in drinking after the in-person BASICS intervention, but no additional reductions were seen with the addition of an electronic booster session. Findings suggest that although brief motivational interventions delivered in person to mandated students have been shown to be effective with mandated students, there is no additional benefit from an electronic booster session delivered 3-month post-intervention for this population.

  12. Effectiveness of an Electronic Booster Session Delivered to Mandated Students.

    PubMed

    Linowski, Sally A; DiFulvio, Gloria T; Fedorchak, Diane; Puleo, Elaine

    2016-01-01

    College student drinking continues to be a problem in the United States. Students who have violated campus alcohol policy are at particularly high risk for dangerous drinking. While Brief Alcohol Screening and Intervention for College Students (BASICS) has been found to be an effective strategy in reducing high-risk drinking and associated consequences, questions remain about ways to further reduce risk or sustain changes associated with a face-to face intervention. The purpose of this study was to assess the effectiveness of a computer-delivered personalized feedback (electronic booster) delivered to policy violators who completed a mandated BASICS program. At 3-month post-intervention, 346 participants (60.4% male and 39.6% female) were randomized to one of two conditions: assessment only (n = 171) or electronic booster feedback (n = 175). Follow-up assessments were given to all participants at 3, 6, and 12-month post-initial intervention. Both groups showed reductions in drinking after the in-person BASICS intervention, but no additional reductions were seen with the addition of an electronic booster session. Findings suggest that although brief motivational interventions delivered in person to mandated students have been shown to be effective with mandated students, there is no additional benefit from an electronic booster session delivered 3-month post-intervention for this population. PMID:26857563

  13. Changes to Medicare Secondary Payer (MSP) provisions--HCFA. Notice.

    PubMed

    1991-01-11

    This notice describes how subsections 6202(b), (c), and (e) of the Omnibus Budget Reconciliation Act of 1989 (Pub. L. 101-239) affect the Medicare Program These subsections: Create uniform rules for computing Medicare secondary payments for all MSP situations; Exempt from the MSP provisions services performed for a religious order by members of the order who take a vow of poverty; Prohibit group health plans (GHPs) from "taking into account" that an individual is entitled to Medicare when Medicare is the secondary payer; Prohibit GHPs from differentiating, in the services they provide, between individuals with end-stage renal disease (ESRD) and other individuals covered by the plan; Require that GHPs of employers of 20 or more employees provide the same benefits under the same conditions to employees age 65 or older and employees' spouses age 65 or older as they provide to employees and spouses under age 65; Impose a 25 percent excise tax on contributions that employers and employee organizations make to nonconforming GHPs, i.e., plans that do not comply with the MSP provisions; Extend to all MSP situations the Federal Government's right to take legal action to collect double damages if a primary plan fails to comply with the Medicare secondary payment requirements of the law; Make the provisions for special enrollment periods for the disabled parallel to those in effect for the working aged. The statutory changes made by subsections 6202(b), (c), and (e) can be put into effect without first issuing regulations because it is clear on the face of the statute what the Congress intended.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10109426

  14. Packaging effective community service delivery: the utility of mandates and contracts in obtaining administrative cooperation.

    PubMed

    Woodard, K L

    1994-01-01

    Voluntary agreements, mandates, and contracts integrate networks of social service organizations, allowing them to function as coordinated wholes. The author reviews the history of contracting and mandating in the public sector. It is hypothesized that contracted relationships formalize agreements between local organizations dependent on others. Mandated relationships are perceived to be important by policy-makers at a state or federal level. The differential acceptance and rejection of these relationships in the community is explored. Data from social service agencies are used to compare administrators' assessments of the effectiveness of mandated and contracted relationships used to coordinate a group of agencies delivering services to children. When a mandated relationship has been formalized into a contract by a local administrator the perceived effectiveness of that relationship is higher than any other relationship in the community. If the mandated relationship has not been formalized by a contract this relationship is perceived to be the least effective. Important mandated inter-organizational ties without monetary incentives are less likely to work. Local administrators having developed the contracted ties see these ties as producing a higher level of performance. PMID:10138341

  15. Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer Perspective

    PubMed Central

    Silverman, Stuart; Agodoa, Irene; Kruse, Morgan; Parthan, Anju; Orwoll, Eric

    2015-01-01

    Purpose. To evaluate the cost-effectiveness of denosumab versus other osteoporotic treatments in older men with osteoporosis from a US payer perspective. Methods. A lifetime cohort Markov model previously developed for postmenopausal osteoporosis (PMO) was used. Men in the model were 78 years old, with a BMD T-score of −2.12 and a vertebral fracture prevalence of 23%. During each 6-month Markov cycle, patients could have experienced a hip, vertebral or nonhip, nonvertebral (NHNV) osteoporotic fracture, remained in a nonfracture state, remained in a postfracture state, or died. Background fracture risks, mortality rates, persistence rates, health utilities, and medical and drug costs were derived from published sources. Previous PMO studies were used for drug efficacy in reducing fracture risk. Lifetime expected costs and quality-adjusted life-years (QALYs) were estimated for denosumab, generic alendronate, risedronate, ibandronate, teriparatide, and zoledronate. Results. Denosumab had an incremental cost-effectiveness ratio (ICER) of $16,888 compared to generic alendronate and dominated all other treatments. Results were most sensitive to changes in costs of denosumab and the relative risk of hip fracture. Conclusion. Despite a higher annual treatment cost compared to other medications, denosumab is cost-effective compared to other osteoporotic treatments in older osteoporotic US men. PMID:26783494

  16. Patient-Reported Outcomes Are Changing the Landscape in Oncology Care: Challenges and Opportunities for Payers

    PubMed Central

    Zagadailov, Erin; Fine, Michael; Shields, Alan

    2013-01-01

    Background A patient-reported outcome (PRO) is a subjective report that comes from a patient without interpretation by a clinician. Because of the increasingly significant role of PROs in the development and evaluation of new medicines, the US Food and Drug Administration (FDA) issued a formal guidance to describe how PRO instruments will be reviewed and evaluated with respect to claims in approved medical product labeling. Meanwhile, PROs continue to appear in oncology clinical trials more frequently; however, it is unclear how payers and policymakers can use PRO data in the context of decision-making for cancer treatments. Objective The objective of this article is to discuss the challenges and opportunities of incorporating oncology-related PRO data into payer decision-making. Discussion Payer concerns with PRO instruments are often related to issues regarding measurement, relevance, quality, and interpretability of PROs. Payers may dismiss PROs that do not independently predict improved outcomes. The FDA guidance released in 2009 demonstrates, as evidenced by the case of ruxolitinib, how PRO questionnaires can be generated in a relevant, trustworthy, and meaningful way, which provides an opportunity for payers and policy decision makers to focus on how to use PRO data in their decision-making. This is particularly relevant in oncology, where a recent and sizable number of clinical trials include PRO measures. Conclusion As an increasing number of oncology medications enter the market with product labeling claims that contain PRO data, payers will need to better familiarize themselves with the opportunities associated with PRO questionnaires when making coverage decisions. PRO measures will continue to provide valuable information regarding the risk–benefit profile of novel agents. As such, PRO measures may provide evidence that should be considered in payers' decisions and discussions; however, the formal role of PROs and the pertinence of PROs in decision

  17. Primary Payer at DX: Issues with Collection and Assessment of Data Quality.

    PubMed

    Sherman, Recinda L; Williamson, Laura; Andrews, Patricia; Kahn, Amy

    2016-01-01

    An individual's access to health insurance influences the amount and type of health services a patient receives for prevention and treatment, and, ultimately, influences survival. The North American Association of Central Cancer Registries (NAACCR) Item #630, Primary Payer at DX, is a required field intended to document health insurance status for the purpose of supporting patterns-of-care studies and other research. However, challenges related to the uniformity of collection and availability of data needed to populate this field diminish the value of the Primary Payer at DX data. A NAACCR taskforce worked on issues surrounding the collection of Primary Payer at DX; including proposing a crosswalk between Primary Payer at DX and the new Public Health Payment Typology standard, often available in hospital discharge databases. However, there are issues with compatibility between coding systems, intent of data collection, timelines for coding insurance, and changes in insurance coverage (partly due to the Affordable Care Act) that continue to complicate the collection and use of Primary Payer at DX data. PMID:27556850

  18. Factors Influencing Compliance with Legislative Mandates within Information Technology Departments

    ERIC Educational Resources Information Center

    Gioia, Paul J.

    2014-01-01

    Since 2001, information technology (IT) leadership has had to contend with a host of new federal and local regulatory mandates. The purpose of this quantitative study was to identify and assess the possible inefficiencies associated with efforts to comply with recent legislative IT mandates and to model the impact of these mandates on the…

  19. 17 CFR 232.101 - Mandated electronic submissions and exceptions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Mandated electronic... COMMISSION REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Electronic Filing Requirements § 232.101 Mandated electronic submissions and exceptions. (a) Mandated electronic submissions. (1)...

  20. 17 CFR 232.101 - Mandated electronic submissions and exceptions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 3 2014-04-01 2014-04-01 false Mandated electronic... COMMISSION REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Electronic Filing Requirements § 232.101 Mandated electronic submissions and exceptions. (a) Mandated electronic submissions. (1)...

  1. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Acquisitions satisfying the mandate. 490.305 Section 490.305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate....

  2. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Vehicle acquisition mandate schedule. 490.302 Section 490.302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule....

  3. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Acquisitions satisfying the mandate. 490.305 Section 490.305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate....

  4. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Vehicle acquisition mandate schedule. 490.302 Section 490.302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule....

  5. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Vehicle acquisition mandate schedule. 490.302 Section 490.302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule....

  6. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Vehicle acquisition mandate schedule. 490.302 Section 490.302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule....

  7. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Vehicle acquisition mandate schedule. 490.302 Section 490.302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule....

  8. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Acquisitions satisfying the mandate. 490.305 Section 490.305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate....

  9. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Acquisitions satisfying the mandate. 490.305 Section 490.305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate....

  10. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Acquisitions satisfying the mandate. 490.305 Section 490.305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate....

  11. Legislating Clinical Practice: Counselor Responses to an Evidence-Based Practice Mandate

    PubMed Central

    Rieckmann, Traci; Bergmann, Luke; Rasplica, Caitlin

    2013-01-01

    The demand to connect research findings with clinical practice for patients with substance use disorders has accelerated state and federal efforts focused on implementation of evidence-based practices (EBPs). One unique state driven strategy is Oregon’s Evidence-Based Practice mandate, which ties state funds to specific treatment practices. Clinicians play an essential role in implementation of shifts in practice patterns and use of EBPs, but little is understood about how legislative efforts impact clinicians’ sentiments and decision-making. This study presents longitudinal data from focus groups and interviews completed during the planning phase (n = 66) and early implementation of the mandate (n = 73) to investigate provider attitudes toward this policy change. Results reflect three emergent themes: (1) concern about retaining individualized treatment and clinical latitude, (2) distrust of government involvement in clinical care, and (3) the need for accountability and credibility for the field. We conclude with recommendations for state agencies considering EBP mandates. PMID:22185037

  12. Relative efficacy of drugs: an emerging issue between regulatory agencies and third-party payers.

    PubMed

    Eichler, Hans-Georg; Bloechl-Daum, Brigitte; Abadie, Eric; Barnett, David; König, Franz; Pearson, Steven

    2010-04-01

    Drug regulatory agencies have traditionally assessed the quality, safety and efficacy of drugs, and the current paradigm dictates that a new drug should be licensed when the benefits outweigh the risks. By contrast, third-party payers base their reimbursement decisions predominantly on the health benefits of the drug relative to existing treatment options (termed relative efficacy; RE). Over the past decade, the role of payers has become more prominent, and time-to-market no longer means time-to-licensing but time-to-reimbursement. Companies now have to satisfy the sometimes divergent needs of both regulators and payers, and to address RE during the pre-marketing stages. This article describes the current political background to the RE debate and presents the scientific and methodological challenges as they relate to RE assessment. In addition, we explain the impact of RE on drug development, and speculate on future developments and actions that are likely to be required from key players.

  13. The National Oncology Working Group (NOW) initiative: payer and provider collaborations in oncology benefits management.

    PubMed

    Soper, Aileen M; Reeder, C E; Brown, Loreen M; Stojanovska, Ana; Lennert, Barbara J

    2010-04-01

    Payers recognize the need to expand benefits management for oncology but struggle to find effective solutions amid the complexity of available therapies and skepticism from oncologists, who are facing their own set of economic pressures. An effort called the National Oncology Working Group (NOW) Initiative is trying to change the sometimes adversarial relationship between payers and oncologists through a collaborative model. The group, which is supported by pharmaceutical manufacturer sanofi-aventis, is developing patient-centered strategies for successful and sustainable oncology benefits management. The focus includes finding consensus between payers and providers and devising solutions for oncology management such as decreasing variability of cancer care and improving end-of-life care for patients with terminal illness. NOW is designing tools that will be tested in small-scale regional demonstration projects, which NOW participants anticipate will set an example for successful oncology benefits management that can be replicated and expanded.

  14. Estimating Nitrogen Load Resulting from Biofuel Mandates.

    PubMed

    Alshawaf, Mohammad; Douglas, Ellen; Ricciardi, Karen

    2016-01-01

    The Energy Policy Act of 2005 and the Energy Independence and Security Act (EISA) of 2007 were enacted to reduce the U.S. dependency on foreign oil by increasing the use of biofuels. The increased demand for biofuels from corn and soybeans could result in an increase of nitrogen flux if not managed properly. The objectives of this study are to estimate nitrogen flux from energy crop production and to identify the catchment areas with high nitrogen flux. The results show that biofuel production can result in an increase of nitrogen flux to the northern Gulf of Mexico from 270 to 1742 thousand metric tons. Using all cellulosic (hay) ethanol or biodiesel to meet the 2022 mandate is expected to reduce nitrogen flux; however, it requires approximately 25% more land when compared to other scenarios. Producing ethanol from switchgrass rather than hay results in three-times more nitrogen flux, but requires 43% less land. Using corn ethanol for 2022 mandates is expected to have double the nitrogen flux when compared to the EISA-specified 2022 scenario; however, it will require less land area. Shifting the U.S. energy supply from foreign oil to the Midwest cannot occur without economic and environmental impacts, which could potentially lead to more eutrophication and hypoxia. PMID:27171101

  15. Estimating Nitrogen Load Resulting from Biofuel Mandates

    PubMed Central

    Alshawaf, Mohammad; Douglas, Ellen; Ricciardi, Karen

    2016-01-01

    The Energy Policy Act of 2005 and the Energy Independence and Security Act (EISA) of 2007 were enacted to reduce the U.S. dependency on foreign oil by increasing the use of biofuels. The increased demand for biofuels from corn and soybeans could result in an increase of nitrogen flux if not managed properly. The objectives of this study are to estimate nitrogen flux from energy crop production and to identify the catchment areas with high nitrogen flux. The results show that biofuel production can result in an increase of nitrogen flux to the northern Gulf of Mexico from 270 to 1742 thousand metric tons. Using all cellulosic (hay) ethanol or biodiesel to meet the 2022 mandate is expected to reduce nitrogen flux; however, it requires approximately 25% more land when compared to other scenarios. Producing ethanol from switchgrass rather than hay results in three-times more nitrogen flux, but requires 43% less land. Using corn ethanol for 2022 mandates is expected to have double the nitrogen flux when compared to the EISA-specified 2022 scenario; however, it will require less land area. Shifting the U.S. energy supply from foreign oil to the Midwest cannot occur without economic and environmental impacts, which could potentially lead to more eutrophication and hypoxia. PMID:27171101

  16. Distinctions in Disclosure: Mandated Informed Consent in Abortion and ART.

    PubMed

    Daar, Judith

    2015-01-01

    Enactment of mandated pre-procedure disclosures in abortion and assisted reproductive technology (ART) services has swelled in recent years. Calls to equally regard these mandates as neutral tools in furtherance of patient protection fail to acknowledge key substantive and structural differences in these reproduction-affecting mandates. While ART mandates permit physicians to use their medical judgment to protect presumptively vulnerable egg donors and gestational carriers, abortion disclosures impart scientifically suspect messaging aimed at dissuading women from pursuing pregnancy termination. These and other distinctions counsel in favor of regarding and analyzing abortion and ART mandated disclosures as separate and distinguishable informed consent tools.

  17. Proposal for Canadian-style single-payer health care receives cool reception in US.

    PubMed Central

    Korcok, M

    1995-01-01

    Is health care reform dead in the US? It may be, if the reception given President Clinton's reform plan and a proposal for a single-payer program in California is any indication. There has been a dramatic move to the right south of the border, where people have lined up to oppose "big government" and additional government programs. Still, American proponents of a single-payer program similar to Canada's insist that the battle for reform is not yet over. Images p407-a PMID:7828107

  18. High rate of fistula placement in a cohort of dialysis patients in a single payer system

    PubMed Central

    BLOSSER, Christopher D.; AYEHU, Gashu; WU, Sam; LOMAGRO, Ruth M.; MALONE, Ellen; BRUNELLI, Steven M.; ITKIN, Max; GOLDEN, Michael; MCCOMBS, Peter; LIPSCHUTZ, Joshua H.

    2011-01-01

    Arteriovenous fistulas (AVFs) are considered superior to arteriovenous grafts and catheters. Never-theless, AVF prevalence in the United States remains under the established target. The complication rates and financial cost of vascular access continue to rise and disproportionately contribute to the burgeoning health care costs. The relationship between financial incentives for a type of vascular access and rate of access placement is unclear. All chronic hemodialysis patients (n=99) receiving care at Philadelphia Veterans Affairs Medical Center as of August 1, 2008 were participants. Demographic characteristics, vascular access type, and nonrelative value unit compensation were assessed as predictors, and the vascular access prevalence rate, operative times, and frequency of access interventions were analyzed. A 73.7% AVF rate was achieved in this cohort of patients with 51.5% diabetes mellitus. The number of access procedures per patient per year remained constant over time. The Philadelphia Veterans Affairs Medical Center, a single payer system, achieved superior AVF prevalence and exceeded the national AVF target. Financial incentives for arteriovenous graft placement currently exist in the United States, as there is similar Medicare reimbursement for arterio-venous graft and basilic vein transposition, despite longer operative times for basilic vein transpositions. The high AVF prevalence at the Philadelphia Veterans Affairs Medical Center may be due to the VA nonrelative value unit-driven system that allows for interdisciplinary care, priority of AVFs, and frequent use of basilic vein transposition surgery, when appropriate. We have identified an important, hypothesis-generating example of a nonrelative value unit-based approach to vascular access yielding superior results with respect to patient care and cost. PMID:20812959

  19. High rate of fistula placement in a cohort of dialysis patients in a single payer system.

    PubMed

    Blosser, Christopher D; Ayehu, Gashu; Wu, Sam; Lomagro, Ruth M; Malone, Ellen; Brunelli, Steven M; Itkin, Max; Golden, Michael; McCombs, Peter; Lipschutz, Joshua H

    2010-10-01

    Arteriovenous fistulas (AVFs) are considered superior to arteriovenous grafts and catheters. Nevertheless, AVF prevalence in the United States remains under the established target. The complication rates and financial cost of vascular access continue to rise and disproportionately contribute to the burgeoning health care costs. The relationship between financial incentives for a type of vascular access and rate of access placement is unclear. All chronic hemodialysis patients (n=99) receiving care at Philadelphia Veterans Affairs Medical Center as of August 1, 2008 were participants. Demographic characteristics, vascular access type, and nonrelative value unit compensation were assessed as predictors, and the vascular access prevalence rate, operative times, and frequency of access interventions were analyzed. A 73.7% AVF rate was achieved in this cohort of patients with 51.5% diabetes mellitus. The number of access procedures per patient per year remained constant over time. The Philadelphia Veterans Affairs Medical Center, a single payer system, achieved superior AVF prevalence and exceeded the national AVF target. Financial incentives for arteriovenous graft placement currently exist in the United States, as there is similar Medicare reimbursement for arteriovenous graft and basilic vein transposition, despite longer operative times for basilic vein transpositions. The high AVF prevalence at the Philadelphia Veterans Affairs Medical Center may be due to the VA nonrelative value unit-driven system that allows for interdisciplinary care, priority of AVFs, and frequent use of basilic vein transposition surgery, when appropriate. We have identified an important, hypothesis-generating example of a nonrelative value unit-based approach to vascular access yielding superior results with respect to patient care and cost.

  20. The Mandate Mystery: How Mandates Impact School Districts Physically and Financially

    ERIC Educational Resources Information Center

    Dorris, Denae

    2010-01-01

    Renovation and construction of Texas public schools is occurring at a rapid pace and at high prices. Business continues to blossom in the area of school construction. Several factors influence the need to renovate or construct schools, but the impact curriculum mandates have on school construction is seldom explored. This study investigated the…

  1. A Comparative Analysis of the Influence of High Stakes Testing Mandates in the Elementary School

    ERIC Educational Resources Information Center

    Inserra, Albert; Bossert, Kenneth R.

    2008-01-01

    The No Child Left Behind Act of 2001, sponsored by President George W. Bush, calls for 100 percent proficiency in reading and mathematics by 2014. This Federal mandate has caused all public schools in the United States to examine the programs in use to meet these requirements. In addition, states across the country have implemented a series of…

  2. 42 CFR 411.31 - Authority to bill primary payers for full charges.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Authority to bill primary payers for full charges. 411.31 Section 411.31 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT...

  3. 42 CFR 411.31 - Authority to bill primary payers for full charges.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Authority to bill primary payers for full charges. 411.31 Section 411.31 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT...

  4. 78 FR 75304 - Medicare Program; Medicare Secondary Payer and Certain Civil Money Penalties

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-11

    ... either the Office of Inspector General (OIG) or CMS (See the October 20, 1994 (58 FR 52967) notice titled...; Medicare Secondary Payer and Certain Civil Money Penalties AGENCY: Centers for Medicare & Medicaid Services... rulemaking (ANPRM) solicits public comment on specific practices for which civil money penalties (CMPs)...

  5. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment when Medicare is not primary payer. 417.528 Section 417.528 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS,...

  6. 78 FR 78802 - Medicare Program; Right of Appeal for Medicare Secondary Payer Determination Relating to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... Self- Insurance), No Fault Insurance, and Workers' Compensation Laws and Plans AGENCY: Centers for...-fault insurance, and workers' compensation laws or plans when Medicare pursues a Medicare Secondary Payer (MSP) recovery claim directly from the liability insurance (including self-insurance), no...

  7. Mandated Coverage of Preventive Care and Reduction in Disparities: Evidence From Colorectal Cancer Screening

    PubMed Central

    Kapinos, Kandice A.

    2015-01-01

    Objectives. We identified correlates of racial/ethnic disparities in colorectal cancer screening and changes in disparities under state-mandated insurance coverage. Methods. Using Behavioral Risk Factor Surveillance System data, we estimated a Fairlie decomposition in the insured population aged 50 to 64 years and a regression-adjusted difference-in-difference-in-difference model of changes in screening attributable to mandates. Results. Under mandated coverage, blood stool test (BST) rates increased among Black, Asian, and Native American men, but rates among Whites also increased, so disparities did not change. Endoscopic screening rates increased by 10 percentage points for Hispanic men and 3 percentage points for non-Hispanic men. BST rates fell among Hispanic relative to non-Hispanic men. We found no changes for women. However, endoscopic screening rates improved among lower income individuals across all races and ethnicities. Conclusions. Mandates were associated with a reduction in endoscopic screening disparities only for Hispanic men but may indirectly reduce racial/ethnic disparities by increasing rates among lower income individuals. Findings imply that systematic differences in insurance coverage, or health plan fragmentation, likely existed without mandates. These findings underscore the need to research disparities within insured populations. PMID:25905835

  8. No Teacher Left Unqualified: How Teachers and Principals Respond to the Highly Qualified Mandate

    ERIC Educational Resources Information Center

    Karelitz, Tzur M.; Fields, Erica; Levy, Abigail Jurist; Martinez-Gudapakkam, Audrey; Jablonski, Erica

    2011-01-01

    In this paper, we examine the NCLB definition of a "highly qualified" teacher, the combined nature of federal and state highly qualified mandates, and how science teachers and their principals in one large, urban district have responded. In particular, we report on the kinds of licenses that teachers of science hold; the relationship between…

  9. Utilizing Online Education in Florida to Meet Mandated Class Size Limitations

    ERIC Educational Resources Information Center

    Mattox, Kari Ann

    2012-01-01

    With the passage of a state constitutional amendment in 2002, Florida school districts faced the challenge of meeting class size mandates in core subjects, such as mathematics, English, and science by the 2010-2011 school year, or face financial penalties. Underpinning the amendment's goals was the argument that smaller classes are more effective…

  10. 10 CFR 490.201 - Alternative fueled vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Alternative fueled vehicle acquisition mandate schedule. 490.201 Section 490.201 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory State Fleet Program § 490.201 Alternative fueled vehicle acquisition...

  11. 10 CFR 490.201 - Alternative fueled vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Alternative fueled vehicle acquisition mandate schedule. 490.201 Section 490.201 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory State Fleet Program § 490.201 Alternative fueled vehicle acquisition...

  12. 10 CFR 490.201 - Alternative fueled vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Alternative fueled vehicle acquisition mandate schedule. 490.201 Section 490.201 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory State Fleet Program § 490.201 Alternative fueled vehicle acquisition...

  13. 10 CFR 490.201 - Alternative fueled vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Alternative fueled vehicle acquisition mandate schedule. 490.201 Section 490.201 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory State Fleet Program § 490.201 Alternative fueled vehicle acquisition...

  14. 10 CFR 490.201 - Alternative fueled vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Alternative fueled vehicle acquisition mandate schedule. 490.201 Section 490.201 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory State Fleet Program § 490.201 Alternative fueled vehicle acquisition...

  15. Developing a Critical Lens among Preservice Teachers while Working within Mandated Performance-Based Assessment Systems

    ERIC Educational Resources Information Center

    Moss, Glenda

    2008-01-01

    This article addresses the dilemma of promoting critical pedagogy within portfolio assessment, which has been implemented in many teacher education programs to meet state and national mandates for performance-based assessment. It explores how one teacher educator works to move portfolio assessment to a level of critical self-reflection that…

  16. Lessons from a New Continuing Education Mandate: The Experience of NASW-NYC

    ERIC Educational Resources Information Center

    Schachter, Robert

    2016-01-01

    The New York City Chapter of the National Association of Social Workers (NASW-NYC), one of the largest in the country, launched a continuing education initiative in 2015 in response to passage of a new statute mandating that all MSW-level state licensed social workers begin accumulating approved hours of continuing education as a requirement for…

  17. California Secondary School Physical Education Teachers' Attitudes toward the Mandated Use of the Fitnessgram

    ERIC Educational Resources Information Center

    Ferguson, Robert H.; Keating, Xiaofen Deng; Guan, Jianmin; Chen, Li; Bridges, Dwan M.

    2007-01-01

    This study aimed to determine how California secondary physical education teachers perceive the state mandated youth fitness testing for the 5th, 7th, and 9th grades using Fitnessgram. The participants were secondary school physical education teachers (N = 323). A previously validated attitudinal instrument (Keating & Silverman, 2004a) was used to…

  18. A Qualitative Case Study of Teachers' Perceptions of Professional Learning through Mandated Collaboration

    ERIC Educational Resources Information Center

    Wilt, Barbara C.

    2016-01-01

    Teacher collaboration is a school improvement priority that has the potential to positively impact student learning by building the capacity of teachers. In some states, teacher collaboration is mandated by legislation. The literature indicates that policy-driven collaboration in a top-down approach results in unintentional consequences and…

  19. Cost of a lymphedema treatment mandate-10 years of experience in the Commonwealth of Virginia.

    PubMed

    Weiss, Robert

    2016-12-01

    Treatment of chronic illness accounts for over 90 % of Medicare spending. Chronic lymphedema places over 3 million Americans at risk of recurrent cellulitis. Health insurers and legislators have taken an active role in fighting attempts to mandate the treatment of lymphedema for fear that provision of the physical therapy and compression materials would result in large and uncontrollable claim costs. The author knows of no open source of lymphedema treatment cost data based on population coverage or claims. Published studies compare cost of treatment versus cost of non-treatment for a select group of lymphedema patients. They do not provide the data necessary for insurance underwriters' estimations of expected claim costs for a larger general population with a range of severities, or for legislators' evaluations of the costs of proposed mandates to cover treatment of lymphedema according to current medical standards. These data are of interest to providers, advocates and legislators in Canada, Australia and England as well as the U.S.The Commonwealth of Virginia has had a lymphedema treatment mandate since 2004. Reported data for 2004-2013, representing 80 % of the Virginia healthcare insurance market, contains claims and utilization data and claims-based estimates of the premium impact of its lymphedema mandate. The average actual annual lymphedema claim cost was $1.59 per individual contract and $3.24 per group contract for the years reported, representing 0.053 and 0.089 % of average total claims. The estimated premium impact ranged 0.00-0.64 % of total average premium for all mandated coverage contracts. In this study actual costs are compared with pre-mandate state mandate commission estimates for proposed lymphedema mandates from Virginia, Massachusetts and California.Ten years of insurance experience with a lymphedema treatment mandate in Virginia shows that costs of lymphedema treatment are an insignificant part of insured healthcare costs, and that

  20. Impact of Nurse Staffing Mandates on Safety-Net Hospitals: Lessons from California

    PubMed Central

    McHugh, Matthew D; Brooks Carthon, Margo; Sloane, Douglas M; Wu, Evan; Kelly, Lesly; Aiken, Linda H

    2012-01-01

    Context California is the first and only state to implement a patient-to-nurse ratio mandate for hospitals. Increasing nurse staffing is an important organizational intervention for improving patient outcomes. Evidence suggests that staffing improved in California hospitals after the mandate was enacted, but the outcome for hospitals bearing a disproportionate share of uncompensated care—safety-net hospitals—remains unclear. One concern was that California's mandate would burden safety-net hospitals without improving staffing or that hospitals would reduce their skill mix, that is, the proportion of registered nurses of all nursing staff. We examined the differential effect of California's staffing mandate on safety-net and non-safety-net hospitals. Methods We used a time-series design with Annual Hospital Disclosure data files from the California Office of Statewide Health Planning and Development (OSHPD) for the years 1998 to 2007 to assess differences in the effect of California's mandate on staffing outcomes in safety-net and non-safety-net hospitals. Findings The mandate resulted in significant staffing improvements, on average nearly a full patient per nurse fewer (−0.98) for all California hospitals. The greatest effect was in those hospitals with the lowest staffing levels at the outset, both safety-net and non-safety-net hospitals, as the legislation intended. The mandate led to significantly improved staffing levels for safety-net hospitals, although there was a small but significant difference in the effect on staffing levels of safety-net and non-safety-net hospitals. Regarding skill mix, a marginally higher proportion of registered nurses was seen in non-safety-net hospitals following the mandate, while the skill mix remained essentially unchanged for safety-net hospitals. The difference between the two groups of hospitals was not significant. Conclusions California's mandate improved staffing for all hospitals, including safety-net hospitals

  1. Cost of a lymphedema treatment mandate-10 years of experience in the Commonwealth of Virginia.

    PubMed

    Weiss, Robert

    2016-12-01

    Treatment of chronic illness accounts for over 90 % of Medicare spending. Chronic lymphedema places over 3 million Americans at risk of recurrent cellulitis. Health insurers and legislators have taken an active role in fighting attempts to mandate the treatment of lymphedema for fear that provision of the physical therapy and compression materials would result in large and uncontrollable claim costs. The author knows of no open source of lymphedema treatment cost data based on population coverage or claims. Published studies compare cost of treatment versus cost of non-treatment for a select group of lymphedema patients. They do not provide the data necessary for insurance underwriters' estimations of expected claim costs for a larger general population with a range of severities, or for legislators' evaluations of the costs of proposed mandates to cover treatment of lymphedema according to current medical standards. These data are of interest to providers, advocates and legislators in Canada, Australia and England as well as the U.S.The Commonwealth of Virginia has had a lymphedema treatment mandate since 2004. Reported data for 2004-2013, representing 80 % of the Virginia healthcare insurance market, contains claims and utilization data and claims-based estimates of the premium impact of its lymphedema mandate. The average actual annual lymphedema claim cost was $1.59 per individual contract and $3.24 per group contract for the years reported, representing 0.053 and 0.089 % of average total claims. The estimated premium impact ranged 0.00-0.64 % of total average premium for all mandated coverage contracts. In this study actual costs are compared with pre-mandate state mandate commission estimates for proposed lymphedema mandates from Virginia, Massachusetts and California.Ten years of insurance experience with a lymphedema treatment mandate in Virginia shows that costs of lymphedema treatment are an insignificant part of insured healthcare costs, and that

  2. Chronological History of Federal Fleet Actions and Mandates (Brochure)

    SciTech Connect

    Not Available

    2011-04-01

    This chronological history of Federal fleet actions and mandates provides a year-by-year timeline of the acts, amendments, executive orders, and other regulations that affect Federal fleets. The fleet actions and mandates included in the timeline span from 1988 to 2009.

  3. Discipline and Play with/in a Mandated Literacy Curriculum

    ERIC Educational Resources Information Center

    Kontovourki, Stavroula; Siegel, Marjorie

    2009-01-01

    In this article, the authors explore a young child's lived experience of discipline and play with/in a mandated balanced literacy curriculum. Mandating balanced literacy presents an interesting case of disciplining literacy because it is rooted in the progressive tradition of meaning-and-process pedagogies. As such, it avoids the most obvious…

  4. Hostility in mandated students: exploratory analysis and implications for treatment.

    PubMed

    Barthelmes, Caitlin K; Borsari, Brian; Hustad, John T P; Barnett, Nancy P

    2010-04-01

    College students mandated to receive an intervention following an alcohol-related campus violation are a high-risk group of students experiencing the negative effects of alcohol. Understanding the psychological properties associated with mandated students' alcohol use may provide useful clinical information. Hostility is a trait that has shown association with heavy drinking in adults but has gone unstudied in mandated students. We examined the relationship between hostility and a variety of drinking-related variables in mandated students (N = 466). Results indicated that individuals reporting higher levels of hostility reported riskier drinking and alcohol-related problems, yet exhibited ambivalence regarding their alcohol use. Findings are discussed in the context of treating mandated students exhibiting high hostility and risky drinking, a particularly challenging population. PMID:20116962

  5. Hostility in mandated students: Exploratory analysis and implications for treatment

    PubMed Central

    Barthelmes, Caitlin K.; Borsari, Brian; Hustad, John T.P.; Barnett, Nancy P.

    2011-01-01

    College students mandated to receive an intervention following an alcohol-related campus violation are a high-risk group of students experiencing the negative effects of alcohol. Understanding the psychological properties associated with mandated students’ alcohol use may provide useful clinical information. Hostility is a trait that has shown association with heavy drinking in adults but has gone unstudied in mandated students. We examined the relationship between hostility and a variety of drinking-related variables in mandated students (N = 466). Results indicated that individuals reporting higher levels of hostility reported riskier drinking and alcohol-related problems, yet exhibited ambivalence regarding their alcohol use. Findings are discussed in the context of treating mandated students exhibiting high hostility and risky drinking, a particularly challenging population. PMID:20116962

  6. UnitedHealthcare experience illustrates how payers can enable patient engagement.

    PubMed

    Sandy, Lewis G; Tuckson, Reed V; Stevens, Simon L

    2013-08-01

    Patient engagement is crucial to better outcomes and a high-performing health system, but efforts to support it often focus narrowly on the role of physicians and other care providers. Such efforts miss payers' unique capabilities to help patients achieve better health. Using the experience of UnitedHealthcare, a large national payer, this article demonstrates how health plans can analyze and present information to both patients and providers to help close gaps in care; share detailed quality and cost information to inform patients' choice of providers; and offer treatment decision support and value-based benefit designs to help guide choices of diagnostic tests and therapies. As an employer, UnitedHealth Group has used these strategies along with an "earn-back" program that provides positive financial incentives through reduced premiums to employees who adopt healthful habits. UnitedHealth's experience provides lessons for other payers and for Medicare and Medicaid, which have had minimal involvement with demand-side strategies and could benefit from efforts to promote activated beneficiaries.

  7. UnitedHealthcare experience illustrates how payers can enable patient engagement.

    PubMed

    Sandy, Lewis G; Tuckson, Reed V; Stevens, Simon L

    2013-08-01

    Patient engagement is crucial to better outcomes and a high-performing health system, but efforts to support it often focus narrowly on the role of physicians and other care providers. Such efforts miss payers' unique capabilities to help patients achieve better health. Using the experience of UnitedHealthcare, a large national payer, this article demonstrates how health plans can analyze and present information to both patients and providers to help close gaps in care; share detailed quality and cost information to inform patients' choice of providers; and offer treatment decision support and value-based benefit designs to help guide choices of diagnostic tests and therapies. As an employer, UnitedHealth Group has used these strategies along with an "earn-back" program that provides positive financial incentives through reduced premiums to employees who adopt healthful habits. UnitedHealth's experience provides lessons for other payers and for Medicare and Medicaid, which have had minimal involvement with demand-side strategies and could benefit from efforts to promote activated beneficiaries. PMID:23918489

  8. Can Payers Use Prices to Improve Quality? Evidence from English Hospitals.

    PubMed

    Allen, Thomas; Fichera, Eleonora; Sutton, Matt

    2016-01-01

    In most activity-based financing systems, payers set prices reactively based on historical averages of hospital reported costs. If hospitals respond to prices, payers might set prices proactively to affect the volume of particular treatments or clinical practice. We evaluate the effects of a unique initiative in England in which the price offered to hospitals for discharging patients on the same day as a particular procedure was increased by 24%, while the price for inpatient treatment remained unchanged. Using national hospital records for 205,784 patients admitted for the incentivised procedure and 838,369 patients admitted for a range of non-incentivised procedures between 1 December 2007 and 31 March 2011, we consider whether this price change had the intended effect and/or produced unintended effects. We find that the price change led to an almost six percentage point increase in the daycase rate and an 11 percentage point increase in the planned daycase rate. Patients benefited from a lower proportion of procedures reverted to open surgery during a planned laparoscopic procedure and from a reduction in long stays. There was no evidence that readmission and death rates were affected. The results suggest that payers can set prices proactively to incentivise hospitals to improve quality.

  9. Cost Implications to Health Care Payers of Improving Glucose Management among Adults with Type 2 Diabetes

    PubMed Central

    Nuckols, Teryl K; McGlynn, Elizabeth A; Adams, John; Lai, Julie; Go, Myong-Hyun; Keesey, Joan; Aledort, Julia E

    2011-01-01

    Objective To assess the cost implications to payers of improving glucose management among adults with type 2 diabetes. Data Source/Study Setting Medical-record data from the Community Quality Index (CQI) study (1996–2002), pharmaceutical claims from four Massachusetts health plans (2004–2006), Medicare Fee Schedule (2009), published literature. Study Design Probability tree depicting glucose management over 1 year. Data Collection/Extraction Methods We determined how frequently CQI study subjects received recommended care processes and attained Health Care Effectiveness Data and Information Set (HEDIS) treatment goals, estimated utilization of visits and medications associated with recommended care, assigned costs based on utilization, and then modeled how hospitalization rates, costs, and goal attainment would change if all recommended care was provided. Principal Findings Relative to current care, improved glucose management would cost U.S.$327 (U.S.$192–711 in sensitivity analyses) more per person with diabetes annually, largely due to antihyperglycemic medications. Cost-effectiveness to payers, defined as incremental annual cost per patient newly attaining any one of three HEDIS goals, would be U.S.$1,128; including glycemic crises reduces this to U.S.$555–1,021. Conclusions The cost of improving glucose management appears modest relative to diabetes-related health care expenditures. The incremental cost per patient newly attaining HEDIS goals enables payers to consider costs as well as outcomes that are linked to future profitability. PMID:21457256

  10. Association between payer mix and costs, revenues and profitability: a cross-sectional study of Lebanese hospitals.

    PubMed

    Saleh, S; Ammar, W; Natafgi, N; Mourad, Y; Dimassi, H; Harb, H

    2015-09-08

    This study aimed to examine the association between the payer mix and the financial performance of public and private hospitals in Lebanon. The sample comprised 24 hospitals, representing the variety of hospital characteristics in Lebanon. The distribution of the payer mix revealed that the main sources of revenue were public sources (61.1%), out-of-pocket (18.4%) and private insurance (18.2%). Increases in the percentage of revenue from public sources were associated with lower total costs and revenues, but not profit margins. An inverse association was noted between increased revenue from private insurance and profitability, attributed to increased costs. Increased percentage of out of- pocket payments was associated with lower costs and higher profitability. The study provides evidence that payer mix is associated with hospital costs, revenues and profitability. This should initiate/inform discussions between public and private payers and hospitals about the level of payment and its association with hospital sector financial viability.

  11. Eight reasons payer interoperability and data sharing are essential in ACOs. Interoperability standards could be a prerequisite to measuring care.

    PubMed

    Mookencherry, Shefali

    2012-01-01

    It makes strategic and business sense for payers and providers to collaborate on how to take substantial cost out of the healthcare delivery system. Acting independently, neither medical groups, hospitals nor health plans have the optimal mix of resources and incentives to significantly reduce costs. Payers have core assets such as marketing, claims data, claims processing, reimbursement systems and capital. It would be cost prohibitive for all but the largest providers to develop these capabilities in order to compete directly with insurers. Likewise, medical groups and hospitals are positioned to foster financial interdependence among providers and coordinate the continuum of patient illnesses and care settings. Payers and providers should commit to reasonable clinical and cost goals, and share resources to minimize expenses and financial risks. It is in the interest of payers to work closely with providers on risk-management strategies because insurers need synergy with ACOs to remain cost competitive. It is in the interest of ACOs to work collaboratively with payers early on to develop reasonable and effective performance benchmarks. Hence, it is essential to have payer interoperability and data sharing integrated in an ACO model. PMID:22352172

  12. School Administrator Assessments of Bullying and State-Mandated Testing

    ERIC Educational Resources Information Center

    Lacey, Anna; Cornell, Dewey G.

    2016-01-01

    Bully victimization is associated with lower academic performance for individual students; however, less is known about the impact of bullying on the academic performance of the school as a whole. This study examined how retrospective administrator reports of both the prevalence of teasing and bullying (PTB) and the use of evidence-based bullying…

  13. Minnesota State Colleges and Universities '99 Session: Mandates and Curiosities.

    ERIC Educational Resources Information Center

    Minnesota State Colleges and Universities System, St. Paul.

    This publication highlights and explains relevant Minnesota legislative developments affecting higher education. For each bill, there is a summary provided in plain English, followed by copies of related portions of the legislation. The bills presented are: (1) Higher Education Omnibus Funding Bill (H.F. 2380); (2) Bonding Omnibus Bill (H.F.…

  14. Insurance Mandates Boost U.S. Autism Diagnoses

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_159812.html Insurance Mandates Boost U.S. Autism Diagnoses Early treatment provides ... the Penn researchers analyzed inpatient and outpatient health insurance claims from 2008 through 2012 for more than ...

  15. Payers' Views of the Changes Arising through the Possible Adoption of Adaptive Pathways

    PubMed Central

    Ermisch, Michael; Bucsics, Anna; Vella Bonanno, Patricia; Arickx, Francis; Bybau, Alexander; Bochenek, Tomasz; van de Casteele, Marc; Diogene, Eduardo; Fürst, Jurij; Garuolienė, Kristina; van der Graaff, Martin; Gulbinovič, Jolanta; Haycox, Alan; Jones, Jan; Joppi, Roberta; Laius, Ott; Langner, Irene; Martin, Antony P.; Markovic-Pekovic, Vanda; McCullagh, Laura; Magnusson, Einar; Nilsen, Ellen; Selke, Gisbert; Sermet, Catherine; Simoens, Steven; Sauermann, Robert; Schuurman, Ad; Ramos, Ricardo; Vlahovic-Palcevski, Vera; Zara, Corinne; Godman, Brian

    2016-01-01

    Payers are a major stakeholder in any considerations and initiatives concerning adaptive licensing of new medicinal products, also referred to as Medicines Adaptive Pathways to patients (MAPPs). Firstly, the scope and necessity of MAPPs need further scrutiny, especially with regard to the definition of unmet need. Conditional approval pathways already exist for new medicines for seriously debilitating or life-threatening diseases and only a limited number of new medicines are innovative. Secondly, MAPPs will result in new medicines on the market with limited evidence about their effectiveness and safety. Additional data are to be collected after approval. Consequently, adaptive pathways may increase the risk of exposing patients to ineffective or unsafe medicines. We have already seen medicines approved conventionally that subsequently proved ineffective or unsafe amongst a wider, more co-morbid population as well as medicines that could have been considered for approval under MAPPs but subsequently proved ineffective or unsafe in Phase III trials and were never licensed. Thirdly, MAPPs also put high demands on payers. Routine collection of patient level data is difficult with high transaction costs. It is not clear who will fund these. Other challenges for payers include shifts in the risk governance framework, implications for evaluation and HTA, increased complexity of setting prices, difficulty with ensuring equity in the allocation of resources, definition of responsibility and liability and implementation of stratified use. Exit strategies also need to be agreed in advance, including price reductions, rebates, or reimbursement withdrawals when price premiums are not justified. These issues and concerns will be discussed in detail including potential ways forward. PMID:27733828

  16. Risk sharing arrangements for pharmaceuticals: potential considerations and recommendations for European payers

    PubMed Central

    2010-01-01

    Background There has been an increase in 'risk sharing' schemes for pharmaceuticals between healthcare institutions and pharmaceutical companies in Europe in recent years as an additional approach to provide continued comprehensive and equitable healthcare. There is though confusion surrounding the terminology as well as concerns with existing schemes. Methods Aliterature review was undertaken to identify existing schemes supplemented with additional internal documents or web-based references known to the authors. This was combined with the extensive knowledge of health authority personnel from 14 different countries and locations involved with these schemes. Results and discussion A large number of 'risk sharing' schemes with pharmaceuticals are in existence incorporating both financial-based models and performance-based/outcomes-based models. In view of this, a new logical definition is proposed. This is "risk sharing' schemes should be considered as agreements concluded by payers and pharmaceutical companies to diminish the impact on payers' budgets for new and existing schemes brought about by uncertainty and/or the need to work within finite budgets". There are a number of concerns with existing schemes. These include potentially high administration costs, lack of transparency, conflicts of interest, and whether health authorities will end up funding an appreciable proportion of a new drug's development costs. In addition, there is a paucity of published evaluations of existing schemes with pharmaceuticals. Conclusion We believe there are only a limited number of situations where 'risk sharing' schemes should be considered as well as factors that should be considered by payers in advance of implementation. This includes their objective, appropriateness, the availability of competent staff to fully evaluate proposed schemes as well as access to IT support. This also includes whether systematic evaluations have been built into proposed schemes. PMID:20529296

  17. School Personnel & Mandated Reporting of Child Maltreatment.

    ERIC Educational Resources Information Center

    Mahoney, Kevin S.

    1995-01-01

    Focuses on the issues that arise when school professionals are required to report child abuse and neglect. Reviews the duties and immunities arising under state reporting statutes and the reporting practices and perceptions of school staff. Recommends an increase in staff education and federal establishment of the scope of the definition of child…

  18. The ACR Managed Care Committee: focusing private payers on radiology issues.

    PubMed

    Ullrich, Christopher G; Keysor, Kathryn J

    2007-02-01

    The ACR Managed Care/Private Payer Relations Committee is an important committee of the ACR Commission on Economics. This report reviews the committee's mission, structure, and processes and some of its current recommendations to ACR membership. The development of and participation in radiology advisory committees is a vital strategy in this process. Separating professional and technical charges, rather than submitting global charges, will help preserve radiology's professional integrity in the future. The Imaging Provider Report Card (IPRC) will allow radiology to define practice quality and performance in an era of pay-for-performance reimbursement. The IPRC also provides an external blueprint on what each practice needs to do to improve itself. American College of Radiology accreditation plays a key role in certifying radiology's quality to both payers and patients. Sound business management, group governance, and business size are also important elements of professional practice success. Working together through the ACR promotes the integrity of our profession and the quality of care patients want and deserve.

  19. WHY DO AMERICANS STILL NEED SINGLE-PAYER HEALTH CARE AFTER MAJOR HEALTH REFORM?

    PubMed

    Chaufan, Claudia

    2015-01-01

    Many observers have considered the Affordable Care Act (ACA) the most significant health care overhaul since Medicare, in the tradition of Great Society programs. And yet, in opinion polls, Americans across the political spectrum repeatedly express their strong support for Medicare, alongside their disapproval of the ACA. This feature of American public opinion is often seen as a contradiction and often explained as "incoherence," a mere feature of Americans' "muddled mind." In this article I argue that what explains this seeming contradiction is not any peculiarity of Americans' psychology but rather the grip of the corporate class on the political process and on key social institutions (e.g., mass media, judiciary), no less extraordinary today than in the past. I also argue that ordinary Americans, like millions of their counterparts in the world, would eagerly support a single-payer national health program that speaks to their interests rather than to those of the 1 percent. I will describe the ACA, compare it to Medicare, explain the concept of single payer, and conclude that the task is not to persuade presumably recalcitrant Americans to support the ACA but rather to organize a mass movement to struggle for what is right and join the rest of the world in the road toward health justice. PMID:26460454

  20. Adverse Selection and an Individual Mandate: When Theory Meets Practice*

    PubMed Central

    Hackmann, Martin B.; Kolstad, Jonathan T.; Kowalski, Amanda E.

    2014-01-01

    We develop a model of selection that incorporates a key element of recent health reforms: an individual mandate. Using data from Massachusetts, we estimate the parameters of the model. In the individual market for health insurance, we find that premiums and average costs decreased significantly in response to the individual mandate. We find an annual welfare gain of 4.1% per person or $51.1 million annually in Massachusetts as a result of the reduction in adverse selection. We also find smaller post-reform markups. PMID:25914412

  1. Targeting Scarce Resources under the Older Americans Act. Hearing before the Subcommittee on Aging of the Committee on Labor and Human Resources. United States Senate, Ninety-Eighth Congress, First Session on Examination of the Targeting of Services Needed to Maintain Economic and Social Independence of Older People as Mandated in Title III of the Older Americans Act.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    This document presents prepared statements and witness testimony from the Congressional hearing on the Older Americans Act. An opening statement by Senator Charles Grassley, subcommittee chairman, contains a brief overview of the Older Americans Act. An extensive statement on the proposed targeting of services mandated under Title III of the Older…

  2. Abolishing the Office of Juvenile Justice and Delinquency Prevention. Hearing before the Subcommittee on Juvenile Justice of the Committee on the Judiciary. United States Senate, Ninety-Ninth Congress, Second Session on Freezing Fund Which Congress Has Mandated for Certain Vital Juvenile Justice Programs.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on the Judiciary.

    This document contains witness testimonies and prepared statements from the Senate hearing called to inquire into the procedures used by the administration to freeze funds which had been mandated by Congress for juvenile justice programs. In opening statements, Senator Arlen Specter called the administration's actions illegal and Senator Jeremiah…

  3. 42 CFR 137.60 - May a statutorily mandated grant be added to a funding agreement?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false May a statutorily mandated grant be added to a... Statutorily Mandated Grants § 137.60 May a statutorily mandated grant be added to a funding agreement? Yes, in accordance with section 505(b)(2) of the Act , a statutorily mandated grant may be added to the...

  4. 42 CFR 137.60 - May a statutorily mandated grant be added to a funding agreement?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May a statutorily mandated grant be added to a... Statutorily Mandated Grants § 137.60 May a statutorily mandated grant be added to a funding agreement? Yes, in accordance with section 505(b)(2) of the Act , a statutorily mandated grant may be added to the...

  5. Music Educators' Expertise and Mandate: Who Decides, Based on What?

    ERIC Educational Resources Information Center

    Angelo, Elin

    2016-01-01

    Who should define music educators' expertise and mandate, and on what basis? Is this for example individual music educators, diverse collectives, employment institutions or political frameworks? How can one discuss professional quality and codes of ethic in this field, where these questions inseparably adhere to personal qualities and quality of a…

  6. 17 CFR 232.101 - Mandated electronic submissions and exceptions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... supplemental information submitted after the Form ID filing shall not be submitted in electronic format; (x... 17 Commodity and Securities Exchanges 2 2012-04-01 2012-04-01 false Mandated electronic... COMMISSION REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Electronic Filing...

  7. Keeping Children Safe: Afterschool Staff and Mandated Child Maltreatment Reporting

    ERIC Educational Resources Information Center

    Gandarilla, Maria; O'Donnell, Julie

    2014-01-01

    With 8.4 million children in the U.S. spending an average of eight hours a week in afterschool programs, afterschool providers are an important part of the network of caring adults who can help to keep children safe. In addition, afterschool staff are "mandated reporters." Whether or not the laws specifically mention afterschool staff,…

  8. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Acquisitions satisfying the mandate. 490.202 Section 490.202 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory... (regardless of the model year of manufacture), capable of operating on alternative fuels that was...

  9. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Acquisitions satisfying the mandate. 490.202 Section 490.202 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory... (regardless of the model year of manufacture), capable of operating on alternative fuels that was...

  10. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Acquisitions satisfying the mandate. 490.202 Section 490.202 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory... (regardless of the model year of manufacture), capable of operating on alternative fuels that was...

  11. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Acquisitions satisfying the mandate. 490.202 Section 490.202 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory... (regardless of the model year of manufacture), capable of operating on alternative fuels that was...

  12. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Acquisitions satisfying the mandate. 490.202 Section 490.202 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory... (regardless of the model year of manufacture), capable of operating on alternative fuels that was...

  13. A Practical Response to a Legislative Phonics Mandate.

    ERIC Educational Resources Information Center

    Fox, Barbara; Wright, Marypat

    2000-01-01

    In response to a legislative mandate to teach phonics, a rural North Carolina school district devised a plan where at-risk children received small-group instruction in phonics, reading, writing, and spelling in addition to regular reading instruction. A local university trained teacher assistants to implement the plan. Reading, writing, and…

  14. Implementing the Mandate: The Limitations of Benchmark Tests

    ERIC Educational Resources Information Center

    Bancroft, Kim

    2010-01-01

    As mandated by No Child Left Behind, schools must find ways to improve test scores. How do benchmark tests fare as a means of informing teachers in order to raise achievement for low-income students? This study of English language arts instruction at a low-income high school investigates the administration's use of standardized benchmark…

  15. Mandated Competency-Based Teacher Certification and the Public Interest.

    ERIC Educational Resources Information Center

    Spaulding, Robert L.

    Responding to the current lack of an empirical basis for competency-based teacher certification, Georgia has mandated studies leading to the establishment of empirical criteria. In the Carroll County Competency-Based Teacher Certification Project, the instructional behaviors of some 60 certified teachers and the classroom behaviors of the…

  16. Resisting Reading Mandates: How To Triumph with the Truth.

    ERIC Educational Resources Information Center

    Garan, Elaine M.

    Teachers today are in a stranglehold as a glut of mandates and standards restrict their ability to make decisions in their own classrooms. In many schools, scripted, regimented commercial programs further erode their power to view their students as individuals with unique talents and needs. Even the words they use "to teach" are no longer their…

  17. Public Support for Mandated Nicotine Reduction in Cigarettes

    PubMed Central

    Abrams, David B.; Niaura, Raymond S.; Richardson, Amanda; Vallone, Donna M.

    2013-01-01

    Objectives. We assessed public support for a potential Food and Drug Administration (FDA)–mandated reduction in cigarette nicotine content. Methods. We used nationally representative data from a June 2010 cross-sectional survey of US adults (n = 2649) to obtain weighted point estimates and correlates of support for mandated nicotine reduction. We also assessed the potential role of political ideology in support of FDA regulation of nicotine. Results. Nearly 50% of the public supported mandated cigarette nicotine reduction, with another 28% having no strong opinion concerning this potential FDA regulation. Support for nicotine reduction was highest among Hispanics, African Americans, and those with less than a high school education. Among smokers, the odds of supporting FDA nicotine regulation were 2.77 times higher among smokers who intended to quit in the next 6 months than among those with no plans to quit. Conclusions. Mandating nicotine reduction in cigarettes to nonaddictive levels may reduce youth initiation and facilitate adult cessation. The reasons behind nicotine regulation need to be communicated to the public to preempt tobacco industry efforts to impede such a regulation. PMID:23327262

  18. What Motivates Public Support for Legally Mandated Mental Health Treatment?

    ERIC Educational Resources Information Center

    Watson, Amy C.; Corrigan, Patrick W.; Angell, Beth

    2005-01-01

    The use of legal coercion to compel individuals to participate in mental health treatment is expanding despite a lack of empirical support for many of its forms. Policies supporting mandated treatment are made by legislators and judges, often based on perceptions of public concern. Using data from the MacArthur Mental Health Module contained in…

  19. Education Policy Mediation: Principals' Work with Mandated Literacy Assessment

    ERIC Educational Resources Information Center

    Comber, Barbara; Cormack, Phil

    2011-01-01

    Mandated literacy assessment is now a ubiquitous practice in many western educational systems. While educational researchers, principals, teachers and education unions continue to offer vociferous resistance in some nations, in others it is now commonplace in the educational landscape and built into the rhythms of the school year. This paper is…

  20. The HHS Mandate and Religious Liberty: A Primer

    ERIC Educational Resources Information Center

    Keim, Adele Auxier

    2013-01-01

    "We are in a war," Health and Human Services Secretary Kathleen Sebelius declared to cheers at a 2011 National Abortion and Reproductive Rights Action League (NARAL) Pro-Choice America fund-raiser. Secretary Sebelius was referring in part to the uproar caused by the "HHS Mandate," her agency's rule that employer-provided…

  1. A Review of Open Access Self-Archiving Mandate Policies

    ERIC Educational Resources Information Center

    Xia, Jingfeng; Gilchrist, Sarah B.; Smith, Nathaniel X. P.; Kingery, Justin A.; Radecki, Jennifer R.; Wilhelm, Marcia L.; Harrison, Keith C.; Ashby, Michael L.; Mahn, Alyson J.

    2012-01-01

    This article reviews the history of open access (OA) policies and examines the current status of mandate policy implementations. It finds that hundreds of policies have been proposed and adopted at various organizational levels and many of them have shown a positive effect on the rate of repository content accumulation. However, it also detects…

  2. Single-payer health care systems: the roles and responsibilities of the public and private sectors.

    PubMed

    Munn, Jeffrey D; Wozniak, Lynne

    2007-01-01

    Health care systems all over the world are experiencing some change as they look for a new balance between supply and demand. This article provides context for the U.S. health care financing debate by examining the health care systems of five other countries: Canada, the United Kingdom, Australia, China and India. The authors show that, with few exceptions, countries around the world have seen an increase in both government and private health care spending between 1998 and 2002. The authors also demonstrate that employers throughout most of the world are becoming more, rather than less, involved in the funding and delivery of health care to employees and their dependents-even among nations with so-called single-payer health systems. PMID:17886729

  3. The UK relative to other single payer-dominated healthcare markets for regenerative medicine therapies.

    PubMed

    Rose, James B; Williams, David J

    2012-05-01

    The UK has for many years been considered by businesses, including those based in the UK, as at best a second market for the launch of innovative medical technology products. Historically, this has been attributed to the slow pace of adoption in its National Health Service (NHS). The NHS is perceived to be subject to cost containment, high levels of fragmentation and a lack of strategic incentives to resolve its key failings as a market. Canada and Sweden offer examples of different operating models of healthcare delivery in a single payer-dominated market, and as a consequence, have evolved with different market characteristics. Together, these economies represent an important subsection of healthcare markets that are predominantly publically funded. This report examines the barriers to market entry for regenerative medicine products in these economies and attempts to evaluate the upcoming UK healthcare reforms in terms of impact on the regenerative medicine industry sector.

  4. The UK relative to other single payer-dominated healthcare markets for regenerative medicine therapies.

    PubMed

    Rose, James B; Williams, David J

    2012-05-01

    The UK has for many years been considered by businesses, including those based in the UK, as at best a second market for the launch of innovative medical technology products. Historically, this has been attributed to the slow pace of adoption in its National Health Service (NHS). The NHS is perceived to be subject to cost containment, high levels of fragmentation and a lack of strategic incentives to resolve its key failings as a market. Canada and Sweden offer examples of different operating models of healthcare delivery in a single payer-dominated market, and as a consequence, have evolved with different market characteristics. Together, these economies represent an important subsection of healthcare markets that are predominantly publically funded. This report examines the barriers to market entry for regenerative medicine products in these economies and attempts to evaluate the upcoming UK healthcare reforms in terms of impact on the regenerative medicine industry sector. PMID:22594333

  5. Medicare Program; Obtaining Final Medicare Secondary Payer Conditional Payment Amounts via Web Portal. Final rule.

    PubMed

    2016-05-17

    This final rule specifies the process and timeline for expanding CMS' existing Medicare Secondary Payer (MSP) Web portal to conform to section 201 of the Medicare IVIG and Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act). The final rule specifies a timeline for developing a multifactor authentication solution to securely permit authorized users other than the beneficiary to access CMS' MSP conditional payment amounts and claims detail information via the MSP Web portal. It also requires that we add functionality to the existing MSP Web portal that permits users to: Notify us that the specified case is approaching settlement; obtain time and date stamped final conditional payment summary statements and amounts before reaching settlement; and ensure that relatedness disputes and any other discrepancies are addressed within 11 business days of receipt of dispute documentation.

  6. The Dragon in School Backyards: The Influence of Mandated Testing on School Contexts and Educators' Narrative Knowing

    ERIC Educational Resources Information Center

    Craig, Cheryl J.

    2004-01-01

    Researched in the narrative inquiry tradition, this article examines the influence of state-mandated accountability testing on Eagle High School's dramatically shifting context and the embodied knowledge held and expressed by principal, Henry Richards, and the Eagle teachers. Through carefully unpacking Richards's dragon in school backyards…

  7. Vermont's Community-Oriented All-Payer Medical Home Model Reduces Expenditures and Utilization While Delivering High-Quality Care.

    PubMed

    Jones, Craig; Finison, Karl; McGraves-Lloyd, Katharine; Tremblay, Timothy; Mohlman, Mary Kate; Tanzman, Beth; Hazard, Miki; Maier, Steven; Samuelson, Jenney

    2016-06-01

    Patient-centered medical home programs using different design and implementation strategies are being tested across the United States, and the impact of these programs on outcomes for a general population remains unclear. Vermont has pursued a statewide all-payer program wherein medical home practices are supported with additional staffing from a locally organized shared resource, the community health team. Using a 6-year, sequential, cross-sectional methodology, this study reviewed annual cost, utilization, and quality outcomes for patients attributed to 123 practices participating in the program as of December 2013 versus a comparison population from each year attributed to nonparticipating practices. Populations are grouped based on their practices' stage of participation in a calendar year (Pre-Year, Implementation Year, Scoring Year, Post-Year 1, Post-Year 2). Annual risk-adjusted total expenditures per capita at Pre-Year for the participant group and comparison group were not significantly different. The difference-in-differences change from Pre-Year to Post-Year 2 indicated that the participant group's expenditures were reduced by -$482 relative to the comparison (95% CI, -$573 to -$391; P < .001). The lower costs were driven primarily by inpatient (-$218; P < .001) and outpatient hospital expenditures (-$154; P < .001), with associated changes in inpatient and outpatient hospital utilization. Medicaid participants also had a relative increase in expenditures for dental, social, and community-based support services ($57; P < .001). Participants maintained higher rates on 9 of 11 effective and preventive care measures. These results suggest that Vermont's community-oriented medical home model is associated with improved outcomes for a general population at lower expenditures and utilization. (Population Health Management 2016;19:196-205). PMID:26348492

  8. Vermont's Community-Oriented All-Payer Medical Home Model Reduces Expenditures and Utilization While Delivering High-Quality Care

    PubMed Central

    Jones, Craig; Finison, Karl; McGraves-Lloyd, Katharine; Tremblay, Timothy; Tanzman, Beth; Hazard, Miki; Maier, Steven; Samuelson, Jenney

    2016-01-01

    Abstract Patient-centered medical home programs using different design and implementation strategies are being tested across the United States, and the impact of these programs on outcomes for a general population remains unclear. Vermont has pursued a statewide all-payer program wherein medical home practices are supported with additional staffing from a locally organized shared resource, the community health team. Using a 6-year, sequential, cross-sectional methodology, this study reviewed annual cost, utilization, and quality outcomes for patients attributed to 123 practices participating in the program as of December 2013 versus a comparison population from each year attributed to nonparticipating practices. Populations are grouped based on their practices' stage of participation in a calendar year (Pre-Year, Implementation Year, Scoring Year, Post-Year 1, Post-Year 2). Annual risk-adjusted total expenditures per capita at Pre-Year for the participant group and comparison group were not significantly different. The difference-in-differences change from Pre-Year to Post-Year 2 indicated that the participant group's expenditures were reduced by −$482 relative to the comparison (95% CI, −$573 to −$391; P < .001). The lower costs were driven primarily by inpatient (−$218; P < .001) and outpatient hospital expenditures (−$154; P < .001), with associated changes in inpatient and outpatient hospital utilization. Medicaid participants also had a relative increase in expenditures for dental, social, and community-based support services ($57; P < .001). Participants maintained higher rates on 9 of 11 effective and preventive care measures. These results suggest that Vermont's community-oriented medical home model is associated with improved outcomes for a general population at lower expenditures and utilization. (Population Health Management 2016;19:196–205) PMID:26348492

  9. Physical therapy mandates by Medicare administrative contractors: effective or wasteful?

    PubMed

    Fehring, Thomas K; Fehring, Keith; Odum, Susan M; Halsey, David

    2013-10-01

    Documentation of medical necessity for arthroplasty has come under scrutiny by Medicare. In some jurisdictions three months of physical therapy prior to arthroplasty has been mandated. The purpose of this study was to determine the efficacy and cost of this policy to treat advanced osteoarthritis. A systematic review was performed to assimilate efficacy data for physical therapy in patients with advanced osteoarthritis. The number of arthroplasties performed annually was obtained to calculate cost. Evidence-based studies documenting the efficacy of physical therapy in treating advanced arthritis are lacking with a potential cost of 36-68 million dollars. Physical therapy mandates by administrative contractors are not only ineffective but are costly without patient benefit. Medical necessity documentation should be driven by orthopedists not retroactively by Medicare contractors.

  10. The legal basis of forensic psychiatry: statutorily mandated psychiatric diagnoses.

    PubMed

    Bloom, J D; Rogers, J L

    1987-07-01

    Using the Oregon statutory scheme as an example, the authors review certain areas of the law where psychiatric expertise is mandated by statute. This review points out the diversity of determinations where forensic psychiatric expertise is required by law. The authors' thesis is that forensic psychiatry draws its vitality from the law. Legal requirements, however, should not dictate psychiatric response, which should be guided by psychiatric knowledge and ethical concerns.

  11. Rice fortification: a comparative analysis in mandated settings.

    PubMed

    Forsman, Carmen; Milani, Peiman; Schondebare, Jill A; Matthias, Dipika; Guyondet, Christophe

    2014-09-01

    Legal mandates can play an important role in the success of rice fortification programs that involve the private sector. However, merely enacting mandatory legislation does not guarantee success; it requires a coordinated, multidimensional cross-sector effort that addresses stewardship, develops an appropriate rice fortification technology, enables sustainable production and distribution channels through a range of private-sector players, ensures quality, generates consumer demand, and monitors progress. Furthermore, economic sustainability must be built into the supply chain and distribution network to enable the program to outlast government administrations and/or time-limited funding. Hence, mandates can serve as valuable long-term enablers of cross-sector mobilization and collaboration and as catalysts of civil society engagement in and ownership of fortification programs. This paper compares the rice fortification experiences of Costa Rica and the Philippines--two countries with mandates, yet distinctly different industry landscapes. Costa Rica has achieved national success through strong government stewardship and active market development--key elements of success regardless of industry structure. With a comparatively more diffuse rice industry structure, the Philippines has also had success in limited geographies where key stakeholders have played an active role in market development. A comparative analysis provides lessons that may be relevant to other rice fortification programs. PMID:24913356

  12. Rice fortification: a comparative analysis in mandated settings.

    PubMed

    Forsman, Carmen; Milani, Peiman; Schondebare, Jill A; Matthias, Dipika; Guyondet, Christophe

    2014-09-01

    Legal mandates can play an important role in the success of rice fortification programs that involve the private sector. However, merely enacting mandatory legislation does not guarantee success; it requires a coordinated, multidimensional cross-sector effort that addresses stewardship, develops an appropriate rice fortification technology, enables sustainable production and distribution channels through a range of private-sector players, ensures quality, generates consumer demand, and monitors progress. Furthermore, economic sustainability must be built into the supply chain and distribution network to enable the program to outlast government administrations and/or time-limited funding. Hence, mandates can serve as valuable long-term enablers of cross-sector mobilization and collaboration and as catalysts of civil society engagement in and ownership of fortification programs. This paper compares the rice fortification experiences of Costa Rica and the Philippines--two countries with mandates, yet distinctly different industry landscapes. Costa Rica has achieved national success through strong government stewardship and active market development--key elements of success regardless of industry structure. With a comparatively more diffuse rice industry structure, the Philippines has also had success in limited geographies where key stakeholders have played an active role in market development. A comparative analysis provides lessons that may be relevant to other rice fortification programs.

  13. Socioeconomic Effects of Chronic Obstructive Pulmonary Disease from the Public Payer's Perspective in Poland.

    PubMed

    Wziątek-Nowak, Weronika; Gierczyński, Jakub; Dąbrowiecki, Piotr; Gałązka-Sobotka, Małgorzata; Fal, Andrzej M; Gryglewicz, Jerzy; Badyda, Artur J

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is currently the third most common cause of death worldwide and the total number of people affected reaches over 200 million. It is estimated that approximately 50 % of persons having COPD are not aware of it. In the EU, it is estimated that the total annual costs of COPD exceed €140 billion, and the expected increase in the number of cases and deaths due to COPD would further enhance economic and social costs of the disease. In this article we present the results of cost analysis of health care benefits associated with the treatment of COPD and with the disease-related incapacity for work. The analysis is based on the data of the National Health Fund and the Social Insurance Institutions, public payers of health benefits in Poland. The annual 2012 expenditures incurred for COPD treatment was €40 million, and the benefits associated with incapacity for work reached more than €55 million. The extent of these expenditures indicates that it is necessary to optimize the functioning system, including the allocation of resources for prevention, social awareness, and detection of COPD at early stages when treatment costs are relatively low. PMID:26801147

  14. Socioeconomic Effects of Chronic Obstructive Pulmonary Disease from the Public Payer's Perspective in Poland.

    PubMed

    Wziątek-Nowak, Weronika; Gierczyński, Jakub; Dąbrowiecki, Piotr; Gałązka-Sobotka, Małgorzata; Fal, Andrzej M; Gryglewicz, Jerzy; Badyda, Artur J

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is currently the third most common cause of death worldwide and the total number of people affected reaches over 200 million. It is estimated that approximately 50 % of persons having COPD are not aware of it. In the EU, it is estimated that the total annual costs of COPD exceed €140 billion, and the expected increase in the number of cases and deaths due to COPD would further enhance economic and social costs of the disease. In this article we present the results of cost analysis of health care benefits associated with the treatment of COPD and with the disease-related incapacity for work. The analysis is based on the data of the National Health Fund and the Social Insurance Institutions, public payers of health benefits in Poland. The annual 2012 expenditures incurred for COPD treatment was €40 million, and the benefits associated with incapacity for work reached more than €55 million. The extent of these expenditures indicates that it is necessary to optimize the functioning system, including the allocation of resources for prevention, social awareness, and detection of COPD at early stages when treatment costs are relatively low.

  15. 78 FR 69113 - Statutorily Mandated Designation of Difficult Development Areas for 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-18

    ... October 27, 2011 (76 FR 66741), entitled ``Statutorily Mandated Designation of Difficult Development Areas... URBAN DEVELOPMENT Statutorily Mandated Designation of Difficult Development Areas for 2014 AGENCY: Office of the Secretary, HUD. ACTION: Notice. SUMMARY: This notice designates ``Difficult...

  16. Payer Perspectives on PCSK9 Inhibitors: A Conversation with Stephen Gorshow, MD, and James T. Kenney, RPh, MBA.

    PubMed

    Mehr, Stanton R

    2016-02-01

    The new proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors can have significant budget effects, depending on the breadth of the US Food and Drug Administration (FDA)'s approved labeling. American Health & Drug Benefits asked Stephen Gorshow, MD, Regional Medical Director, UnitedHealthcare, and James T. Kenney, RPh, MBA, Manager, Specialty and Pharmacy Contracts, Harvard Pilgrim Health Care, to participate in a teleconference to better understand how payers are approaching the management of these agents.

  17. Payer Perspectives on PCSK9 Inhibitors: A Conversation with Stephen Gorshow, MD, and James T. Kenney, RPh, MBA

    PubMed Central

    Mehr, Stanton R.

    2016-01-01

    The new proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors can have significant budget effects, depending on the breadth of the US Food and Drug Administration (FDA)'s approved labeling. American Health & Drug Benefits asked Stephen Gorshow, MD, Regional Medical Director, UnitedHealthcare, and James T. Kenney, RPh, MBA, Manager, Specialty and Pharmacy Contracts, Harvard Pilgrim Health Care, to participate in a teleconference to better understand how payers are approaching the management of these agents. PMID:27066194

  18. Payer Perspectives on PCSK9 Inhibitors: A Conversation with Stephen Gorshow, MD, and James T. Kenney, RPh, MBA.

    PubMed

    Mehr, Stanton R

    2016-02-01

    The new proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors can have significant budget effects, depending on the breadth of the US Food and Drug Administration (FDA)'s approved labeling. American Health & Drug Benefits asked Stephen Gorshow, MD, Regional Medical Director, UnitedHealthcare, and James T. Kenney, RPh, MBA, Manager, Specialty and Pharmacy Contracts, Harvard Pilgrim Health Care, to participate in a teleconference to better understand how payers are approaching the management of these agents. PMID:27066194

  19. Sharing risk between payer and provider by leasing health technologies: an affordable and effective reimbursement strategy for innovative technologies?

    PubMed

    Edlin, Richard; Hall, Peter; Wallner, Klemens; McCabe, Christopher

    2014-06-01

    The challenge of implementing high-cost innovative technologies in health care systems operating under significant budgetary pressure has led to a radical shift in the health technology reimbursement landscape. New reimbursement strategies attempt to reduce the risk of making the wrong decision, that is, paying for a technology that is not good value for the health care system, while promoting the adoption of innovative technologies into clinical practice. The remaining risk, however, is not shared between the manufacturer and the health care payer at the individual purchase level; it continues to be passed from the manufacturer to the payer at the time of purchase. In this article, we propose a health technology payment strategy-technology leasing reimbursement scheme-that allows the sharing of risk between the manufacturer and the payer: the replacing of up-front payments with a stream of payments spread over the expected duration of benefit from the technology, subject to the technology delivering the claimed health benefit. Using trastuzumab (Herceptin) in early breast cancer as an exemplar technology, we show how a technology leasing reimbursement scheme not only reduces the total budgetary impact of the innovative technology but also truly shares risk between the manufacturer and the health care system, while reducing the value of further research and thus promoting the rapid adoption of innovative technologies into clinical practice.

  20. New mandates? No problem for The Rockefeller University Press.

    PubMed

    Rossner, Mike

    2013-04-01

    The existing public access policy for our three journals-The Journal of Cell Biology, The Journal of Experimental Medicine, and The Journal of General Physiology-is fully compliant with new policies from the Research Councils UK (RCUK) and the Wellcome Trust. In addition to mandating public access, the new policies specify licensing terms for reuse of content by third parties, in particular for text and data mining. We question the need for these specific terms, and we have added a statement to our licensing policy stipulating that anyone, including commercial entities, is permitted to mine our published text and data.

  1. The impact of maternity length-of-stay mandates on the labor market and insurance coverage.

    PubMed

    Sabik, Lindsay M; Laugesen, Miriam J

    2012-01-01

    To understand the effects of insurance regulation on the labor market and insurance coverage, this study uses a difference-in-difference-in-differences analysis to compare five states that passed minimum maternity length-of-stay laws with states that waited until after a federal law was passed. On average, we do not find statistically significant effects on labor market outcomes such as hours of work and wages. However, we find that employees of small firms in states with maternity length-of-stay mandates experienced a 6.2-percentage-point decline in the likelihood of having employer-sponsored insurance. Implementation of federal health reform that requires minimum benefit standards should consider the implications for firms of differing sizes.

  2. Nudges or mandates? The ethics of mandatory flu vaccination.

    PubMed

    Dubov, Alex; Phung, Connie

    2015-05-21

    According to the CDC report for the 2012-2013 influenza season, there was a modest increase in the vaccination coverage rate among healthcare workers from 67% in 2011-2012, to 72% in 2012-2013 to the current 75% coverage. This is still far from reaching the US National Healthy People 2020 goal of 90% hospitals vaccination rates. The reported increase in coverage is attributed to the growing number of healthcare facilities with vaccination requirements with average rates of 96.5%. However, a few other public health interventions stir so much controversy and debate as vaccination mandates. The opposition stems from the belief that a mandatory flu shot policy violates an individual right to refuse unwanted treatment. This article outlines the historic push to achieve higher vaccination rates among healthcare professionals and a number of ethical issues arising from attempts to implement vaccination mandates. It then turns to a review of cognitive biases relevant in the context of decisions about influenza vaccination (omission bias, ambiguity aversion, present bias etc.) The article suggests that a successful strategy for policy-makers and others hoping to increase vaccination rates is to design a "choice architecture" that influences behavior of healthcare professionals without foreclosing other options. Nudges incentivize vaccinations and help better align vaccination intentions with near-term actions.

  3. Does mandating offenders to treatment improve completion rates?

    PubMed

    Coviello, Donna M; Zanis, Dave A; Wesnoski, Susan A; Palman, Nicole; Gur, Arona; Lynch, Kevin G; McKay, James R

    2013-04-01

    While it is known that community-based outpatient treatment for substance abusing offenders is effective, treatment completion rates are low and much of the prior research has been conducted with offenders in residential treatment or therapeutic communities. The aim of the present study was to assess whether offenders who are mandated to community-based outpatient treatment have better completion rates compared to those who enter treatment voluntarily. The 160 research participants were a heterogeneous group of substance abusers who were under various levels of criminal justice supervision (CJS) in the community. The participants were enrolled in an intensive outpatient program and were recruited into the study between July 2007 and October 2010. All offenders received weekly therapy sessions using a cognitive problem solving framework and 45% completed the 6 month treatment program. Interestingly, those who were mandated demonstrated less motivation at treatment entry, yet were more likely to complete treatment compared to those who were not court-ordered to treatment. While controlling for covariates known to be related to treatment completion, the logistic regression analyses demonstrated that court-ordered offenders were over 10 times more likely to complete treatment compared to those who entered treatment voluntarily (OR=10.9, CI=2.0-59.1, p=.006). These findings demonstrate that stipulated treatment for offenders may be an effective way to increase treatment compliance.

  4. Mandate-based health reform and the labor market: Evidence from the Massachusetts reform.

    PubMed

    Kolstad, Jonathan T; Kowalski, Amanda E

    2016-05-01

    We model the labor market impact of the key provisions of the national and Massachusetts "mandate-based" health reforms: individual mandates, employer mandates, and subsidies. We characterize the compensating differential for employer-sponsored health insurance (ESHI) and the welfare impact of reform in terms of "sufficient statistics." We compare welfare under mandate-based reform to welfare in a counterfactual world where individuals do not value ESHI. Relying on the Massachusetts reform, we find that jobs with ESHI pay $2812 less annually, somewhat less than the cost of ESHI to employers. Accordingly, the deadweight loss of mandate-based health reform was approximately 8 percent of its potential size.

  5. Impact of passive health status monitoring to care providers and payers in assisted living.

    PubMed

    Alwan, Majd; Sifferlin, Elena Brito; Turner, Beverely; Kell, Steve; Brower, Peter; Mack, David C; Dalal, Siddharth; Felder, Robin A

    2007-06-01

    The objective of this study was to assess the impact of passive health status monitoring on the cost of care, as well as the efficiencies of professional caregivers in assisted living. We performed a case-controlled study to assess economic impact of passive health status monitoring technology in an assisted-living facility. Passive monitoring systems were installed in the assisted-living units of 21 residents to track physiological parameters (heart rate and breathing rate), the activities of daily living (ADLs), and key alert conditions. Professional caregivers were provided with access to the wellness status of the monitored residents they serve. The monitored individuals' cost of medical care was compared to that of an age, gender, and health status matched cohort. Similarly, efficiency and workloads of professional caregivers providing care to the monitored individuals were compared to those of caregivers providing care to the control cohort in the control site. Over the 3-month period of the study, a comparison between the monitored and control cohorts showed reductions in billable interventions (47 vs. 73, p = 0.040), hospital days (7 vs. 33, p = 0.004), and estimated cost of care (21,187.02 dollars vs. 67,753.88 dollars with monitoring cost included, p = 0.034). A comparison between efficiency normalized workloads of monitoring and control sites' caregivers revealed significant differences both at the beginning (0.6 vs. 1.38, p = 0.041) and the end (0.84 vs. 1.94, p = 0.002) of the study. The results demonstrate that monitoring technologies have significantly reduced billable interventions, hospital days, and cost of care to payers, and had a positive impact on professional caregivers' efficiency. PMID:17603830

  6. The impact of Medicaid payer status on hospitalizations in nursing homes

    PubMed Central

    Cai, Shubing; Miller, Susan C.; Nelson, Dallas L.; Mukamel, Dana B.

    2015-01-01

    Objectives To examine the association between payer status (Medicaid versus private-pay) and the risk of hospitalizations among long-term stay nursing home (NH) residents who reside in the same facility. Data and study population The 2007–2010 national Medicare Claims and the Minimum Data Set were linked. We identified newly admitted NH residents who became long-stayers and then followed them for 180 days. Analyses Three dichotomous outcomes – all-cause, discretionary and nondiscretionary hospitalizations during the follow-up period – were defined. Linear probability model with facility fixed-effects and robust standard errors were used to examine the within-facility difference in hospitalizations between Medicaid and private-pay residents. A set of sensitivity analyses were performed to examine the robustness of the findings. Results The prevalence of all-cause hospitalization during a 180-day follow-up period was 23.3% among Medicaid residents compared to 21.6% among private-pay residents. After accounting for individual characteristics and facility effects, the probability of any all-cause hospitalization was 1.8 percentage point (P<0.01) higher for Medicaid residents than for private-pay residents within the same facility. We also found Medicaid residents were more likely to be hospitalized for discretionary conditions (5% increase in the likelihood of discretionary hospitalizations), but not for non-discretionary conditions. The findings from the sensitivity analyses were consistent with the main analyses. Conclusion Observed higher hospitalization rates for Medicaid NH residents are at least in part driven by the financial incentive NHs have to hospitalize Medicaid residents. PMID:26067881

  7. Cost-Utility of Cognitive Behavioral Therapy for Low Back Pain From the Commercial Payer Perspective

    PubMed Central

    Norton, Giulia; McDonough, Christine M.; Cabral, Howard; Shwartz, Michael; Burgess, James F.

    2016-01-01

    Study Design Markov cost-utility model. Objective To evaluate the cost-utility of cognitive behavioral therapy (CBT) for the treatment of persistent nonspecific low back pain (LBP) from the perspective of US commercial payers. Summary of Background Data CBT is widely deemed clinically effective for LBP treatment. The evidence is suggestive of cost-effectiveness. Methods We constructed and validated a Markov intention-to-treat model to estimate the cost-utility of CBT, with 1-year and 10-year time horizons. We applied likelihood of improvement and utilities from a randomized controlled trial assessing CBT to treat LBP. The trial randomized subjects to treatment but subjects freely sought health care services. We derived the cost of equivalent rates and types of services from US commercial claims for LBP for a similar population. For the 10-year estimates, we derived recurrence rates from the literature. The base case included medical and pharmaceutical services and assumed gradual loss of skill in applying CBT techniques. Sensitivity analyses assessed the distribution of service utilization, utility values, and rate of LBP recurrence. We compared health plan designs. Results are based on 5000 iterations of each model and expressed as an incremental cost per quality-adjusted life-year. Results The incremental cost-utility of CBT was $7197 per quality-adjusted life-year in the first year and $5855 per quality-adjusted life-year over 10 years. The results are robust across numerous sensitivity analyses. No change of parameter estimate resulted in a difference of more than 7% from the base case for either time horizon. Including chiropractic and/or acupuncture care did not substantively affect cost-effectiveness. The model with medical but no pharmaceutical costs was more cost-effective ($5238 for 1 yr and $3849 for 10 yr). Conclusion CBT is a cost-effective approach to manage chronic LBP among commercial health plans members. Cost-effectiveness is demonstrated for

  8. Racial disparities in renal cell carcinoma: a single-payer healthcare experience.

    PubMed

    Mafolasire, Abiodun; Yao, Xiaopan; Nawaf, Cayce; Suarez-Sarmiento, Alfredo; Chow, Wong-Ho; Zhao, Wei; Corley, Douglas; Hofmann, Jonathan N; Purdue, Mark; Adeniran, Adebowale J; Shuch, Brian

    2016-08-01

    Significant racial disparities in survival for renal cell carcinoma (RCC) exist between white and black patients. Differences in access to care and comorbidities are possible contributors. To investigate if racial disparities persist when controlling for access to care, we analyzed data from a single-payer healthcare system. As part of a case-control study within the Kaiser Permanente Northern California system, pathologic and clinical records were obtained for RCC cases (2152 white, 293 black) diagnosed from 1998 to 2008. Patient demographics, comorbidities, tumor characteristics, and treatment status were compared. Overall survival and disease-specific survival (DSS) were calculated by the Kaplan-Meier method. A Cox proportion hazards model estimated the independent associations of race, comorbidity, and clinicopathologic variables with DSS. We found that compared to white patients, black patients were diagnosed at a younger age (median 62 vs. 66 years, P < 0.001), were more likely to have papillary RCC (15% vs. 5.2%, P < 0.001), and had similar rates of surgical treatment (78.8% vs. 77.9%, P = 0.764). On multivariate analysis, advanced American Joint Committee on Cancer (AJCC) stage, lack of surgical treatment, larger tumor size, and higher grade were predictors of worse DSS. Race was not an independent predictor of survival. Therefore, we conclude that within a single healthcare system, differences in characteristics of black and white patients with RCC persist; black patients had different comorbidities, were younger, and had decreased tumor stage. However, unlike other series, race was not an independent predictor of DSS, suggesting that survival differences in large registries may result from barriers to healthcare access and/or comorbidity rather than disease biology. PMID:27228559

  9. [Economical situation of public payer and financing of medical benefits during the years of 1999 - 2010].

    PubMed

    Tarhoni, Mariusz; Kuszewski, Krzysztof

    2010-01-01

    The authors of the publication analyse financial effects which are the result of applying division algorithms concerning public payer organizational units during the years of 1999 - 2010. Unpublished financial data illustrating the division of financial resources in public health insurance in Poland in the years 1999 - 2009 and accepted plan for 2010 are presented. This data has been aggregated in such a way that the system of the 17 "Kasa Chorych" introduced on the 1st of January 1999, working until the 31st of March 2003 could be compared with the introduced on the 1st of April 2003 system of Voivodship Branches of NFZ (National Health Fund). Perpetual increase of expenses for benefits and medical services financed from public resources forces the necessity of rationalizing costs and financing system of these benefits. In 10 years perspective the changing tendencies of partition in the accepted algorithms of financial leveling can be seen. The obtained results allow drawing conclusions according to the rise of the level of medical benefits financing in each voivodship. There is no way of saying unmistakably whether substantial increase in financing of health care units is proportional to increased accessibility and quality of medical benefits. The changes of diversity of financial resources flow from voivodships which give away to those which take, frequent changes inside one and the same voivodship from giving away to taking can be helpful in the evaluation of rational level of financing of e.g. hospitals and helpful in forming rules of financial"sensitivity" (optimal and possible to finance) for the insured population in question. The result of the conducted analysis shows that flow of the amount of financial resources between the NFZ Voivod Branches resulting from leveling algorithms in the whole country is bigger than the planned lowering of income from premium in NFZ for the year 2010. PMID:20499670

  10. The evolution of healthcare quality measurement in the United States.

    PubMed

    Burstin, H; Leatherman, S; Goldmann, D

    2016-02-01

    Quality measurement is fundamental to systematic improvement of the healthcare system. Whilst the United States has made significant investments in healthcare quality measurement and improvement, progress has been somewhat limited. Public and private payers in the United States increasingly mandate measurement and reporting as part of pay-for-performance programmes. Numerous issues have limited improvement, including lack of alignment in the use of measures and improvement strategies, the fragmentation of the U.S. healthcare system, and the lack of national electronic systems for measurement, reporting, benchmarking and improvement. Here, we provide an overview of the evolution of U.S. quality measurement efforts, including the role of the National Quality Forum. Important contextual changes such as the growing shift towards electronic data sources and clinical registries are discussed together with international comparisons. In future, the U.S. healthcare system needs to focus greater attention on the development and use of measures that matter. The three-part aim of effective care, affordable care and healthy communities in the U.S. National Quality Strategy focuses attention on population health and reduction in healthcare disparities. To make significant improvements in U.S. health care, a closer connection between measurement and both evolving national data systems and evidence-based improvement strategies is needed. PMID:26785953

  11. The evolution of healthcare quality measurement in the United States.

    PubMed

    Burstin, H; Leatherman, S; Goldmann, D

    2016-02-01

    Quality measurement is fundamental to systematic improvement of the healthcare system. Whilst the United States has made significant investments in healthcare quality measurement and improvement, progress has been somewhat limited. Public and private payers in the United States increasingly mandate measurement and reporting as part of pay-for-performance programmes. Numerous issues have limited improvement, including lack of alignment in the use of measures and improvement strategies, the fragmentation of the U.S. healthcare system, and the lack of national electronic systems for measurement, reporting, benchmarking and improvement. Here, we provide an overview of the evolution of U.S. quality measurement efforts, including the role of the National Quality Forum. Important contextual changes such as the growing shift towards electronic data sources and clinical registries are discussed together with international comparisons. In future, the U.S. healthcare system needs to focus greater attention on the development and use of measures that matter. The three-part aim of effective care, affordable care and healthy communities in the U.S. National Quality Strategy focuses attention on population health and reduction in healthcare disparities. To make significant improvements in U.S. health care, a closer connection between measurement and both evolving national data systems and evidence-based improvement strategies is needed.

  12. Intrinsicality: reconsidering spirituality, meaning(s) and mandates.

    PubMed

    Hammell, K W

    2001-06-01

    Canadian occupational therapists have placed spirituality as the central core of their theoretical Model, depicting inner and outer selves that contradict simultaneous declarations concerning the integration of mind/body/spirit. Even the word spirituality has discrepant meanings and failure to articulate one chosen meaning leads to ambiguity. This paper argues that occupational therapists must agree upon a single definition of spirituality that is congruent with our professional mandate and philosophical perspective; and that prevention of misunderstandings between and amongst clients and other health care professionals demands recourse to our own terminology. It is proposed that intrinsicality be employed to articulate the personal philosophy of meaning with which we interpret our lives. Influenced by environmental context and in homeostatic relationship with the body and mind, intrinsicality constitutes the essence of the self and informs occupational choices based upon personal values and priorities. Acknowledgement of intrinsicality respects the uniqueness of individuals' meanings. PMID:11433917

  13. Global health report. A snapshot of the payer systems, major diseases and workforce trends from around the world.

    PubMed

    Scalise, Dagmara; Hopkins, Kendra A

    2003-07-01

    International trade and travel have rendered political and geographic boundaries irrelevant when it comes to diseases. HIV and SARS are among the more recent examples of deadly viruses that spread swiftly from one continent to the next before international health experts can identify them, much less begin to search for a cure. This snapshot of global health issues looks at payer systems from a cross section of nations, lists the world's eight most infectious diseases and their rate of incidence by region, and pays special attention to the shortage of health care workers, which has reached crisis proportions in many areas and is pitting nation against nation in the competition for qualified staff.

  14. Transformative Use of an Improved All-Payer Hospital Discharge Data Infrastructure for Community-Based Participatory Research: A Sustainability Pathway

    PubMed Central

    Salemi, Jason L; Salinas-Miranda, Abraham A; Wilson, Roneé E; Salihu, Hamisu M

    2015-01-01

    Objective To describe the use of a clinically enhanced maternal and child health (MCH) database to strengthen community-engaged research activities, and to support the sustainability of data infrastructure initiatives. Data Sources/Study Setting Population-based, longitudinal database covering over 2.3 million mother–infant dyads during a 12-year period (1998–2009) in Florida. Setting: A community-based participatory research (CBPR) project in a socioeconomically disadvantaged community in central Tampa, Florida. Study Design Case study of the use of an enhanced state database for supporting CBPR activities. Principal Findings A federal data infrastructure award resulted in the creation of an MCH database in which over 92 percent of all birth certificate records for infants born between 1998 and 2009 were linked to maternal and infant hospital encounter-level data. The population-based, longitudinal database was used to supplement data collected from focus groups and community surveys with epidemiological and health care cost data on important MCH disparity issues in the target community. Data were used to facilitate a community-driven, decision-making process in which the most important priorities for intervention were identified. Conclusions Integrating statewide all-payer, hospital-based databases into CBPR can empower underserved communities with a reliable source of health data, and it can promote the sustainability of newly developed data systems. PMID:25879276

  15. Congress, courts, and commerce: upholding the individual mandate to protect the public's health.

    PubMed

    Hodge, James G; Brown, Erin C Fuse; Orenstein, Daniel G; O'Keefe, Sarah

    2011-01-01

    Among multiple legal challenges to the Patient Protection and Affordable Care Act (PPACA) is the premise that PPACA's "individual mandate" (requiring all individuals to obtain health insurance by 2014 or face civil penalties) is inviolate of Congress' interstate commerce powers because Congress lacks the power to regulate commercial "inactivity." Several courts initially considering this argument have rejected it, but federal district courts in Virginia and Florida have concurred, leading to numerous appeals and prospective review of the United States Supreme Court. Despite creative arguments, the dispositive constitutional question is not whether Congress' interstate commerce power extends to commercial inactivity. Rather, it is whether Congress may regulate individual decisions with significant economic ramifications in the interests of protecting and promoting the public's health. This article offers a counter-interpretation of the scope of Congress' interstate commerce power to regulate in furtherance of the public's health.

  16. B2, B7 or B10: Which palm-based blend mandate wise to be chosen in Malaysia?

    NASA Astrophysics Data System (ADS)

    Applanaidu, Shri-Dewi; Abidin, Norhaslinda Zainal; Ali, Anizah Md.

    2015-12-01

    The diminishing fossil energy resources, coupled with heightened interest in the abatement of greenhouse gas emissions and concerns about energy security have motivated Malaysia to produce palm-based biodiesel and it has been started to be exported since 2006. In line with this issue, the government in Malaysia launched the palm-based biodiesel blending mandate of five percent (B5) in the federal administration of Putrajaya on 1st June 2011. This was then followed by four states: Malacca on July 11, Negeri Sembilan on August 1, Kuala Lumpur on September 1 and Selangor on October 1 of the same year but it is yet to be implemented nationwide. However what is the wise blend mandate to be chosen? Thus, this paper seeks to examine the possible impact of various blend mandates implementation (B2, B7 and B10) on the palm oil industry market variables (stock and price) since the main aim of biodiesel industry in Malaysia is to reduce domestic palm oil stock to below one million tones and provide a floor price to support Crude Palm Oil (CPO) prices at RM2,000 per tonne. A structural econometric model consisting of nine structural equations and three identities was proposed in this study. The model has been estimated by two stage least squares (2SLS) method using annual data for the period 1976-2013. The study indicates that counterfactual simulation of a decrease from B5 to B2 predicts a decrease (11.2 per cent) in CPO domestic consumption for biodiesel usage, 731.02 per cent reduction in CPO stock and an increase of 27.41 percent in domestic price of CPO. However the increase in the blend mandate from B5 to B7 and B10 suggest that domestic consumption of CPO for biodiesel purpose increase 7.40 and 18.55 percent respectively. The interesting findings in this study suggest that no matter whether Malaysian government increase or decrease the blend mandate the increase in the price of CPO are the same with an increase of is 27.41 percent. Hence, this study suggests that the

  17. B2, B7 or B10: Which palm-based blend mandate wise to be chosen in Malaysia?

    SciTech Connect

    Applanaidu, Shri-Dewi Ali, Anizah Md.; Abidin, Norhaslinda Zainal

    2015-12-11

    The diminishing fossil energy resources, coupled with heightened interest in the abatement of greenhouse gas emissions and concerns about energy security have motivated Malaysia to produce palm-based biodiesel and it has been started to be exported since 2006. In line with this issue, the government in Malaysia launched the palm-based biodiesel blending mandate of five percent (B5) in the federal administration of Putrajaya on 1{sup st} June 2011. This was then followed by four states: Malacca on July 11, Negeri Sembilan on August 1, Kuala Lumpur on September 1 and Selangor on October 1 of the same year but it is yet to be implemented nationwide. However what is the wise blend mandate to be chosen? Thus, this paper seeks to examine the possible impact of various blend mandates implementation (B2, B7 and B10) on the palm oil industry market variables (stock and price) since the main aim of biodiesel industry in Malaysia is to reduce domestic palm oil stock to below one million tones and provide a floor price to support Crude Palm Oil (CPO) prices at RM2,000 per tonne. A structural econometric model consisting of nine structural equations and three identities was proposed in this study. The model has been estimated by two stage least squares (2SLS) method using annual data for the period 1976-2013. The study indicates that counterfactual simulation of a decrease from B5 to B2 predicts a decrease (11.2 per cent) in CPO domestic consumption for biodiesel usage, 731.02 per cent reduction in CPO stock and an increase of 27.41 percent in domestic price of CPO. However the increase in the blend mandate from B5 to B7 and B10 suggest that domestic consumption of CPO for biodiesel purpose increase 7.40 and 18.55 percent respectively. The interesting findings in this study suggest that no matter whether Malaysian government increase or decrease the blend mandate the increase in the price of CPO are the same with an increase of is 27.41 percent. Hence, this study suggests that

  18. Heterogeneity and the Effect of Mental Health Parity Mandates on the Labor Market*

    PubMed Central

    Andersen, Martin

    2015-01-01

    Health insurance benefit mandates are believed to have adverse effects on the labor market, but efforts to document such effects for mental health parity mandates have had limited success. I show that one reason for this failure is that the association between parity mandates and labor market outcomes vary with mental distress. Accounting for this heterogeneity, I find adverse labor market effects for non-distressed individuals, but favorable effects for moderately distressed individuals and individuals with a moderately distressed family member. On net, I conclude that the mandates are welfare increasing for moderately distressed workers and their families, but may be welfare decreasing for non-distressed individuals. PMID:26210944

  19. Heterogeneity and the effect of mental health parity mandates on the labor market.

    PubMed

    Andersen, Martin

    2015-09-01

    Health insurance benefit mandates are believed to have adverse effects on the labor market, but efforts to document such effects for mental health parity mandates have had limited success. I show that one reason for this failure is that the association between parity mandates and labor market outcomes vary with mental distress. Accounting for this heterogeneity, I find adverse labor market effects for non-distressed individuals, but favorable effects for moderately distressed individuals and individuals with a moderately distressed family member. On net, I conclude that the mandates are welfare increasing for moderately distressed workers and their families, but may be welfare decreasing for non-distressed individuals.

  20. The impact on hospitals of reducing surgical complications suggests many will need shared savings programs with payers.

    PubMed

    Krupka, Dan C; Sandberg, Warren S; Weeks, William B

    2012-11-01

    Reducing the complications that patients experience following surgery has garnered renewed attention from the medical and policy community. Reducing surgical complications is, foremost, critically important for patients. Moreover, in a competitive environment increasingly characterized by transparency of outcomes, the surgical complication rate is an important measure of hospital performance that could strongly influence choices of care and care sites made by patients and payers. However, programs to achieve such improvements can reduce hospital revenues, as reimbursements to treat patients for complications decrease. In this article we examine the business case for hospitals' consideration of programs to reduce surgical complications. We found that if a hospital's surgical inpatient volume is not growing, such a program results in negative cash flow. We also found that if a hospital's surgical volume is growing, and if the hospital can sufficiently reduce the average length-of-stay for surgical patients without complications, the cash flow could be positive. We recommend that hospitals with limited growth prospects that are nonetheless contemplating a surgical complication reduction program establish agreements with payers to share in any savings generated by the program.

  1. Assessing clarity of message communication for mandated USEPA drinking water quality reports.

    PubMed

    Phetxumphou, Katherine; Roy, Siddhartha; Davy, Brenda M; Estabrooks, Paul A; You, Wen; Dietrich, Andrea M

    2016-04-01

    The United States Environmental Protection Agency mandates that community water systems (CWSs), or drinking water utilities, provide annual consumer confidence reports (CCRs) reporting on water quality, compliance with regulations, source water, and consumer education. While certain report formats are prescribed, there are no criteria ensuring that consumers understand messages in these reports. To assess clarity of message, trained raters evaluated a national sample of 30 CCRs using the Centers for Disease Control Clear Communication Index (Index) indices: (1) Main Message/Call to Action; (2) Language; (3) Information Design; (4) State of the Science; (5) Behavioral Recommendations; (6) Numbers; and (7) Risk. Communication materials are considered qualifying if they achieve a 90% Index score. Overall mean score across CCRs was 50 ± 14% and none scored 90% or higher. CCRs did not differ significantly by water system size. State of the Science (3 ± 15%) and Behavioral Recommendations (77 ± 36%) indices were the lowest and highest, respectively. Only 63% of CCRs explicitly stated if the water was safe to drink according to federal and state standards and regulations. None of the CCRs had passing Index scores, signaling that CWSs are not effectively communicating with their consumers; thus, the Index can serve as an evaluation tool for CCR effectiveness and a guide to improve water quality communications.

  2. Assessing clarity of message communication for mandated USEPA drinking water quality reports.

    PubMed

    Phetxumphou, Katherine; Roy, Siddhartha; Davy, Brenda M; Estabrooks, Paul A; You, Wen; Dietrich, Andrea M

    2016-04-01

    The United States Environmental Protection Agency mandates that community water systems (CWSs), or drinking water utilities, provide annual consumer confidence reports (CCRs) reporting on water quality, compliance with regulations, source water, and consumer education. While certain report formats are prescribed, there are no criteria ensuring that consumers understand messages in these reports. To assess clarity of message, trained raters evaluated a national sample of 30 CCRs using the Centers for Disease Control Clear Communication Index (Index) indices: (1) Main Message/Call to Action; (2) Language; (3) Information Design; (4) State of the Science; (5) Behavioral Recommendations; (6) Numbers; and (7) Risk. Communication materials are considered qualifying if they achieve a 90% Index score. Overall mean score across CCRs was 50 ± 14% and none scored 90% or higher. CCRs did not differ significantly by water system size. State of the Science (3 ± 15%) and Behavioral Recommendations (77 ± 36%) indices were the lowest and highest, respectively. Only 63% of CCRs explicitly stated if the water was safe to drink according to federal and state standards and regulations. None of the CCRs had passing Index scores, signaling that CWSs are not effectively communicating with their consumers; thus, the Index can serve as an evaluation tool for CCR effectiveness and a guide to improve water quality communications. PMID:27105408

  3. Telemental health: responding to mandates for reform in primary healthcare.

    PubMed

    Myers, Kathleen M; Lieberman, Daniel

    2013-06-01

    Telemental health (TMH) has established a niche as a feasible, acceptable, and effective service model to improve the mental healthcare and outcomes for individuals who cannot access traditional mental health services. The Accountability Care Act has mandated reforms in the structure, functioning, and financing of primary care that provide an opportunity for TMH to move into the mainstream healthcare system. By partnering with the Integrated Behavioral Healthcare Model, TMH offers a spectrum of tools to unite primary care physicians and mental health specialist in a mind-body view of patients' healthcare needs and to activate patients in their own care. TMH tools include video-teleconferencing to telecommute mental health specialists to the primary care setting to collaborate with a team in caring for patients' mental healthcare needs and to provide direct services to patients who are not progressing optimally with this collaborative model. Asynchronous tools include online therapies that offer an efficient first step to treatment for selected disorders such as depression and anxiety. Patients activate themselves in their care through portals that provide access to their healthcare information and Web sites that offer on-demand information and communication with a healthcare team. These synchronous and asynchronous TMH tools may move the site of mental healthcare from the clinic to the home. The evolving role of social media in facilitating communication among patients or with their healthcare team deserves further consideration as a tool to activate patients and provide more personalized care. PMID:23611641

  4. US Government mandates for clinical and translational research.

    PubMed

    Shuster, Jonathan J

    2012-02-01

    This commentary is germane for clinical and translational researchers. Basic scientists may face different obstacles to developing their research careers. Over the past several years, the federal government has seen reductions in funding for extramural research. It seems that under the adverse economic forecasts, things are going to get worse. It might seem logical for the federal government to stretch whatever limited resources exist, by asking the institutions to cost-share greater fractions of the actual research costs, and as an incentive, avoid the imposition of unfunded mandates. But alas, although well intended, there have been expensive requirements imposed by the government, making it difficult for investigators and institutions to adequately fund and conduct their research and for scientific journals to maintain paying subscribers. Five prominent and costly changes, which are the focus of this commentary are (1) HIPAA, (2) http://ClinicalTrials.Gov, (3) Clinical and Translational Science Awards, (4) Upcoming rule changes for IRBs, and (5) PubMedCentral, each of which will be discussed in the ensuing paragraphs.

  5. Telemental health: responding to mandates for reform in primary healthcare.

    PubMed

    Myers, Kathleen M; Lieberman, Daniel

    2013-06-01

    Telemental health (TMH) has established a niche as a feasible, acceptable, and effective service model to improve the mental healthcare and outcomes for individuals who cannot access traditional mental health services. The Accountability Care Act has mandated reforms in the structure, functioning, and financing of primary care that provide an opportunity for TMH to move into the mainstream healthcare system. By partnering with the Integrated Behavioral Healthcare Model, TMH offers a spectrum of tools to unite primary care physicians and mental health specialist in a mind-body view of patients' healthcare needs and to activate patients in their own care. TMH tools include video-teleconferencing to telecommute mental health specialists to the primary care setting to collaborate with a team in caring for patients' mental healthcare needs and to provide direct services to patients who are not progressing optimally with this collaborative model. Asynchronous tools include online therapies that offer an efficient first step to treatment for selected disorders such as depression and anxiety. Patients activate themselves in their care through portals that provide access to their healthcare information and Web sites that offer on-demand information and communication with a healthcare team. These synchronous and asynchronous TMH tools may move the site of mental healthcare from the clinic to the home. The evolving role of social media in facilitating communication among patients or with their healthcare team deserves further consideration as a tool to activate patients and provide more personalized care.

  6. Mandated empowerment: handing antipoverty policy back to the poor?

    PubMed

    Banerjee, Abhijit V; Duflo, Esther

    2008-01-01

    The current trend in antipoverty policy emphasizes mandated empowerment: the poor are being handed the responsibility for making things better for themselves, largely without being asked whether this is what they want. Beneficiary control is now being built into public service delivery, while microcredit and small business promotion are seen as better ways to help the poor. The clear presumption is that the poor are both able and happy to exercise these new powers. This essay uses two examples to raise questions about these strategies. The first example is about entrepreneurship among the poor. Using data from a number of countries, we argue that there is no evidence that the median poor entrepreneur is trying his best to expand his existing businesses, even if we take into account the many constraints he faces. While many poor people own businesses, this seems to be more a survival strategy than something they want to do. The second example comes from an evaluation of a program in India that aims to involve poor rural parents in improving local public schools. The data suggest that despite being informed that they now have both the right to intervene in the school and access to funds for that purpose, and despite being made aware of how little the children were learning, parents opt to not get involved. Both examples raise concerns about committing ourselves entirely to antipoverty strategies that rely on the poor doing a lot of the work.

  7. Alcohol Use Problems Mediate the Relation between Cannabis Use Frequency and College Functioning among Students Mandated to an Alcohol Diversion Program

    ERIC Educational Resources Information Center

    McChargue, Dennis E.; Klanecky, Alicia K.; Anderson, Jennifer

    2012-01-01

    The present study examined the degree to which alcohol use problems explained the relationship between cannabis use frequency and college functioning. Undergraduates (N = 546) mandated to an alcohol diversion program at a Midwestern United States university completed screening questionnaires between October 2003 and April 2006. Sobel's (1982) test…

  8. Why Am I Teaching This? Investigating the Tension between Mandated Curriculum and Teacher Autonomy

    ERIC Educational Resources Information Center

    Costello, David

    2012-01-01

    This article shares the experience of a teacher investigating the tension between a mandated literacy program and his desire to teach in response to his perceptions of students' needs. Qualitative teacher research methodology is used to study the impact of mandated literacy practices on teaching and learning; and to answer the question: how is my…

  9. Can Nightmares Become Sweet Dreams? Peer Review in the Wake of a Systemwide Administrative Mandate.

    ERIC Educational Resources Information Center

    Langsam, Deborah M.; Dubois, Philip L.

    1996-01-01

    In 1993, the University of North Carolina at Charlotte's governing board mandated peer evaluation for nontenured faculty. Participants in the American Association for Higher Education's peer review project feared the mandate would taint efforts to introduce faculty to collegial approaches to peer review. However, negative fallout from the mandate…

  10. The Views of Low-Income Employees Regarding Mandated Comprehensive Employee Benefits for the Sake of Health

    PubMed Central

    Adikes, Katherin A.; Hull, Sara C.; Dams, Marion

    2013-01-01

    Socioeconomic factors stand in the way of good health for low-income populations. We suggest that employee benefits might serve as a means of improving the health of low-wage earners. We convened groups of low-income earners to design hypothetical employee benefit packages. Qualitative analysis of group discussions regarding state-mandated benefits indicated that participants were interested in a great variety of benefits, beyond health care, that address socioeconomic determinants of health. Long-term financial and educational investments were of particular value. These results may facilitate the design of employee benefits that promote the health of low-income workers. PMID:20391255

  11. Why Hospitals and Payers are Recommending Home Care Upon Discharge Instead of SNF or Traditional Home Health Services--Alternative Payment Model Hospital Incentives Aligning with Patient Choice.

    PubMed

    Luke, Josh

    2016-01-01

    Seniors and other hospital patients in the United States have traditionally had the option of being discharged to a skilled nursing facility (convalescent home) for post-acute services, or home with nursing and therapy services provided in the home setting. Traditionally, these home based services have been referred to as "home health." As more Americans have retired, home health services have expanded and are readily accessible. This growth put tremendous stress on the Medicare fund which pays for senior care services. However, "Home Care," which traditionally has been viewed as non-medical home based services, has also become a booming industry for the cost conscious in recent years as more Americans reach retirement age. With the passing of the Affordable Care Act in 2010, providers and payers are now finding themselves responsible for post-acute care and continuous patient health, so cost efficient solutions for post-acute care are thriving. For the first time in history, American hospitals and Insurers are recognizing Home Care as an effective model that achieves the Triple Aim of Health Care reform. Home Care, which is no longer completely non-medical services, has proven to be an integral part of the care continuum for seniors in recent years and is now becoming a viable solution for keeping patients well, while still honoring their desire to age and heal at home. This paper analyzes the benefits and risks of home care and provides a clear understanding as to why American hospitals are emphasizing SNF Avoidance and skipping home health, opting instead to refer patients directly to home care as the preferred discharge solution in a value based model. PMID:27180473

  12. Why Hospitals and Payers are Recommending Home Care Upon Discharge Instead of SNF or Traditional Home Health Services--Alternative Payment Model Hospital Incentives Aligning with Patient Choice.

    PubMed

    Luke, Josh

    2016-01-01

    Seniors and other hospital patients in the United States have traditionally had the option of being discharged to a skilled nursing facility (convalescent home) for post-acute services, or home with nursing and therapy services provided in the home setting. Traditionally, these home based services have been referred to as "home health." As more Americans have retired, home health services have expanded and are readily accessible. This growth put tremendous stress on the Medicare fund which pays for senior care services. However, "Home Care," which traditionally has been viewed as non-medical home based services, has also become a booming industry for the cost conscious in recent years as more Americans reach retirement age. With the passing of the Affordable Care Act in 2010, providers and payers are now finding themselves responsible for post-acute care and continuous patient health, so cost efficient solutions for post-acute care are thriving. For the first time in history, American hospitals and Insurers are recognizing Home Care as an effective model that achieves the Triple Aim of Health Care reform. Home Care, which is no longer completely non-medical services, has proven to be an integral part of the care continuum for seniors in recent years and is now becoming a viable solution for keeping patients well, while still honoring their desire to age and heal at home. This paper analyzes the benefits and risks of home care and provides a clear understanding as to why American hospitals are emphasizing SNF Avoidance and skipping home health, opting instead to refer patients directly to home care as the preferred discharge solution in a value based model.

  13. Exposure of California Kindergartners to Students With Personal Belief Exemptions From Mandated School Entry Vaccinations

    PubMed Central

    Jones, Malia; Baras, Yelena

    2012-01-01

    Objectives. Personal belief exemptions (PBEs) from mandated school entry vaccinations have increased in California over the past decade. Infectious disease outbreaks in the state may be associated with the aggregation of intentionally unvaccinated children within schools. We sought to quantify the exposure of California kindergartners to children with PBEs at school. Methods. We used cross-sectional California Department of Public Health data on 3 kindergarten cohorts to define and calculate multiple measures of exposure to children with exemptions, including interaction and aggregation indices, for the state as a whole (2008–2010) and by county (2010). Results. In 2010, the PBE rate in California was 2.3 per 100 students, and the school PBE rate for the average kindergartner with a PBE was 15.6 per 100. More than 7000 kindergartners in California attend schools with PBE rates greater than 20 per 100, including 2700 kindergartners with PBEs. Exposure measures vary considerably across counties. Conclusions. Our results suggest increasing levels of exposure among kindergarten students in California to other kindergartners with PBEs. Our data provide a concrete set of metrics through which public health and education officials can identify high-risk areas as targets for policy and programmatic interventions. PMID:22698009

  14. 42 CFR 137.72 - Are Self-Governance Tribes and their employees carrying out statutorily mandated grant programs...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... published at 25 CFR Part 900, Subpart M. ... carrying out statutorily mandated grant programs added to a funding agreement covered by the Federal Tort... mandated grant programs added to a funding agreement covered by the Federal Tort Claims Act (FTCA)?...

  15. 42 CFR 137.72 - Are Self-Governance Tribes and their employees carrying out statutorily mandated grant programs...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... published at 25 CFR Part 900, Subpart M. ... carrying out statutorily mandated grant programs added to a funding agreement covered by the Federal Tort... mandated grant programs added to a funding agreement covered by the Federal Tort Claims Act (FTCA)?...

  16. Exploring the psychological underpinnings of the moral mandate effect: motivated reasoning, group differentiation, or anger?

    PubMed

    Mullen, Elizabeth; Skitka, Linda J

    2006-04-01

    When people have strong moral convictions about outcomes, their judgments of both outcome and procedural fairness become driven more by whether outcomes support or oppose their moral mandates than by whether procedures are proper or improper (the moral mandate effect). Two studies tested 3 explanations for the moral mandate effect. In particular, people with moral mandates may (a) have a greater motivation to seek out procedural flaws when outcomes fail to support their moral point of view (the motivated reasoning hypothesis), (b) be influenced by in-group distributive biases as a result of identifying with parties that share rather than oppose their moral point of view (the group differentiation hypothesis), or (c) react with anger when outcomes are inconsistent with their moral point of view, which, in turn, colors perceptions of both outcomes and procedures (the anger hypothesis). Results support the anger hypothesis.

  17. Suicide and organ donors: spillover effects of mental health insurance mandates.

    PubMed

    Fernandez, Jose; Lang, Matthew

    2015-04-01

    This paper considers the effect of mental health insurance mandates on the supply of cadaveric donors. We find that enacting a mental health mandate decreases the count of organ donors from suicides and results are driven by female donors. Using a number of empirical specifications, we calculate that the mental health parity laws are responsible for an approximately 0.52% decrease in cadaveric donors. Additional regression results show that the mandates are not related to other types of organ donations, ruling out the possibility that the mandates are related to an overall trend in the supply of organ donations. The findings suggest that future policies aimed at reducing suicide in a large and significant way can potentially increase the inefficiency that currently exists in the organ donor market.

  18. 42 CFR 137.70 - Are the reporting requirements different for a statutorily mandated grant program added to a...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... statutorily mandated grant program added to a funding agreement? 137.70 Section 137.70 Public Health PUBLIC... requirements different for a statutorily mandated grant program added to a funding agreement? Yes, the reporting requirements for a statutorily mandated grant program added to a funding agreement are subject...

  19. 42 CFR 137.69 - May a statutorily mandated grant program added to a funding agreement be redesigned?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false May a statutorily mandated grant program added to a...-GOVERNANCE Statutorily Mandated Grants § 137.69 May a statutorily mandated grant program added to a funding... terms and conditions of the grant award, a program added to a funding agreement under a...

  20. 42 CFR 137.68 - May funds from a statutorily mandated grant added to a funding agreement be reallocated?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May funds from a statutorily mandated grant added to a funding agreement be reallocated? 137.68 Section 137.68 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.68 May funds from a statutorily mandated grant...

  1. 42 CFR 137.68 - May funds from a statutorily mandated grant added to a funding agreement be reallocated?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false May funds from a statutorily mandated grant added to a funding agreement be reallocated? 137.68 Section 137.68 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.68 May funds from a statutorily mandated grant...

  2. 42 CFR 137.70 - Are the reporting requirements different for a statutorily mandated grant program added to a...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... statutorily mandated grant program added to a funding agreement? 137.70 Section 137.70 Public Health PUBLIC... requirements different for a statutorily mandated grant program added to a funding agreement? Yes, the reporting requirements for a statutorily mandated grant program added to a funding agreement are subject...

  3. 42 CFR 137.69 - May a statutorily mandated grant program added to a funding agreement be redesigned?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May a statutorily mandated grant program added to a...-GOVERNANCE Statutorily Mandated Grants § 137.69 May a statutorily mandated grant program added to a funding... terms and conditions of the grant award, a program added to a funding agreement under a...

  4. An experiment with regulated competition and individual mandates for universal health care: the new Dutch health insurance system.

    PubMed

    Rosenau, Pauline Vaillancourt; Lako, Christiaan J

    2008-12-01

    The 2006 Enthoven-inspired Dutch health insurance reform, based on regulated competition with a mandate for individuals to purchase insurance, will interest U.S. policy makers who seek universal coverage. This ongoing experiment includes guaranteed issue, price competition for a standardized basic benefits package, community rating, sliding-scale income-based subsidies for patients, and risk equalization for insurers. Our assessment of the first two years is based on Dutch Central Bank statistics, national opinion polls, consumer surveys, and qualitative interviews with policy makers. The first lesson for the United States is that the new Dutch health insurance model may not control costs. To date, consumer premiums are increasing, and insurance companies report large losses on the basic policies. Second, regulated competition is unlikely to make voters/citizens happy; public satisfaction is not high, and perceived quality is down. Third, consumers may not behave as economic models predict, remaining responsive to price incentives. Finally, policy makers should not underestimate the opposition from health care providers who define their profession as more than simply a job. If regulated competition with individual mandates performs poorly in auspicious circumstances such as the Netherlands, how will this model fare in the United States, where access, quality, and cost challenges are even greater? Might the assumptions of economic theory not apply in the health sector?

  5. Civil rights for people with disabilities: obstacles related to the least restrictive environment mandate.

    PubMed

    Palley, Elizabeth

    2009-01-01

    State and other social service agencies as well as service providers are governed by laws that often provide unclear guidance regarding the rights of people with disabilities. Although some standards can be, and have been, developed to protect the rights of people with disabilities, all people with disabilities are not the same and therefore, each can require very different types of accommodations. Some aspects of disability rights must be individually based, including the requirement that people with disabilities receive educational services in the least restrictive environment and care in the most inclusive setting. The current interpretation of these mandates suggests that agency decisions rely on professional judgments. Unless professionals work with their clients, this reliance can serve to disempower those whom the law was intended to protect. Though much debated, the legal definition of a person with a disability is unclear. This article examines the concept of disability and that of the least restrictive environment as well as that of the "most inclusive setting," explains to whom they apply, discusses how they have been defined both in statutes and case law, and elaborates on the role of social workers as a result of the law's reliance on professional judgment in ascertaining client rights. PMID:19235002

  6. Civil rights for people with disabilities: obstacles related to the least restrictive environment mandate.

    PubMed

    Palley, Elizabeth

    2009-01-01

    State and other social service agencies as well as service providers are governed by laws that often provide unclear guidance regarding the rights of people with disabilities. Although some standards can be, and have been, developed to protect the rights of people with disabilities, all people with disabilities are not the same and therefore, each can require very different types of accommodations. Some aspects of disability rights must be individually based, including the requirement that people with disabilities receive educational services in the least restrictive environment and care in the most inclusive setting. The current interpretation of these mandates suggests that agency decisions rely on professional judgments. Unless professionals work with their clients, this reliance can serve to disempower those whom the law was intended to protect. Though much debated, the legal definition of a person with a disability is unclear. This article examines the concept of disability and that of the least restrictive environment as well as that of the "most inclusive setting," explains to whom they apply, discusses how they have been defined both in statutes and case law, and elaborates on the role of social workers as a result of the law's reliance on professional judgment in ascertaining client rights.

  7. Understanding modern energy policy: An evaluation of RPS mandates and behavioral nudges

    NASA Astrophysics Data System (ADS)

    Brannan, Deborah Lynn Baker

    Climate change has emerged as one of the leading policy issues of the early 21st century. In response, a variety of policies and programs have been adopted encouraging renewable energy, energy efficiency and energy conservation. My dissertation consists of three research papers which evaluate two classes of modern energy policy in the United States: renewable energy mandates and behavioral nudges. The Renewable Portfolio Standard (RPS) is the most prominent state-level renewable energy policy in the United States and has been debated several times at the federal level. Using a fixed-effects panel data model I study the existing experience of the RPS to help inform the policy debate. In contrast with the previous literature that has predominantly studied the average effect of the RPS on renewable capacity investments I explore factors resulting in the heterogeneous effect of the RPS policy. Relying on a basic understanding the electric utility industry and the electricity dispatch process I provide insight into existing experience with the RPS. Spurred by political and economic barriers to adopting renewable energy policy, interest has increased in using motivational techniques informed by behavioral science to encourage reductions in energy consumption. Existing research has predominantly addressed residential energy consumption. The remainder of my dissertation applies well-established motivational techniques to the transportation sector. Using an experimental design, I test whether real-time feedback and social norms can encourage fuel efficient driving behavior. I find that real-time feedback has a large impact on fuel economy, particularly when aggregated across the entire vehicle fleet. I also find some evidence suggesting that social norms can encourage eco-driving, but perhaps more importantly, identify key challenges associated with using social norms in a transportation setting.

  8. Collaboration a Make-or-Break Mandate for NCLB Waivers

    ERIC Educational Resources Information Center

    McNeil, Michele

    2011-01-01

    States that want newly offered relief from certain provisions of the No Child Left Behind Act are scrambling to satisfy an easily overlooked requirement that they "meaningfully" engage with teachers, unions, parents, and community organizations, and even modify their waiver proposals based on that input. Federal education officials warn that…

  9. 38 CFR 17.106 - VA collection rules; third-party payers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Social Security Act (42 U.S.C. 1395, et seq.) and 42 CFR part 403, subpart B. No-fault insurance means an... calculated using the applicable method for such charges established by VA in 38 CFR 17.101. (2) If the third... United States under 31 U.S.C. 3701, et seq., 4 CFR parts 101 through 104, 28 CFR part 11, 31 CFR part...

  10. 38 CFR 17.106 - VA collection rules; third-party payers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Social Security Act (42 U.S.C. 1395, et seq.) and 42 CFR part 403, subpart B. No-fault insurance means an... calculated using the applicable method for such charges established by VA in 38 CFR 17.101. (2) If the third... United States under 31 U.S.C. 3701, et seq., 4 CFR parts 101 through 104, 28 CFR part 11, 31 CFR part...

  11. 38 CFR 17.106 - VA collection rules; third-party payers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Social Security Act (42 U.S.C. 1395, et seq.) and 42 CFR part 403, subpart B. No-fault insurance means an... calculated using the applicable method for such charges established by VA in 38 CFR 17.101. (2) If the third... United States under 31 U.S.C. 3701, et seq., 4 CFR parts 101 through 104, 28 CFR part 11, 31 CFR part...

  12. Budgetary impact of treating acute promyelocytic leukemia patients with first-line arsenic trioxide and retinoic acid from an Italian payer perspective.

    PubMed

    Kruse, Morgan; Wildner, Rebecca; Barnes, Gisoo; Martin, Monique; Mueller, Udo; Lo-Coco, Francesco; Pathak, Ashutosh

    2015-01-01

    The objective of this study was to estimate the net cost of arsenic trioxide (ATO) added to all-trans retinoic acid (ATRA) compared to ATRA plus chemotherapy when used in first-line acute promyelocytic leukemia (APL) treatment for low to intermediate risk patients from the perspective of the overall Italian healthcare systemA Markov model was developed with 3 health states: stable disease, disease event and death. Each month, patients could move from stable to disease event or die from either state. After a disease event, patients discontinued initial treatment and switched to the other regimen as second-line therapy. Treatment regimens, efficacy and adverse events were derived from published sources and expert opinion; unit costs were collected from standard Italian sources. Clinical outcomes and costs for pre-ATO and post-ATO scenarios were combined with population and product utilization information to calculate the total budgetary impact using a 3-year time horizon; one-way sensitivity analyses were conducted. Three-year cumulative pharmacy costs for ATO+ATRA were €46,700 per-patient versus €6,500 for ATRA+chemotherapy; however, medical costs for ATO+ATRA were €12,300 per-patient versus €30,200 for ATRA+chemotherapy. The total budgetary impact was estimated to be an additional €127,300, €312,500 and €477,800 in the first, second and third years, respectively. The model was most sensitive to changes in the cost of the ATO+ATRA regimen during the consolidation phase. Budgetary impact models are valuable to payers making formulary decisions regarding the access and affordability of new medicines. The cost of treatment analysis showed that pharmacy costs for ATO+ATRA were higher than for ATRA+chemotherapy, while all other evaluated costs were lower for ATO+ATRA treated patients. The average budgetary impact was €305,900 per year overall, representing a 3.5% increase. Further research is needed to determine the cost-effectiveness of ATO+ATRA compared

  13. The impact of payer-specific hospital case mix on hospital costs and revenues for third-party patients.

    PubMed

    Lee, Keon-Hyung; Roh, M P H Chul-Young

    2007-02-01

    Competition among hospitals and managed care have forced hospital industry to be more efficient. With higher degrees of hospital competition and managed care penetration, hospitals have argued that the rate of increase in hospital cost is greater than the rate of increase in hospital revenue. By developing a payer-specific case mix index (CMI) for third-party patients, this paper examined the effect of hospital case mix on hospital cost and revenue for third-party patients in California using the hospital financial and utilization data covering 1986-1998. This study found that the coefficients for CMIs in the third-party hospital revenue model were greater than those in the hospital cost model until 1995. Since 1995, however, the coefficients for CMIs in the third-party hospital revenue model have been less than those in hospital cost models. Over time, the differences in coefficients for CMIs in hospital revenue and cost models for third-party patients have become smaller and smaller although those differences are statistically insignificant.

  14. Success under duress: policies and practices managers view as keys to profitability in five California hospitals with challenging payer mix.

    PubMed

    Rundall, Thomas; Oberlin, Shelley; Thygesen, Brian; Janus, Katharina

    2012-01-01

    Hospitals with a challenging payer mix (CPM)-high proportions of uninsured and Medicaid patients and a low proportion of commercially insured patients-are an important source of care for low-income, uninsured people. Achieving profitability is difficult for CPM hospitals. From 2005 through 2008, only one-third of 67 CPM hospitals in California reported positive total margins. In-depth group interviews were completed with the management leadership teams of a diverse group of five profitable CPM hospitals to identify the management strategies and practices that the hospitals' leadership teams credited for their financial success. Twelve management policy and practice topics were identified. Four of the policies and practices that managers identified involve organizational actions to increase hospital revenue or operational efficiency. These factors are consistent with those identified in previous research. However, managers also identified eight factors not previously revealed in research on hospital profitability, including management policies and practices that establish the organizational culture, workforce, relationships, monitoring systems, and governance necessary to ensure that hospital employees and affiliated physicians support and successfully implement organizational actions necessary to achieve profitability.

  15. 17 CFR 232.101 - Mandated electronic submissions and exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....S.C. 78l(h)). Editorial Note: For Federal Register citations affecting § 232.101 see the List of CFR... (§ 259.5s of this chapter) or under rule 29 (§ 250.29 of this chapter); (13) Reports to State Commissions, if furnished by Public Utility Holding Companies under Exhibit E to Form U5S (§ 259.5s of...

  16. The Impact of Single-Payer Health Care on Physician Income in Canada, 1850–2005

    PubMed Central

    2011-01-01

    This study traces the average net income of Canadian physicians over 150 years to determine the impact of medicare. It also compares medical income in Canada to that in the United States. Sources include academic studies, government reports, Census data, taxation statistics, and surveys. The results show that Canadian doctors enjoyed a windfall in earnings during the early years of medicare and that, after a period of adjustment, medicare enhanced physician income. Except during the windfall boom, Canadian physicians have earned less than their American counterparts. Until at least 2005, however, the medical profession was the top-earning trade in Canada relative to all other professions. PMID:21566029

  17. The impact of single-payer health care on physician income in Canada, 1850-2005.

    PubMed

    Duffin, Jacalyn

    2011-07-01

    This study traces the average net income of Canadian physicians over 150 years to determine the impact of medicare. It also compares medical income in Canada to that in the United States. Sources include academic studies, government reports, Census data, taxation statistics, and surveys. The results show that Canadian doctors enjoyed a windfall in earnings during the early years of medicare and that, after a period of adjustment, medicare enhanced physician income. Except during the windfall boom, Canadian physicians have earned less than their American counterparts. Until at least 2005, however, the medical profession was the top-earning trade in Canada relative to all other professions.

  18. Melding regulatory, pharmaceutical industry, and U.S. payer perspectives on improving approaches to heterogeneity of treatment effect in research and practice.

    PubMed

    Willke, Richard J; Crown, William; Del Aguila, Michael; Cziraky, Mark J; Khan, Zeba M; Migliori, Richard

    2013-01-01

    Effective pursuit of the science and management of heterogeneity of treatment effect (HTE) relies on the mutual understanding of the perspectives of, and collaboration among, the various stakeholders in health care. In this article, we compare, contrast, and endeavor to find areas of alignment across the perspectives of three such stakeholders -regulators, the biopharmaceutical and device industry, and U.S. payers. First, we discuss how evidence of HTE is generated and could be improved upon. For pharmaceuticals, much of the initial research is conducted by the pharmaceutical industry, guided by basic science but also delimited by potential markets, regulatory approval requirements, trial size considerations, and payer expectations for evidence of value. Once a drug is marketed, further evidence can be generated via combining trial data, conducting meta-analysis, and analyzing real-world results through observational research designs; we explore how these efforts can benefit from cooperation across these stakeholders. Second, we discuss the equally important utilization of HTE evidence so that physicians and patients have access to and can benefit from the learnings from this research. Research findings must be translated into actionable information and guidelines that can be incorporated into everyday practice. Doing so requires interaction and collaboration among all involved, based on facilitated communication as well as further evaluation research. We provide examples of several cross-sectorial initiatives that are under way in this area. Finally, we explore some economic aspects of HTE research as part of the drug development, marketing, and treatment process. Understanding the economic incentives present is fundamental to aligning those incentives to improve the availability and utilization of HTE evidence. Clear understandings among regulators, pharma, and payers about high-value targets, methods to efficiently generate and communicate information, and value

  19. Melding regulatory, pharmaceutical industry, and U.S. payer perspectives on improving approaches to heterogeneity of treatment effect in research and practice.

    PubMed

    Willke, Richard J; Crown, William; Del Aguila, Michael; Cziraky, Mark J; Khan, Zeba M; Migliori, Richard

    2013-01-01

    Effective pursuit of the science and management of heterogeneity of treatment effect (HTE) relies on the mutual understanding of the perspectives of, and collaboration among, the various stakeholders in health care. In this article, we compare, contrast, and endeavor to find areas of alignment across the perspectives of three such stakeholders -regulators, the biopharmaceutical and device industry, and U.S. payers. First, we discuss how evidence of HTE is generated and could be improved upon. For pharmaceuticals, much of the initial research is conducted by the pharmaceutical industry, guided by basic science but also delimited by potential markets, regulatory approval requirements, trial size considerations, and payer expectations for evidence of value. Once a drug is marketed, further evidence can be generated via combining trial data, conducting meta-analysis, and analyzing real-world results through observational research designs; we explore how these efforts can benefit from cooperation across these stakeholders. Second, we discuss the equally important utilization of HTE evidence so that physicians and patients have access to and can benefit from the learnings from this research. Research findings must be translated into actionable information and guidelines that can be incorporated into everyday practice. Doing so requires interaction and collaboration among all involved, based on facilitated communication as well as further evaluation research. We provide examples of several cross-sectorial initiatives that are under way in this area. Finally, we explore some economic aspects of HTE research as part of the drug development, marketing, and treatment process. Understanding the economic incentives present is fundamental to aligning those incentives to improve the availability and utilization of HTE evidence. Clear understandings among regulators, pharma, and payers about high-value targets, methods to efficiently generate and communicate information, and value

  20. A proposed ethical framework for vaccine mandates: competing values and the case of HPV.

    PubMed

    Field, Robert I; Caplan, Arthur L

    2008-06-01

    Debates over vaccine mandates raise intense emotions, as reflected in the current controversy over whether to mandate the vaccine against human papilloma virus (HPV), the virus that can cause cervical cancer. Public health ethics so far has failed to facilitate meaningful dialogue between the opposing sides. When stripped of its emotional charge, the debate can be framed as a contest between competing ethical values. This framework can be conceptualized graphically as a conflict between autonomy on the one hand, which militates against government intrusion, and beneficence, utilitarianism, justice, and nonmaleficence on the other, which may lend support to intervention. When applied to the HPV vaccine, this framework would support a mandate based on utilitarianism, if certain conditions are met and if herd immunity is a realistic objective.

  1. Fuel-saving mandate drives a hard bargain for Detroit

    SciTech Connect

    Simpson, G.

    1988-09-19

    This article discusses the pros and cons of deregulation of the corporate average fuel efficiency (CAFE) program, which was developed in the 1970s as a solution to the problems of fuel shortages and rising fuel costs. The CAFE program is administered by the DOT and National Highway Traffic Safety Administration. Detroit automakers state that the CAFE program forces the decline of larger, safer cars in lieu of smaller more fuel efficient models, therefore eliminating jobs for Americans as the smaller cars are foreign-made. The automakers and several Washington lobbies want a relaxation or even elimination of these regulations as it will increase jobs in America, increase safety, and encourage competition in the larger car markets, as the regulations drive the cost to produce larger cars up. The opponents to the easing of standards want the regulations doubled as it will lead to savings to the consumer for reduced gasoline consumption, decreased reliance on petroleum imports, environmental protection, and more jobs. The DOT is holding hearing on its latest proposal to ease efficiency standards for 1989-1990, and bills to repeal the law are pending in Congress.

  2. Does Mandating Nursing Home Participation In Quality Reporting Make A Difference? Evidence from Massachusetts

    PubMed Central

    Mukamel, Dana B.; Ye, Zhiqiu; Glance, Laurent G.; Li, Yue

    2015-01-01

    Background Quality report cards have been shown to be effective in influencing patients' referrals and promoting quality improvement in some instances and not others. In this study we investigate one of the mechanisms that may detract from their effectiveness: voluntary versus mandatory participation of nursing homes in public quality reporting. Objectives To answer two questions: 1) Were the nursing homes choosing not to participate low quality performers relative to those who chose to participate? 2) Once participation became mandatory, did those that did not voluntarily participate initially, improve more than those that participated voluntarily? Research Design Massachusetts published the Massachusetts Satisfaction Survey report card for nursing homes for the years 2005, 2007, and 2009. Nursing homes' participation was voluntary in 2005 and mandatory in 2007 and 2009. We performed a retrospective statistical analysis of the relationship between nursing homes' decision to participate in quality reporting and 12 quality outcomes: deficiency citations, staffing, and 8 survey domains. Subjects 424 Massachusetts nursing homes. Results 67% of nursing homes participated in reporting voluntarily. Volunteer nursing homes had better quality for all measures (significant at the 0.05 level or trending towards significance at the 0.10 level for all but 2). Once reporting became mandatory, non-volunteers improved more than volunteers in all but 2 staffing measures (trending towards significance at the 0.10 level in 5). Conclusions Report cards are more effective if nursing homes' participation is mandated. Non-mandatory reporting systems, as those implemented by some states and professional associations, lead to missed opportunities for quality improvements. PMID:26125418

  3. Potential impact of legislation mandating breast density notification: benefits, harms, and cost effectiveness of supplemental ultrasound screening

    PubMed Central

    Sprague, Brian L.; Stout, Natasha K.; Schechter, Clyde; van Ravesteyn, Nicolien T.; Cevik, Mucahit; Alagoz, Oguzhan; Lee, Christoph I.; van den Broek, Jeroen J.; Miglioretti, Diana L.; Mandelblatt, Jeanne S.; de Koning, Harry J.; Kerlikowske, Karla; Lehman, Constance D.; Tosteson, Anna N. A.

    2014-01-01

    Background At least nineteen states have laws that require telling women with dense breasts and a negative screening mammogram to consider supplemental screening. The most readily available supplemental screening modality is ultrasound, yet little is known about its effectiveness. Objective To evaluate the benefits, harms, and cost-effectiveness of supplemental ultrasound screening for women with dense breasts. Design Comparative modeling with 3 validated simulation models. Data Sources Surveillance, Epidemiology, and End Results Program; Breast Cancer Surveillance Consortium; the medical literature. Target Population A contemporary cohort of women eligible for routine screening. Time Horizon Lifetime. Perspective Payer. Interventions Supplemental ultrasound screening for women with dense breasts following a negative screening mammogram. Outcome Measures Breast cancer deaths averted, quality-adjusted life years (QALYs) gained, false positive ultrasound biopsy recommendations, costs, costs per QALY gained. Results of Base-Case Analysis Supplemental ultrasound screening after a negative mammogram for women aged 50–74 with heterogeneously or extremely dense breasts averted 0.36 additional breast cancer deaths (range across models: 0.14–0.75), gained 1.7 QALYs (0.9–4.7), and resulted in 354 false-positive ultrasound biopsy recommendations (345–421) per 1000 women with dense breasts compared with biennial screening by mammography alone. The cost-effectiveness ratio was $325,000 per QALY gained ($112,000-$766,000). Restricting supplemental ultrasound screening to women with extremely dense breasts cost $246,000 per QALY gained ($74,000-$535,000). Results of Sensitivity Analysis The conclusions were not sensitive to ultrasound performance characteristics, screening frequency, or starting age. Limitations Provider costs for coordinating supplemental ultrasound were not considered. Conclusions Supplemental ultrasound screening for women with dense breasts undergoing

  4. State-Mandated Accountability in High Schools: Teachers' Interpretations of a New Era

    ERIC Educational Resources Information Center

    Louis, Karen Seashore; Febey, Karen; Schroeder, Roger

    2005-01-01

    This article addresses conflicting statements about the impact of accountability policies in which some argue that testing undermines good teaching, while others claim that it stimulates improvement. The authors begin with the assumption that it is important to explore implementers' cognitive perspectives in order to understand a policy's effects.…

  5. Block Scheduling Effects on a State Mandated Test of Basic Skills.

    ERIC Educational Resources Information Center

    Veal, William R.; Schreiber, James

    1999-01-01

    Examined the effects of a tri-schedule (traditional, 4x4 block, and hybrid) schedules running at the same time on the academic achievement of 327 high school students. Discusses implications of findings for schools considering block scheduling. (SLD)

  6. Understanding Local Instructional Responses to Federal and State Accountability Mandates: A Typology of Extended Learning Time

    ERIC Educational Resources Information Center

    Midkiff, Brooke; Cohen-Vogel, Lora

    2015-01-01

    For the past dozen years, the federal government has held schools accountable for students' achievement in reading and mathematics. Schools that have not demonstrated improved student scores have faced heavy sanctions, including reconstitution and closure. In response to this high-stakes environment, schools appear to have extended the time…

  7. Prediction of State Mandated Assessment Mathematics Scores from Computer Based Mathematics and Reading Preview Assessments

    ERIC Educational Resources Information Center

    Costa-Guerra, Boris

    2012-01-01

    The study sought to understand whether MAPs computer based assessment of math and language skills using MAPs reading scores can predict student scores on the NMSBA. A key question was whether or not the prediction can be improved by including student language skill scores. The study explored the effectiveness of computer based preview assessments…

  8. Do Fourteenth Amendment Considerations Outweigh a Potential State Interest in Mandating Cochlear Implantation for Deaf Children?

    ERIC Educational Resources Information Center

    Bender, Denise G.

    2004-01-01

    Currently, the decision concerning pediatric cochlear implantation for children remains a personal choice for parents to make. Economic factors, educational outcomes, and societal attitudes concerning deafness could result in an increased governmental interest in this choice. This article examines case law related to the issue of parental autonomy…

  9. A Nationwide Survey of State-Mandated Evaluation Practices for Domestic Violence Agencies

    ERIC Educational Resources Information Center

    Riger, Stephanie; Staggs, Susan L.

    2011-01-01

    Many agencies serving survivors of domestic violence are required to evaluate their services. Three possible evaluation strategies include: a) process measurement, which typically involves a frequency count of agency activities, such as the number of counseling hours given; b) outcome evaluation, which measures the impact of agency activities on…

  10. The Games Concept Approach (GCA) as a Mandated Practice: Views of Singaporean Teachers

    ERIC Educational Resources Information Center

    Rossi, Tony; Fry, Joan M.; McNeill, Mike; Tan, Clara W. K.

    2007-01-01

    This paper reports on the views of Singaporean teachers of a mandated curriculum innovation aimed at changing the nature of games pedagogy within the physical education curriculum framework in Singapore. Since its first appearance over 20 years ago, Teaching Games for Understanding (TGfU), as an approach to games pedagogy has gathered support…

  11. Working within the System: Teachers of English Learners Negotiating a Literacy Instruction Mandate

    ERIC Educational Resources Information Center

    Pease-Alvarez, Lucinda; Samway, Katharine Davies; Cifka-Herrera, Carrie

    2010-01-01

    In an effort to reverse the reading crisis purported to plague public education, schools and districts are mandating prescriptive reading programs and teacher-centered instructional practices in hopes of improving the academic achievement of minority students, including English learners (ELs). The wide-spread implementation of these programs in…

  12. Mandated Literacy Assessment and the Reorganisation of Teachers' Work: Federal Policy, Local Effects

    ERIC Educational Resources Information Center

    Comber, Barbara

    2012-01-01

    This paper explores how mandated literacy assessment is reorganising teachers' work in the context of Australia's National Assessment Program--Literacy and Numeracy, which was implemented in 2008. Students in Years 3, 5, 7 and 9 are tested annually, with school results publicly available. The wider policy context and the emergence of different…

  13. More than "An Apple a Day": New Mandates for School Wellness

    ERIC Educational Resources Information Center

    Woods, Amelia Mays; Weasmer, Jerie

    2006-01-01

    In this article, the authors discuss how, due to the increasing problems of obesity and sedentary lifestyles among children, schools have been mandated to instruct students on the importance of good nutritional habits and daily physical activity. Approaches to stimulating faculty to integrate wellness concepts and activities into curricula depend…

  14. The Usefulness of Accreditation-Mandated Outcomes Assessment in College Foreign Language Education

    ERIC Educational Resources Information Center

    Davis, John McE.

    2012-01-01

    This dissertation investigated the extent to which accreditation-mandated assessment capacity contributes to assessment use in tertiary foreign language (FL) programs. Four research questions were posed to pursue this concern: What is the nature and extent of assessment capacity in college FL programs? Which assessment uses are occurring in…

  15. New Mandates and Imperatives in the Revised "ACA Code of Ethics"

    ERIC Educational Resources Information Center

    Kaplan, David M.; Kocet, Michael M.; Cottone, R. Rocco; Glosoff, Harriet L.; Miranti, Judith G.; Moll, E. Christine; Bloom, John W.; Bringaze, Tammy B.; Herlihy, Barbara; Lee, Courtland C.; Tarvydas, Vilia M.

    2009-01-01

    The first major revision of the "ACA Code of Ethics" in a decade occurred in late 2005, with the updated edition containing important new mandates and imperatives. This article provides interviews with members of the Ethics Revision Task Force that flesh out seminal changes in the revised "ACA Code of Ethics" in the areas of confidentiality,…

  16. Challenges to the Integrity of Science: The Federal Mandate and Issues for Institutions.

    ERIC Educational Resources Information Center

    Hansen, Barbara C.; Hansen, Kenneth D.

    1989-01-01

    A discussion of scientific fraud and research misconduct looks at the federal mandate for more effective control by institutions and sponsoring agencies, the response of higher education associations, and issues awaiting consensus development, including anonymous reports, protection of the "whistle-blower," legal representation, and the nature of…

  17. The Impact of a Universal Class-Size Reduction Policy: Evidence from Florida's Statewide Mandate

    ERIC Educational Resources Information Center

    Chingos, Matthew M.

    2012-01-01

    Class-size reduction (CSR) mandates presuppose that resources provided to reduce class size will have a larger impact on student outcomes than resources that districts can spend as they see fit. I estimate the impact of Florida's statewide CSR policy by comparing the deviations from prior achievement trends in districts that were required to…

  18. Federal Policy Mandating Safer Cigarettes: A Hypothetical Simulation of the Anticipated Population Health Gains or Losses

    ERIC Educational Resources Information Center

    Tengs, Tammy O.; Ahmad, Sajjad; Moore, Rebecca; Gage, Eric

    2004-01-01

    If manufacturing a safer cigarette is technically possible--an open question--then mandating that tobacco manufacturers improve the safety of cigarettes would likely have both positive and negative implications for the nation's health. On the one hand, removing toxins may reduce the incidence of smoking-related diseases and premature mortality in…

  19. Changes in Intimate Partner Violence among Women Mandated to Community Services

    ERIC Educational Resources Information Center

    Macy, Rebecca J.; Rizo, Cynthia F.; Guo, Shenyang; Ermentrout, Dania M.

    2013-01-01

    Increasingly, female victims of intimate partner violence (IPV) are charged with IPV perpetration and mandated by courts or child protective services to receive domestic violence services. A critical need exists for evidence-based interventions targeting the needs of this unique population, but such research is scarce. To address this gap, we…

  20. Tomorrow's Family Reforms: Marriage Course, Marriage Test, Incorporated Families, and Sex Selection Mandate.

    ERIC Educational Resources Information Center

    Shostak, Arthur B.

    1981-01-01

    Discusses specific new laws and programs to strengthen family life suggested in the (N=34) detailed reforms proposed and endorsed by the 1980 White House Conference on Families. Explores four reform possibilities including high school marriage preparation classes, a mandated marriage readiness test, family incorporation, and support for prenatal…

  1. "You Can't Mandate What Matters": Bumping Visions against Practices

    ERIC Educational Resources Information Center

    Merz, Alice H.; Swim, Terri Jo

    2011-01-01

    In this study, an American public school principal's vision of promoting growth in her teachers and students was inspired by the Reggio Emilia approach. Unlike other educational approaches, this approach did not involve a product, i.e., "to become Reggio", and it did not involve a set of rules or mandates. Instead, the principal had her teachers…

  2. What "Hard Times" Means: Mandated Curricula, Class-Privileged Assumptions, and the Lives of Poor Children

    ERIC Educational Resources Information Center

    Dutro, Elizabeth

    2010-01-01

    In this article, I present a qualitative analysis of third graders' experiences with a unit from their district-mandated commercial reading curriculum in which the children made strong connections between a fictional account of a Depression-era farm family's economic hardships and their own 21st century lives in a city with one of the highest…

  3. 24 CFR 5.233 - Mandated use of HUD's Enterprise Income Verification (EIV) System.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... assistance under the: (i) Public Housing program under 24 CFR part 960; (ii) Section 8 Housing Choice Voucher... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Mandated use of HUD's Enterprise Income Verification (EIV) System. 5.233 Section 5.233 Housing and Urban Development Office of...

  4. Educational Alliance: The Importance of Relationships in Adult Education with Court-Mandated Students

    ERIC Educational Resources Information Center

    Mottern, Ron

    2012-01-01

    This conceptual study examines the importance of relationships between teachers and students in court-mandated adult education settings. Although research has been done on the importance of relationships between teachers and incarcerated students, there have been no outstanding studies on the relationships developed between teachers and students…

  5. Prospects: The Congressionally Mandated Study of Educational Growth and Opportunity. The Interim Report.

    ERIC Educational Resources Information Center

    Puma, Michael J.; And Others

    This publication is the first interim report from the Congressionally Mandated Study of Educational Growth and Opportunity (Prospects), and describes students' characteristics and the schools they attend. Prospects is designed to evaluate the short- and long-term consequences of Chapter 1 program participation by following for 5 years large…

  6. A College Administrator's Framework to Assess Compliance with Accreditation Mandates

    ERIC Educational Resources Information Center

    Davis†, Jerry M.; Rivera, John-Juan

    2014-01-01

    A framework to assess the impact of complying with college accreditation mandates is developed based on North's (1996) concepts of transaction costs, property rights, and institutions; Clayton's (1999) Systems Alignment Model; and the educational production function described by Hanushek (2007). The framework demonstrates how sought…

  7. Federal Rule Yields Hope for Science: Testing Mandate Is Expected to Increase Time for Subject

    ERIC Educational Resources Information Center

    Cavanagh, Sean

    2007-01-01

    Some proponents of science education say they have faced no greater foe over the past few years than federally mandated tests in reading and mathematics, which have forced teachers to devote increasingly bigger chunks of class time to building students' skills in those two subjects. But if testing has squeezed science out, can testing also bring…

  8. Addressing Alcohol Use and Problems in Mandated College Students: A Randomized Clinical Trial Using Stepped Care

    ERIC Educational Resources Information Center

    Borsari, Brian; Hustad, John T. P.; Mastroleo, Nadine R.; Tevyaw, Tracy O'Leary; Barnett, Nancy P.; Kahler, Christopher W.; Short, Erica Eaton; Monti, Peter M.

    2012-01-01

    Objective: Over the past 2 decades, colleges and universities have seen a large increase in the number of students referred to the administration for alcohol policies violations. However, a substantial portion of mandated students may not require extensive treatment. Stepped care may maximize treatment efficiency and greatly reduce the demands on…

  9. Bring Me Men and Women. Mandated Change at the U.S. Air Force Academy.

    ERIC Educational Resources Information Center

    Stiehm, Judith Hicks

    The planning and problems associated with the 1975 Congressional mandate calling for the integration of women into the U.S. Air Force Academy are described. The book examines how Air Force planners made decisions and whether their decisions were effective. Beliefs that were previously held inviolable--that upper body strength is important, that…

  10. South African Educators' Mutually Inclusive Mandates to Promote Human Rights and Positive Discipline

    ERIC Educational Resources Information Center

    Coetzee, Susan; Mienie, Cathrine

    2013-01-01

    South African educators are mandated by international and national law to observe and promote human rights. However, given the realities of the limited teaching time available, educators cannot fulfill this obligation solely by teaching the curriculum. Another avenue needs to be found for educators to fulfill this obligation. Educators are also…

  11. Health behaviors of mandated and voluntary students in a motivational intervention program☆

    PubMed Central

    Kazemi, Donna M.; Levine, Maureen J.; Dmochowski, Jacek; Roger Van Horn, K.; Qi, Li

    2015-01-01

    College students engage in many unhealthy behaviors, one of these, heavy alcohol use, is a major global public health problem. Objective This longitudinal study examined whether students' mandated/voluntary status in a program to reduce college drinking was associated with overall health, ethnicity, gender, and personality traits. Both mandated and voluntary groups participated in the Motivational Intervention (MI) program to prevent high risk drinking. Methods Freshmen (710 voluntary, 190 mandated, n = 900) between the ages of 18 and 21, received the MI at baseline and again at 2 weeks, with boosters at 3, 6 and 12 months. Participants completed three measures: the Daily Drinking Questionnaire (DDQ); the Substance Use Risk Profile Scale (SURPS), and the Health Promoting Lifestyle Profile II (HPLPII). Mandated and voluntary participants were compared at baseline and following the intervention using two sample t-tests for continuous variables (overall health, personality traits, drinking measures), and chi-square for categorical variables (gender, ethnicity). Linear mixed models were used to identify associations between HPLP II scores and mandated/voluntary status, time, ethnicity gender and SURPS scale scores. Results In both groups, alcohol consumption dropped significantly by 12 months. Overall health-promoting behaviors, physical activity, stress management, and interpersonal relations improved in both groups between baseline and 12 months. Associations were found between alcohol consumption, personality traits, gender, and lifestyle health-promoting behaviors. In particular, impulsivity and hopelessness were associated with poor health behaviors. Conclusions Intervention programs to reduce drinking by college students need to address developmental dynamics of freshmen students, including gender, psychosocial factors, personality, and lifestyle health-promoting behaviors. PMID:26844100

  12. Insights into Education's Race to the Top: Correlational Survey Exploring Perceptions of Organizational Culture and Change Ambivalence during the Implementation of a Mandated Performance Evaluation System in a Northeast U.S. School District

    ERIC Educational Resources Information Center

    Schwamb, Andrea B.

    2013-01-01

    American public schools are currently facing a new mandated evaluation system that will create substantial change by requiring districts to evaluate professional staff based on two quantified measures: (a) state testing, and (b) a district determined measure. Although reforms have been at the forefront of policymakers' agendas, these initiatives…

  13. 42 CFR 137.73 - What provisions of Title V apply to statutorily mandated grants added to the funding agreement?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What provisions of Title V apply to statutorily mandated grants added to the funding agreement? 137.73 Section 137.73 Public Health PUBLIC HEALTH SERVICE... mandated grants added to the funding agreement? None of the provisions of Title V apply....

  14. 42 CFR 137.73 - What provisions of Title V apply to statutorily mandated grants added to the funding agreement?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false What provisions of Title V apply to statutorily mandated grants added to the funding agreement? 137.73 Section 137.73 Public Health PUBLIC HEALTH SERVICE... mandated grants added to the funding agreement? None of the provisions of Title V apply....

  15. 42 CFR 137.66 - May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false May a Self-Governance Tribe keep interest earned on...-GOVERNANCE Statutorily Mandated Grants § 137.66 May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds? Yes, a Self-Governance Tribe may keep Interest Earned on...

  16. 42 CFR 137.66 - May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May a Self-Governance Tribe keep interest earned on...-GOVERNANCE Statutorily Mandated Grants § 137.66 May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds? Yes, a Self-Governance Tribe may keep Interest Earned on...

  17. 42 CFR 137.67 - How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds? 137.67 Section 137.67 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.67 How may a Self-Governance Tribe use...

  18. 42 CFR 137.66 - May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false May a Self-Governance Tribe keep interest earned on...-GOVERNANCE Statutorily Mandated Grants § 137.66 May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds? Yes, a Self-Governance Tribe may keep Interest Earned on...

  19. 42 CFR 137.66 - May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false May a Self-Governance Tribe keep interest earned on...-GOVERNANCE Statutorily Mandated Grants § 137.66 May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds? Yes, a Self-Governance Tribe may keep Interest Earned on...

  20. 42 CFR 137.67 - How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds? 137.67 Section 137.67 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.67 How may a Self-Governance Tribe use...

  1. 42 CFR 137.67 - How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds? 137.67 Section 137.67 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.67 How may a Self-Governance Tribe use...

  2. 42 CFR 137.67 - How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds? 137.67 Section 137.67 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.67 How may a Self-Governance Tribe use...

  3. 42 CFR 137.67 - How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds? 137.67 Section 137.67 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.67 How may a Self-Governance Tribe use...

  4. 42 CFR 137.66 - May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false May a Self-Governance Tribe keep interest earned on...-GOVERNANCE Statutorily Mandated Grants § 137.66 May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds? Yes, a Self-Governance Tribe may keep Interest Earned on...

  5. The individual mandate as healthcare regulation: what the Obama Administration should have said in NFIB v. Sebelius.

    PubMed

    Moncrieff, Abigail R

    2013-01-01

    There was an argument that the Obama Administration's lawyers could have made--but didn't--in defending Obamacare's individual mandate against constitutional attack. That argument would have highlighted the role of comprehensive health insurance in steering individuals' healthcare savings and consumption decisions. Because consumer-directed healthcare, which reaches its apex when individuals self-insure, suffers from several known market failures and because comprehensive health insurance policies play an unusually aggressive regulatory role in attempting to correct those failures, the individual mandate could be seen as an attempt to eliminate inefficiencies in the healthcare market that arise from individual decisions to self-insure. This argument would done a better job than the Obama Administration's of aligning the individual mandate with existing Commerce Clause and Necessary and Proper Clause precedent, and it would have done a better job of addressing the conservative Justices' primary concerns with upholding the mandate. This Article lays out this forgone defense of the individual mandate.

  6. Does the U.S. biofuels mandate increase the price at the pump?

    NASA Astrophysics Data System (ADS)

    Bolotin, Stephen R.

    The Renewable Fuel Standard (RFS) as amended by the Energy Independence and Security Act of 2007 created a federal mandate for blending conventional biofuels like corn-based ethanol and advanced biofuels like biodiesel and renewable gasoline into the United States transportation fuel supply. The RFS established yearly blending standards for the obligated parties--refiners and importers of petroleum products--that increase progressively until reaching a high of 36 billion gallons by 2022. Each ethanol-equivalent gallon of biofuel blended is assigned a unique Renewable Identification Number (RIN) through the Environmental Protection Agency's (EPA) Moderated Transaction System (EMTS). At year's close, obligated parties must submit their allotted RIN obligations to the EPA to demonstrate compliance. In the case of under-compliance or over-compliance, RINs can be traded between obligated parties freely through the EMTS or carried over for use in the next year. It follows, then, that a RIN carries a market value reflective of the cost of complying with RFS regulations. Indeed, most biofuels cost more than their fossil-based equivalents. When the price of a corn ethanol RIN went from 2-3 cents each in 2012 to nearly $1.50 in July of 2013 due to a perceived shortage in corn ethanol RINs, obligated parties faced the prospect of multimillion-dollar compliance cost increases. Arguing that RFS makes fuel significantly more expensive for consumers, petroleum companies have begun to advocate for the full repeal of the RFS, winning over some allies in Congress. The future of this program is uncertain. In an attempt to quantify the concerns of RFS critics, this thesis estimated the effect that RIN prices have on the wholesale cost of diesel fuel. Using daily price data from January 2011 through August of 2013 on RINs and crude oil, I specified twelve OLS regression models that predict the passthrough of the diesel RIN price to wholesale diesel price. My statistical analysis

  7. Randomized Controlled Trial of BASICS for Heavy Drinking Mandated and Volunteer Undergraduates: 12-Month Outcomes

    PubMed Central

    Terlecki, Meredith A.; Buckner, Julia D.; Larimer, Mary E.; Copeland, Amy L.

    2014-01-01

    This is the first randomized trial testing whether heavy drinking undergraduates mandated to the Brief Alcohol Screening and Intervention for College Students (BASICS) program following a campus alcohol violation would benefit as much as heavy drinking volunteers up to one year post-intervention using control groups with high-risk drinkers to model disciplinary-related and naturalistic changes in drinking. Participants (61% male; 51% mandated; 84% Caucasian; Mage = 20.14 years) were screened for heavy drinking and randomized to BASICS (n = 115) or assessment-only control (n = 110). Outcome measures (drinking, alcohol problems) were collected at baseline, 4 weeks, 3, 6, and 12 months post-intervention. At 4 weeks post-intervention, intent-to-treat multilevel longitudinal models showed that regardless of referral group (mandated or volunteer) BASICS significantly decreased weekly drinking, typical drinks, and peak drinks relative to controls (ds = .41-.92). BASICS had a large effect on decreases in alcohol problems (d = .87). At 12 months post-intervention, BASICS participants (regardless of referral group) reported significantly fewer alcohol problems (d = .56) compared to controls. Significant long-term intervention gains for peak and typical drinks were sustained in both referral groups relative to controls (ds = .42; .11). Referral group had no significant main effect and did not interact with intervention condition to predict outcomes. Given that BASICS was associated with less drinking and fewer alcohol problems (even among heavier drinking mandated students up to one year post-intervention), provision of BASICS-style programs within disciplinary settings may help reduce heavy and problematic drinking among at-risk students. PMID:25844834

  8. Network unites payers, physicians, hospitals. System participants work together to improve access to care and to design cost-saving incentives.

    PubMed

    Cassidy, J

    1993-05-01

    Through Sacred Heart Health System (SHHS), Eugene, OR, physicians, payers, and hospitals are designing a network that will integrate care and improve access by reducing healthcare costs. Together, system members design cost-saving incentives and the products the system offers the community. They promote managed care as the most efficient means to coordinate care and reduce costs. All participants share in the risks of a capitated payment system. Since the system pulled together the payers, physician groups, and hospitals, many of these entities' management functions were consolidated at the system level to avoid duplication and reduce administrative costs. Bringing in physicians was the most difficult yet important aspect of forming a successful network. Working with two physician groups in the community, the system's sponsor-the Sisters of St. Joseph of Peace, Health and Hospital Services-developed the Physician Practice Board. The board, representing 300 physicians, meets weekly and makes recommendations on issues that affect physicians. SHHS also added innovative new functions such as an integrated medical cost management and continuous quality improvement program. Another key to success is a clinically oriented information system, which will allow the system to track patients once they leave the hospital. It also will provide a better understanding of what things have an impact on outcomes and will reduce paperwork. A portion of the system's revenue is designated for initiatives to improve access. And the system recently appointed a tack force on access to explore what they can do in cooperation with others in the community. PMID:10125358

  9. Use of Payer as a Proxy for Health Insurance Status on Admission Results in Misclassification of Insurance Status among Pediatric Trauma Patients.

    PubMed

    Carter, Elizabeth A; Waterhouse, Lauren J; Xiao, Roy; Burd, Randall S

    2016-02-01

    The purpose of this study was to quantify health insurance misclassification among children treated at a pediatric trauma center and to determine factors associated with misclassification. Demographic, medical, and financial information were collected for patients at our institution between 2008 and 2010. Two health insurance variables were created: true (insurance on hospital admission) and payer (source of payment). Multivariable logistic regression was used to determine which factors were independently associated with health insurance misclassification. The two values of health insurance status were abstracted from the hospital financial database, the trauma registry, and the patient medical record. Among 3630 patients, 123 (3.4%) had incorrect health insurance designation. Misclassification was highest in patients who died: 13.9 per cent among all deaths and 30.8 per cent among emergency department deaths. The adjusted odds of misclassification were 6.7 (95% confidence interval: 1.7, 26.6) among patients who died and 16.1 (95% confidence interval: 3.2, 80.77) among patients who died in the emergency department. Using payer as a proxy for health insurance results in misclassification. Approaches are needed to accurately ascertain true health insurance status when studying the impact of insurance on treatment outcomes.

  10. Hospital revenue cycle management and payer mix: do Medicare and Medicaid undermine hospitals' ability to generate and collect patient care revenue?

    PubMed

    Rauscher, Simone; Wheeler, John R C

    2010-01-01

    The continuing efforts of government payers to contain hospital costs have raised concerns among hospital managers that serving publicly insured patients may undermine their ability to manage the revenue cycle successfully. This study uses financial information from two sources-Medicare cost reports for all US hospitals for 2002 to 2007 and audited financial statements for all bond-issuing, not-for-profit hospitals for 2000 to 2006 to examine the relationship between hospitals' shares of Medicare and Medicaid patients and the amount of patient care revenue they generate as well as the speed with which they collect their revenue. Hospital-level fixed effects regression analysis finds that hospitals with higher Medicare and Medicaid payer mix collect somewhat higher average patient care revenues than hospitals with more privately insured and self-pay patients. Hospitals with more Medicare patients also collect on this revenue faster; serving more Medicaid patients is not associated with the speed of patient revenue collection. For hospital managers, these findings may represent good news. They suggest that, despite increases in the number of publicly insured patients served, managers have frequently been able to generate adequate amounts of patient revenue and collect it in a timely fashion.

  11. Hospital revenue cycle management and payer mix: do Medicare and Medicaid undermine hospitals' ability to generate and collect patient care revenue?

    PubMed

    Rauscher, Simone; Wheeler, John R C

    2010-01-01

    The continuing efforts of government payers to contain hospital costs have raised concerns among hospital managers that serving publicly insured patients may undermine their ability to manage the revenue cycle successfully. This study uses financial information from two sources-Medicare cost reports for all US hospitals for 2002 to 2007 and audited financial statements for all bond-issuing, not-for-profit hospitals for 2000 to 2006 to examine the relationship between hospitals' shares of Medicare and Medicaid patients and the amount of patient care revenue they generate as well as the speed with which they collect their revenue. Hospital-level fixed effects regression analysis finds that hospitals with higher Medicare and Medicaid payer mix collect somewhat higher average patient care revenues than hospitals with more privately insured and self-pay patients. Hospitals with more Medicare patients also collect on this revenue faster; serving more Medicaid patients is not associated with the speed of patient revenue collection. For hospital managers, these findings may represent good news. They suggest that, despite increases in the number of publicly insured patients served, managers have frequently been able to generate adequate amounts of patient revenue and collect it in a timely fashion. PMID:21294440

  12. The role and mandate of the World Organisation for Animal Health in veterinary education.

    PubMed

    Vallat, B; Pastoret, P-P

    2009-08-01

    The World Organisation for Animal Health (OIE), which was created in 1924 under the name Office International des Epizooties, is in charge of setting international standards and guidelines for animal health and welfare. The original aim of the Organisation was to control the international spread of infectious animal diseases, but this aim has expanded over the years and now the OIE has a global mandate to 'improve animal health worldwide' for both terrestrial and aquatic animals. A vital factor in successfully fulfilling this mandate is the quality and performance of both the public and private components of national Veterinary Services, which are increasingly working at the interface between human, animal and environmental health. The OIE considers global veterinary education to be key in maintaining and improving the quality of these Veterinary Services. Consequently, the competencies and continuing education of veterinarians are a priority in the assessment tool that the Organisation has developed to evaluate the performance of Veterinary Services (PVS). Evaluating the abilities and training of veterinarians is an important part of a PVS evaluation, as well-educated veterinarians with appropriate training are essential in improving Veterinary Services worldwide and in helping the OIE to fulfil its mandate.

  13. Plasma for fractionation in a public setting: cost analysis from the perspective of the third-party payer

    PubMed Central

    Eandi, Mario; Gandini, Giorgio; Povero, Massimiliano; Zaniolo, Orietta; Pradelli, Lorenzo; Aprili, Giuseppe

    2015-01-01

    Background In Italy, within the legal mandate to pursue national self-sufficiency of plasma-derived medical products, the Regions are starting to organise trade to offset imbalances between need and availability. It is, therefore, necessary to determine the full cost to the Regions of plasma collection and handling. Here we report an analysis of plasma production costs in the Department of Transfusion Medicine of Verona Province, Veneto Region. Materials and methods Plasma is obtained from voluntary, non-remunerated donors from either whole blood or apheresis donation, and in Verona it is collected, validated and distributed only in Regional Health Service facilities, and then delivered to industry for processing. The amounts and costs of materials and activities needed to collect, produce, validate and distribute plasma were obtained from the Department of Transfusion Medicine. Attributable overhead expenses were assumed at 15% of direct costs. When plasma was collected as part of whole blood or from multi-component apheresis, joint costs (the costs of the common manufacturing process before the separation) were allocated to the plasma based on the tariff for single components, taken as proxy of the willingness to pay for them. In an alternative scenario plasma recovered from whole blood donations was considered a by-product. Results The estimated full cost of each valid unit of plasma derived from whole blood, multi-component apheresis, and plasma-apheresis was about € 30, € 73 and € 170, respectively. The estimated total cost per litre of plasma was € 113 for collection from whole blood and € 276 for collection from apheresis. When plasma recovered from whole blood donations was considered a by-product, its cost per litre was estimated to be € 26. Discussion Our results suggest that the Italian donor-based system, in addition to its ethical and social values, can supply plasma at an affordable cost, comparable (albeit slightly higher) with costs in

  14. Nonadherence with Employer-Mandated Sleep Apnea Treatment and Increased Risk of Serious Truck Crashes

    PubMed Central

    Burks, Stephen V.; Anderson, Jon E.; Bombyk, Matthew; Haider, Rebecca; Ganzhorn, Derek; Jiao, Xueyang; Lewis, Connor; Lexvold, Andrew; Liu, Hong; Ning, Jiachen; Toll, Alice; Hickman, Jeffrey S.; Mabry, Erin; Berger, Mark; Malhotra, Atul; Czeisler, Charles A.; Kales, Stefanos N.

    2016-01-01

    Study Objectives: To evaluate the effect of an employer-mandated obstructive sleep apnea (OSA) program on the risk of serious preventable truck crashes. Methods: Data are from the first large-scale, employer-mandated program to screen, diagnose, and monitor OSA treatment adherence in the US trucking industry. A retrospective analysis of cohorts was constructed: polysomnogram-diagnosed drivers (OSA positive n = 1,613, OSA negative n = 403) were matched to control drivers unlikely to have OSA (n = 2,016) on two factors affecting crash risk, experience-at-hire and length of job tenure; tenure was matched on the date of each diagnosed driver's polysomnogram. Auto-adjusting positive airway pressure (APAP) treatment was provided to all cases (i.e. OSA positive drivers); treatment adherence was objectively monitored. Cases were grouped by treatment adherence: “Full Adherence” (n = 682), “Partial Adherence” (n = 571), or “No Adherence” (n = 360). Preventable Department-of-Transportation-reportable crashes/100,000 miles were compared across study subgroups. Robustness was assessed. Results: After the matching date, “No Adherence” cases had a preventable Department of Transportation-reportable crash rate that was fivefold greater (incidence rate ratio = 4.97, 95% confidence interval: 2.09, 10.63) than that of matched controls (0.070 versus 0.014 per 100,000 miles). The crash rate of “Full Adherence” cases was statistically similar to controls (incidence rate ratio = 1.02, 95% confidence interval: 0.48, 2.04; 0.014 per 100,000 miles). Conclusions: Nontreatment-adherent OSA-positive drivers had a fivefold greater risk of serious preventable crashes, but were discharged or quit rapidly, being retained only one-third as long as other subjects. Thus, the mandated program removed risky nontreatment-adherent drivers and retained adherent drivers at the study firm. Current regulations allow nonadherent OSA cases to drive at another firm by keeping their diagnosis

  15. Who should be doing what in the international health: a confusion of mandates in the United Nations?

    PubMed Central

    Lee, K.; Collinson, S.; Walt, G.; Gilson, L.

    1996-01-01

    Since 1945 at least five United Nations organisations have become substantially involved in international health activities. This has led to considerable confusion among policy makers, scholars, and UN staff over distinct and appropriate mandates. Interviews with staff an a historical analysis have shown that while formal mandates have been complementary, effective mandates have led to an unclear delineation of activities. The process of translating formal into effective mandates have been influenced by the decentralised nature of the UN, lack of a master plan for its activities, the considerable growth in the policy agenda and the shift towards a multisectoral approach to health. The identification of each organisation's comparative advantage, at both the global and country levels, is one way of understanding what each organisation does best and perhaps should be doing. There is a need for improved mechanisms to define effective mandates, taking into account comparative advantages, if the mandates of UN organisations are appropriate to meet future challenges in international health. PMID:8611793

  16. Quality, quantity and distribution of medical education and care: regulation by the private sector or mandate by government?

    PubMed

    Anlyan, W G

    1975-05-01

    The public, the federal government and most state governments have become increasingly concerned with the lack of access to primary care as well as the specialty and geographic maldistribution problems. Currently, there is a race in progress between the private sector and the federal government to devise solutions to these problems. In the federal sector, varying pieces of legislation are under active consideration to mandate the correction of specialty and geographic maldistribution; proposals include: 1) setting up federal machinery to regulate the numbers and types of residencies; 2) make obligatory the creation of Departments of Family Practice in each medical school; 3) withdraw current education support from medical schools causing tuition levels to increase substantially--federal student loans would then provide the necessary leverage to obligate the borrower to two years of service in an under-served area in exchange for loan forgiveness. In the private sector, for the first time in the history of the United States, the five major organizations involved in medical care have organized to form the Coordinating Council on Medical Education (CCME) and the Liaison Committee on Graduate Medical Education (LCGME). One of the initial major endeavors of the CCME has been to address itself to the problem of specialty maldistribution. The LCGME has been tooling up to become the accrediting group for residency training thus providing an overview of the quality and quantity of specialty training. It will be the intent of this presentation to bring the membership of the Southern Surgical Association an up-to-date report on these parallel efforts. The author's personal hope is that the private sector can move sufficiently rapidly to set up its own regulatory mechanisms and avert another federally controlled bureaucracy that will forever change the character of the medical profession in the United States.

  17. Re-conceptualising holism in the contemporary nursing mandate: from individual to organisational relationships.

    PubMed

    Allen, Davina

    2014-10-01

    Over the last forty years, nursing's claim to professional expertise has been expressed in terms of its care-giving function. Informed by a distinctive 'holistic' approach, models of nursing identify therapeutic relationships as the cornerstone of practice. While 'knowing the patient' has been central to clinicians' occupational identity, research reveals that nurses not only experience significant material constraints in realising these ideals, their contribution to healthcare extends far beyond direct work with patients. Amidst growing concern about healthcare quality, a body of critical commentary has emerged proposing that the contemporary nursing mandate, with its exclusive focus on care-giving, is no longer serving the interests of the profession or the public. Drawing on an ethnographic study of UK hospital nurses' 'organising work' and insights from practice-based approaches and actor network theory, this paper lays the foundations for a re-conceptualisation of holism within the nursing mandate centred on organisational rather than therapeutic relationships. Nurses can be understood as obligatory passage points in health systems and through myriad processes of 'translational mobilisation' sustain the networks through which care is organised.

  18. Early impact of the federally mandated Local Wellness Policy on physical activity in rural, low-income elementary schools in Colorado.

    PubMed

    Belansky, Elaine S; Cutforth, Nick; Delong, Erin; Ross, Courtney; Scarbro, Sharon; Gilbert, Lynn; Beatty, Bridget; Marshall, Julie A

    2009-01-01

    The What's Working project described the initial impact of the United States' federally mandated Local Wellness Policy in rural, low-income elementary schools located in Colorado. Before and after the Local Wellness Policy mandate went into effect, a survey about school features related to nutrition and physical activity was sent to a random sample of 45 rural elementary schools (i.e., schools located outside of urban areas), in which at least 40% of students qualified for free or reduced-cost lunch. Overall, opportunities for physical activity did not change after the policy went into effect: although time in physical education increased by 14 min per week (P=0.10), time for recess decreased by roughly 19 min per week (P=0.10). Policies supporting student participation in physical education and recess (an unstructured time during school hours when students are allowed to play outside) did not change. The researchers coded Local Wellness Policies and found them to have weak wording that produced minimal impact. Content analysis of key informant interviews suggested several barriers to the impact of the Local Wellness Policies: (1) competing pressures facing school districts, (2) lack of resources devoted to the Local Wellness Policy, (3) principals' lack of knowledge about the policy, and (4) lack of accountability mechanisms to ensure policy implementation. Financial resources and more effective communication about Local Wellness Policies among school districts and principals are needed to elevate the importance of and increase opportunities for physical activity in rural, low-income Colorado elementary schools.

  19. San Francisco's 'pay or play' employer mandate expanded private coverage by local firms and a public care program.

    PubMed

    Colla, Carrie H; Dow, William H; Dube, Arindrajit

    2013-01-01

    In 2008 San Francisco implemented a pay-or-play employer mandate that required firms operating in the city to provide health insurance coverage for employees or contribute to the city's "public option" health access program, Healthy San Francisco. Using data from our Bay Area Employer Health Benefits Survey, we found that in the first two years after implementation, more employers offered insurance and provided employee health benefit coverage relative to employers outside San Francisco not subject to the mandate. Sixty-seven percent reported in 2009 that they had expanded benefits since 2007. Although 22 percent of firms responding to the survey reported contributing to Healthy San Francisco for some employees, we observed no crowd-out of private insurance. Premium changes between 2007 and 2009 were similar in San Francisco and surrounding areas, but more of the burden of premium contributions in San Francisco shifted from workers to employers. Overall, 64 percent of firms responding to the survey supported the employer mandate. San Francisco's experience indicates that such a mandate is feasible, increases access, and is acceptable to many employers, which bodes well for the national employer mandate that will take effect under the Affordable Care Act in 2014.

  20. Vaccinating Health Care Workers Against Influenza: The Ethical and Legal Rationale for a Mandate

    PubMed Central

    Wu, Joel T.; Poland, Gregory A.; Jacobson, Robert M.; Koenig, Barbara A.; Tilburt, Jon C.

    2011-01-01

    Despite improvements in clinician education, symptom awareness, and respiratory precautions, influenza vaccination rates for health care workers have remained unacceptably low for more than three decades, adversely affecting patient safety. When public health is jeopardized, and a safe, low-cost, and effective method to achieve patient safety exists, health care organizations and public health authorities have a responsibility to take action and change the status quo. Mandatory influenza vaccination for health care workers is supported not only by scientific data but also by ethical principles and legal precedent. The recent influenza pandemic provides an opportunity for policymakers to reconsider the benefits of mandating influenza vaccination for health care workers, including building public trust, enhancing patient safety, and strengthening the health care workforce. PMID:21228284

  1. Court-mandated outpatient treatment for insanity acquittees: clinical philosophy and implementation.

    PubMed

    Lamb, H R; Weinberger, L E; Gross, B H

    1988-10-01

    Court-mandated outpatient treatment for offenders found not guilty by reason of insanity is an alternative form of treatment in which insanity acquittees may be released into the community after serving part of their commitment in a forensic hospital. Working with this difficult population requires a close liaison with the criminal justice system and a clearly articulated treatment philosophy. Essential elements include an emphasis on structure and supervision, recognition of the importance of neuroleptic medication, a reality-based approach to therapy and a focus on the problems of everyday living, and incorporation of the principles of case management. Treatment staff must be comfortable with giving support, enforcing limits, and recommending revocation of the patient's community status when necessary. Case illustrations of successful and unsuccessful community treatment for insanity acquittees are included.

  2. Preliminary examination of a mutual intimate partner violence intervention among treatment-mandated couples.

    PubMed

    Wray, Alisha M; Hoyt, Tim; Gerstle, Melissa

    2013-08-01

    Intimate partner violence (IPV) is a widespread global health problem. Despite growing evidence indicating that men and women commit IPV, most traditional interventions focus on male-to-female violence and do not address mutual violence. This circumscribed focus represents one potential reason traditional treatments have had only a modest effect on recidivism. The current study investigated a pilot intervention for mutually violent couples with ethnically diverse, treatment-mandated men and women. Using a longitudinal design, 121 couples were assessed (semistructured clinical interview, Conflict Tactics Scale-Revised [CTS-2]) and mandated to either the pilot intervention or another community agency. Of the 92 couples referred for the 12-week, pilot group intervention (plus 1-2 preparatory, individual sessions), 89% of couples had one or both partners complete. Posttreatment assessments were conducted (CTS-2, satisfaction ratings), anticipating reductions in perpetrated and received IPV among treatment completers. Using 1-year conviction data to assess recidivism (IPV and general violence convictions), it was hypothesized that the lowest recidivism rates would be found when both partners completed, intermediate rates when one partner completed, and the highest rates when neither completed. Consistent with hypotheses, men who completed treatment reported reduced perpetration of physical assault and received less injury, and women who completed reported receiving less physical assault and injury. At 1-year follow-up, couples who completed had lower recidivism rates, with couples in which both partners completed evidencing the best outcomes. Results provide preliminary support for the proposed mutual violence intervention. Clinical implications, including the effect of a thorough assessment and tailored treatment recommendations, are discussed. PMID:23750516

  3. State Health Expenditure Accounts: Minnesota's Perspective

    PubMed Central

    Blewett, Lynn A.; Sonier, Julie; Gustafson, Brent C.; Leitz, Scott D.

    1999-01-01

    Minnesota's approach to the development and use of State health expenditure accounts (SHEAs) was developed to assist State policymakers with decisions regarding health care reform. The accounts are based on an annual survey of third-party payers and summary Medicaid and Medicare data. Summary data are presented along with a discussion of data collection methodology, estimation, and dissemination. Minnesota's experience demonstrates that the ability of States to conduct detailed analysis of health care spending and to use these estimates to change State policy, inform national policy debate, conduct impact analysis, educate policymakers, and monitor market trends. PMID:11481787

  4. Economic grand rounds: experience with mandated use of generic medications for patients covered by the mental health safety net.

    PubMed

    Amirsadri, Alireza; Chapman, Timothy; Breen, Michael; Drake, William; Arfken, Cynthia L

    2014-07-01

    Reducing pharmacy costs without increasing adverse outcomes would relieve some pressure on mental health budgets. This column describes the experience of a publicly funded provider network in a Michigan county that mandated generic use of psychotropic medications to address financial challenges. The percentage of brand-name medications and cost per prescription declined with the policy change, resulting in lower total pharmacy expenditures. No increase was noted in prescriptions per patient or psychiatric hospitalizations. Changes were sustained after the initial implementation period. Mandating generic use may be feasible as a tool for constraining pharmacy costs in mental health budgets.

  5. Class Size: What Research Says and What It Means for State Policy

    ERIC Educational Resources Information Center

    Whitehurst, Grover J.; Chingos, Matthew M.

    2011-01-01

    Class size is one of the small number of variables in American K-12 education that are both thought to influence student learning and are subject to legislative action. Legislative mandates on maximum class size have been very popular at the state level. In recent decades, at least 24 states have mandated or incentivized class-size reduction…

  6. Improving quality outcomes in a single-payer system: lessons learned from the UK National Health Service Breast Screening Programme.

    PubMed

    Wallis, Matthew G; Lawrence, Gill; Brenner, R James

    2008-06-01

    The success of pay-for-performance initiatives in the United States as a function of improved quality of care is likely to be conditioned on the participation of all stakeholders. The ability of providers to develop quality improvement programs that receive sufficient resource support from the government represents a dynamic that has proved successful for the Breast Screening Programme, a part of the National Health Service, in the United Kingdom. A review of selected aspects of the program should serve as a template for consideration of how the deliberate coordination of clinical care can be improved under such circumstances.

  7. Commercial importation of prescription drugs in the United States: short-run implications.

    PubMed

    Danzon, Patricia M; Johnson, Scott J; Long, Genia; Furukawa, Michael F

    2011-04-01

    The option of legalizing the commercial importation of prescription drugs is of continued policy interest as a way to reduce U.S. drug spending. Using IMS data, we estimate potential savings from commercial drug importation under assumptions about percentage of drugs likely to attract imports; potential supply from foreign countries; and share of savings passed on to payers. Our base case estimate is that $1.7 billion per year, or 0.6 percent of total drug spending, would be saved by payers; sensitivity analyses range from 0.2 to 2.5 percent under plausible assumptions and up to 17.4 percent under unrealistic assumptions about unlimited foreign supply, costless trade, and zero profits for intermediaries. Estimated savings to payers are less than the average price differentials between the United States and foreign countries because proposed legislation exempts certain drugs from importation; foreign markets are small relative to the United States; regulatory and other constraints may limit the volume of exports; trade is costly; and intermediaries will retain some savings. Although savings to U.S. payers/consumers would likely be small and have minimal impact on total U.S. health care spending, costs to other countries could be significant, due to reduced access and possibly higher prices. In the long run, reduced investment in R&D could adversely affect consumers globally. PMID:21543707

  8. Medicare program; right of appeal for Medicare secondary payer determinations relating to liability insurance (including self-insurance), no-fault insurance, and workers' compensation laws and plans. Final rule.

    PubMed

    2015-02-27

    This final rule implements provisions of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act) which require us to provide a right of appeal and an appeal process for liability insurance (including self-insurance), no-fault insurance, and workers' compensation laws or plans when Medicare pursues a Medicare Secondary Payer (MSP) recovery claim directly from the liability insurance (including self-insurance), no-fault insurance, or workers' compensation law or plan.

  9. Effectiveness of the Brief Alcohol and Screening Intervention for College Students (BASICS) Program with a Mandated Population

    ERIC Educational Resources Information Center

    DiFulvio, Gloria T.; Linowski, Sally A.; Mazziotti, Janet S.; Puleo, Elaine

    2012-01-01

    Objective: This study evaluated the effectiveness of a large-scale intervention designed to reduce alcohol abuse among adjudicated college students. Participants: Participants were college students mandated to attend a Brief Alcohol Screening and Intervention for College Students (BASICS) program and a randomly selected comparison group of…

  10. Supporting Public High School Teachers in a Context of Multiple Mandates: A Social Justice Approach to Professional Learning Communities

    ERIC Educational Resources Information Center

    Harak, Philip J.

    2012-01-01

    Although public school teaching by its inherent nature presents numerous classroom challenges, the public high school teacher today is faced in addition with multiple external mandates from several outside stakeholders. Given the established track record of professional learning communities (PLCs) to provide teacher support and development, I…

  11. Education Code Mandates of the Board of Governors and Chancellor's Office: Comments on Compliance and Recommendations for Change.

    ERIC Educational Resources Information Center

    Nussbaum, Tom

    This document is a compilation of California Education Code sections which set forth powers or duties of the Board of Governors or Chancellor's Office. Each power or duty is separately identified, followed by comments on the extent to which the mandate is being complied with, what the problems with compliance are, and recommendations as to changes…

  12. Individual and Situational Factors that Influence the Efficacy of Personalized Feedback Substance Use Interventions for Mandated College Students

    ERIC Educational Resources Information Center

    Mun, Eun Young; White, Helene R.; Morgan, Thomas J.

    2009-01-01

    Little is known about individual and situational factors that moderate the efficacy of personalized feedback interventions (PFIs). Mandated college students (N = 348) were randomly assigned either to a PFI delivered in the context of a brief motivational interview (BMI; n = 180) or to a written PFI only (WF) condition and were followed up at 4…

  13. Positioning Teachers: A Discourse Analysis of Russian and American Teacher Identities in the Context of Changing National Assessment Mandates

    ERIC Educational Resources Information Center

    Ignatieva, Raisa P.

    2011-01-01

    The purpose of the study was to uncover the cultural beliefs and values that underlie American and Russian teachers' representations of their professional identities and their understanding of power in education in the context of globally disseminated education reforms and current educational mandates--the No Child Left Behind Act of 2001 (NCLB)…

  14. Court-Mandated Counseling for Men Who Batter: A Three-Day Workshop for Mental Health Professionals. Participant's Manual.

    ERIC Educational Resources Information Center

    Ganley, Anne L.

    The purpose of this manual is to provide a written tool for those participating in a 3-day workshop designed to train mental health professionals from diverse settings and communities to counsel court-mandated batterers. The manual consists of: (1) an outline of the workshop; (2) an introduction; (3) six chapters/sections; (4) notes; and (5) three…

  15. Exploring Asperger's Syndrome, Schlossberg's Transition Theory and Federally Mandated Transition Planning: Seeking Improvements

    ERIC Educational Resources Information Center

    Spencer, Tracy Lynne Wright Lyons

    2013-01-01

    Federally mandated transition planning has done little to improve the postsecondary outcomes of people with Asperger's syndrome. Current high school transition planning for students with Asperger's attempts to address some of these areas through family involvement, community inclusion, and the active participation of the student in…

  16. "Deshaney" and Its Progeny--the Failure to Mandate That Public School Officials Protect Our Tender Youth.

    ERIC Educational Resources Information Center

    Journal of Law and Education, 1995

    1995-01-01

    A majority of federal courts have dismissed lawsuits involving children injured at school and have held that the Constitution does not mandate that affirmative steps should be taken to protect a child. Deals with both the legal and practical issues involved with such a decision. Argues that public school officials have an affirmative…

  17. An Evaluation of Factors that Impact Positive School Climate for School Psychologists in a Time of Conflicting Educational Mandates

    ERIC Educational Resources Information Center

    Thompson, Melody J.; Crank, Joe N.

    2010-01-01

    Educators including school psychologists must negotiate the differing demands of legal mandates and recent educational initiatives that impact their practice and school climate in order to maintain positive effects for students and other school personnel. The No Child Left Behind (NCLB) Act of 2001, the Individuals with Disabilities Education Act,…

  18. Evidence for a need to mandate kidney transplant living donor registries.

    PubMed

    Emara, Mahmoud; Ragheb, Ahmed; Hassan, Abubaker; Shoker, Ahmed

    2008-01-01

    Kidney disease is a global public health problem of growing proportions. Currently the best treatment for end-stage renal failure is transplantation. Living organ donation remains a complex ethical, moral and medical issue. It is based on a premise that kidney donation is associated with short-term minimal risks to harm the donor, and is outweighed by the definite advantages to the recipient. A growing number of patients with end-stage renal disease and shortage of kidney donors poses a pressing need to expand the criteria needed to accept kidney donors. The current donor registries are structured and are driven to expand donor pool. As living kidney donation is not without risks, more attention should be given to protect the donor health. After kidney donation, mild to moderate renal insufficiency may occur. Renal insufficiency, even mild, is associated with increased risks of hypertension, proteinuria and cardiovascular morbidity. We, therefore, foresee a need to mandate the establishment of renal transplant donor registries at all transplanting programs as a prerequisite to protect the long-term well being of kidney donors. These registries can collect the database necessary to develop standards of practice and guidelines for future kidney donation. PMID:18549448

  19. Uncomplicated Resistance Training and Health-Related Outcomes: Evidence for a Public Health Mandate

    PubMed Central

    Phillips, Stuart M.; Winett, Richard A.

    2014-01-01

    PHILLIPS, S.M. and R.A. WINETT. Uncomplicated Resistance Training and Health-Related Outcomes: Evidence for a Public Health Mandate. Curr. Sports Med. Rep., Vol. 9, No. 4, pp. 208–213, 2010. Compared to aerobic training (AT), resistance training (RT) has received far less attention as a prescription for general health. However, RT is as effective as AT in lowering risk for cardiovascular disease, diabetes, and other diseases. There is a clear ability of RT, in contrast to AT, to promote gains, maintenance, or slow loss of skeletal muscle mass/strength. Thus, as an antisarcopenic exercise treatment, RT is of greater benefit than AT; given the aging of our population, this is of primary importance. In our view, a substantial barrier to greater adoption of RT is the incorrectly perceived importance of variables such as external load, intensity, and volume, leading to complex, difficult-to-follow regimes. We propose a more feasible and easier-to-adhere-to paradigm for RT that could affect how RT is viewed and adopted as a prescription for public health. PMID:20622538

  20. Drinking before Drinking: Pre-gaming and Drinking Games in Mandated Students

    PubMed Central

    Boyle, Kelly E.; Hustad, John T. P.; Barnett, Nancy P.; Tevyaw, Tracy O'Leary; Kahler, Christopher W.

    2007-01-01

    Pre-gaming, the practice of consuming alcohol before attending a social function, has not received as much research attention as drinking games among college students. This study investigated the prevalence of both pre-gaming and drinking game participation in a sample of mandated students (N = 334) who had been referred for an alcohol violation. Approximately one-third (31%) of the sample reported pre-gaming on the night of their referral event. Pre-gaming was associated with higher estimated blood alcohol content on that night, along with a greater history of pre-gaming and taking greater responsibility for the incident. A higher proportion of the students (48.7%) reported playing drinking games on the event night and reported the event to be less aversive than non-players. Neither drinking games nor pre-gaming was consistently related to recent alcohol consumption or problems, nor did they frequently occur together on the event night. Pre-gaming was a unique predictor of intoxication on the night of the referral, and drinking games were not. Therefore, pre-gaming and drinking games appear to be distinct activities. This research suggests methods of prevention for both activities as well as promising research directions for future research. PMID:17574344

  1. Affordable Care Act's Mandate Eliminating Contraceptive Cost Sharing Influenced Choices Of Women With Employer Coverage.

    PubMed

    Carlin, Caroline S; Fertig, Angela R; Dowd, Bryan E

    2016-09-01

    Patient cost sharing for contraceptive prescriptions was eliminated for certain insurance plans as part of the Affordable Care Act. We examined the impact of this change on women's patterns of choosing prescription contraceptive methods. Using claims data for a sample of midwestern women ages 18-46 with employer-sponsored coverage, we examined the contraceptive choices made by women in employer groups whose coverage complied with the mandate, compared to the choices of women in groups whose coverage did not comply. We found that the reduction in cost sharing was associated with a 2.3-percentage-point increase in the choice of any prescription contraceptive, relative to the 30 percent rate of choosing prescription contraceptives before the change in cost sharing. A disproportionate share of this increase came from increased selection of long-term contraception methods. Thus, the removal of cost as a barrier seems to be an important factor in contraceptive choice, and our findings about long-term methods may have implications for rates of unintended pregnancy that require further study. PMID:27605640

  2. Evolving trends in nurse regulation: what are the policy impacts for nursing's social mandate?

    PubMed

    Duncan, Susan; Thorne, Sally; Rodney, Patricia

    2015-03-01

    We recognize a paradox of power and promise in the context of legislative and organizational changes in nurse regulation which poses constraints on nursing's capacity to bring voice and influence to pressing matters of healthcare and public policy. The profession is at an important crossroads wherein leaders must be well informed in political, economic and legislative trends to harness the profession's power while also navigating forces that may put at risk its central mission to serve society. We present a critical policy analysis of the impact of recent regulatory trends on what the International Council of Nurses considers nursing's three 'pillars' - the profession of nursing, socioeconomic welfare of nurses and nurse regulation. Themes surfacing from this analysis include regulatory discontinuity, a tightening of regulatory control, and an increasingly managerial governance culture. These themes illuminate insights and strategies required to renew and revitalize the social mandate of our profession amidst a climate of urgency in the questioning of nurse scholars with respect to the future of the profession. At this historic juncture, nurses must clearly understand the implications of legislative and organizational regulatory changes to ensure the profession contributes to full capacity in achieving health and health equity globally. PMID:25382628

  3. Rents From the Essential Health Benefits Mandate of Health Insurance Reform.

    PubMed

    Mendoza, Roger Lee

    2015-01-01

    The essential health benefits mandate constitutes one of the most controversial health care reforms introduced under the U.S. Affordable Care Act of 2010. It bears important theoretical and practical implications for health care risk and insurance management. These essential health benefits are examined in this study from a rent-seeking perspective, particularly in terms of three interrelated questions: Is there an economic rationale for standardized, minimum health care coverage? How is the scope of essential health services and treatments determined? What are the attendant and incidental costs and benefits of such determination/s? Rents offer ample incentives to business interests to expend considerable resources for health care marketing, particularly when policy processes are open to contestation. Welfare losses inevitably arise from these incentives. We rely on five case studies to illustrate why and how rents are created, assigned, extracted, and dissipated in equilibrium. We also demonstrate why rents depend on persuasive marketing and the bargained decisions of regulators and rentiers, as conditioned by the Tullock paradox. Insights on the intertwining issues of consumer choice, health care marketing, and insurance reform are offered by way of conclusion. PMID:26075546

  4. Texas Nurse Staffing Trends Before and After Mandated Nurse Staffing Committees.

    PubMed

    Jones, Terry; Heui Bae, Sung; Murry, Nicole; Hamilton, Patti

    2015-08-01

    This article describes the evolution of mandated nurse staffing committees in Texas from 2002 to 2009 and presents a study that analyzed nurse staffing trends in Texas using a secondary analysis of hospital staffing data (N = 313 hospitals) from 2000 to 2012 obtained from the American Hospital Association Annual Survey. Nurse staffing patterns based on three staffing variables for registered nurses (RNs), licensed vocational nurses (LVNs), and total licensed nurses were identified: full-time equivalents per 1,000 adjusted patient days, productive hours per adjusted patient day, and RN skill mix. Similar to national trends between 2000 and 2012, most Texas hospitals experienced an increase in RN and total nurse staffing, decrease in LVN staffing, and an increase in RN skill mix. The magnitude of total nurse staffing changes in Texas (5% increase) was smaller than national trends (13.6% increase). Texas's small, rural, government hospitals and those with the highest preregulation staffing levels experienced the least change in staffing between 2000 and 2012: median change of 0 to .13 full-time equivalents per 1,000 adjusted patient days and median change in productive hours per patient day of 0 to .23. The varying effects of staffing committees in different organizational contexts should be considered in future staffing legislative proposals and other policy initiatives.

  5. Evolutionary Evaluation: implications for evaluators, researchers, practitioners, funders and the evidence-based program mandate.

    PubMed

    Urban, Jennifer Brown; Hargraves, Monica; Trochim, William M

    2014-08-01

    Evolutionary theory, developmental systems theory, and evolutionary epistemology provide deep theoretical foundations for understanding programs, their development over time, and the role of evaluation. This paper relates core concepts from these powerful bodies of theory to program evaluation. Evolutionary Evaluation is operationalized in terms of program and evaluation evolutionary phases, which are in turn aligned with multiple types of validity. The model of Evolutionary Evaluation incorporates Chen's conceptualization of bottom-up versus top-down program development. The resulting framework has important implications for many program management and evaluation issues. The paper illustrates how an Evolutionary Evaluation perspective can illuminate important controversies in evaluation using the example of the appropriate role of randomized controlled trials that encourages a rethinking of "evidence-based programs". From an Evolutionary Evaluation perspective, prevailing interpretations of rigor and mandates for evidence-based programs pose significant challenges to program evolution. This perspective also illuminates the consequences of misalignment between program and evaluation phases; the importance of supporting both researcher-derived and practitioner-derived programs; and the need for variation and evolutionary phase diversity within portfolios of programs.

  6. Predictors of motivation to change in mandated college students following a referral incident.

    PubMed

    Qi, David; Pearson, Matthew R; Hustad, John T P

    2014-06-01

    The purpose of present study was to understand factors that are related to a desire or motivation to change (MTC) alcohol use in a sample of college students mandated to receive an alcohol intervention. We examined characteristics of and reactions to the referral event, typical alcohol use involvement, and alcohol beliefs about the perceived importance of drinking in college assessed by the College Life Alcohol Salience Scale (CLASS; Osberg et al., 2010) as predictors of MTC following referral to an alcohol intervention. College students (N = 932) who presented for a mandatory alcohol intervention following a referral event (e.g., citation for underage drinking, medical attention for an alcohol-related incident, or driving under the influence) completed an assessment prior to receiving an alcohol intervention. Higher perceived aversiveness of the referral event and higher personal responsibility one felt for the occurrence of the event were positively related to higher MTC. Although alcohol beliefs about the role of drinking in college were not significantly related to either event aversiveness or responsibility, it was negatively related to MTC even after controlling for alcohol use involvement variables. Alcohol beliefs about the role of drinking in college represent an important construct that is related to increased alcohol use and alcohol-related problems and decreased MTC in a sample of college students. Interventions aimed at reducing alcohol beliefs about the role of drinking in college may be an effective strategy to reduce alcohol use and alcohol-related problems by college students.

  7. Rents From the Essential Health Benefits Mandate of Health Insurance Reform.

    PubMed

    Mendoza, Roger Lee

    2015-01-01

    The essential health benefits mandate constitutes one of the most controversial health care reforms introduced under the U.S. Affordable Care Act of 2010. It bears important theoretical and practical implications for health care risk and insurance management. These essential health benefits are examined in this study from a rent-seeking perspective, particularly in terms of three interrelated questions: Is there an economic rationale for standardized, minimum health care coverage? How is the scope of essential health services and treatments determined? What are the attendant and incidental costs and benefits of such determination/s? Rents offer ample incentives to business interests to expend considerable resources for health care marketing, particularly when policy processes are open to contestation. Welfare losses inevitably arise from these incentives. We rely on five case studies to illustrate why and how rents are created, assigned, extracted, and dissipated in equilibrium. We also demonstrate why rents depend on persuasive marketing and the bargained decisions of regulators and rentiers, as conditioned by the Tullock paradox. Insights on the intertwining issues of consumer choice, health care marketing, and insurance reform are offered by way of conclusion.

  8. Resource use and cost of care with biologicals in Crohn's disease in South Africa: a retrospective analysis from a payer perspective.

    PubMed

    Miot, Jacqui; Smith, Susan; Bhimsan, Niri

    2016-08-01

    Background Crohn's disease is a relapsing remitting inflammatory disease of the gastrointestinal tract. Treatment may require expensive biological therapy in severe patients. Affordability of the high cost anti-TNF-α agents has raised concern although evidence suggests cost-offsets can be achieved. There is little information on the resource utilisation of Crohn's patients in low and middle income countries. Objective The objective of this study is to investigate the resource utilisation and costs associated with biologicals treatment of Crohn's disease. Setting The setting for this study is in private healthcare in South Africa from a payer perspective. Method A retrospective longitudinal analysis of an administrative claims database from a large private healthcare insurer of patients who had at least 1 year claims exposure prior to starting biologicals and 2 years follow-up thereafter. Resource utilisation and costs including total Crohn's costs, hospital admissions and surgery, out of hospital costs, biologicals and chronic medicines were analysed. Main outcome measure The primary objective was to compare the change in resource utilisation and costs for Crohn's related conditions before and after starting biological treatment. Results A cohort of 72 patients was identified with a 35% (p = 0.005) reduction in Crohn's related costs (excluding the cost of biologicals) from ZAR 55,925 (U$5369) 1 year before compared to ZAR 36,293 (U$3484) 2 years after starting biological medicines. However, inclusion of the cost of biologicals more than doubled the total costs to ZAR 150,915 (±91,642) U$14,488 (±8798) in Year 2. Significant reductions in out-of hospital Crohn's related spend was also observed. Conclusions A reduction in healthcare costs is seen following starting biologicals in patients with moderate to severe Crohn's disease. However, the high cost of biological therapy outweighs any possible savings achieved in other areas of healthcare utilisation.

  9. Early impact of the federally mandated Local Wellness Policy on physical activity in rural, low-income elementary schools in Colorado.

    PubMed

    Belansky, Elaine S; Cutforth, Nick; Delong, Erin; Ross, Courtney; Scarbro, Sharon; Gilbert, Lynn; Beatty, Bridget; Marshall, Julie A

    2009-01-01

    The What's Working project described the initial impact of the United States' federally mandated Local Wellness Policy in rural, low-income elementary schools located in Colorado. Before and after the Local Wellness Policy mandate went into effect, a survey about school features related to nutrition and physical activity was sent to a random sample of 45 rural elementary schools (i.e., schools located outside of urban areas), in which at least 40% of students qualified for free or reduced-cost lunch. Overall, opportunities for physical activity did not change after the policy went into effect: although time in physical education increased by 14 min per week (P=0.10), time for recess decreased by roughly 19 min per week (P=0.10). Policies supporting student participation in physical education and recess (an unstructured time during school hours when students are allowed to play outside) did not change. The researchers coded Local Wellness Policies and found them to have weak wording that produced minimal impact. Content analysis of key informant interviews suggested several barriers to the impact of the Local Wellness Policies: (1) competing pressures facing school districts, (2) lack of resources devoted to the Local Wellness Policy, (3) principals' lack of knowledge about the policy, and (4) lack of accountability mechanisms to ensure policy implementation. Financial resources and more effective communication about Local Wellness Policies among school districts and principals are needed to elevate the importance of and increase opportunities for physical activity in rural, low-income Colorado elementary schools. PMID:19190570

  10. 42 CFR 137.65 - May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum advance payment? 137.65 Section 137.65 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Statutorily Mandated Grants § 137.65 May a Self-Governance...

  11. 42 CFR 137.65 - May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum advance payment? 137.65 Section 137.65 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Statutorily Mandated Grants § 137.65 May a Self-Governance...

  12. 42 CFR 137.65 - May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum advance payment? 137.65 Section 137.65 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Statutorily Mandated Grants § 137.65 May a Self-Governance...

  13. 42 CFR 137.65 - May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum advance payment? 137.65 Section 137.65 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Statutorily Mandated Grants § 137.65 May a Self-Governance...

  14. 42 CFR 137.65 - May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum advance payment? 137.65 Section 137.65 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Statutorily Mandated Grants § 137.65 May a Self-Governance...

  15. Client and program factors associated with dropout from court mandated drug treatment

    PubMed Central

    Evans, Elizabeth; Li, Libo; Hser, Yih-Ing

    2008-01-01

    To examine why court mandated offenders dropout of drug treatment and to compare their characteristics, treatment experiences, perceptions, and outcomes with treatment completers, we analyzed self-reported and administrative data on 542 dropouts (59%) and 384 completers (41%) assessed for Proposition 36 treatment by thirty sites in five California counties during 2004. At intake, dropouts had lengthier criminal histories, lower treatment motivation, more severe employment and psychiatric problems, and more were using drugs, especially heroin. Relatively fewer dropouts received residential treatment and their retention was much shorter. A similar proportion of dropouts received services as completers and the mean number of services received per day by dropouts was generally more, especially to address psychiatric problems, during the first three months of treatment. The most commonly offender-reported reasons for dropout included low treatment motivation (46.2%) and the difficulty of the Proposition 36 program (20.0%). Consequences for dropout included incarceration (25.3%) and permission to try treatment again (24.0%). Several factors predicting drug treatment dropout were identified. Both groups demonstrated improved functioning at one-year follow-up, but fewer dropouts had a successful outcome (34.5% vs. 59.1%) and their recidivism rate was significantly higher (62.9% vs. 28.9%) even after controlling for baseline differences. Understanding factors associated with drug treatment dropout can aid efforts to improve completion rates, outcomes, and overall effectiveness of California’s Proposition 36 program. Findings may also aid a broader audience of researchers and policy analysts who are charged with designing and evaluating criminal-justice diversion programs for treating drug-addicted offenders. PMID:19150133

  16. Statewide Mandatory Remediation Policies: National, State, and Institutional Perspectives

    ERIC Educational Resources Information Center

    Peak, Charity S.

    2012-01-01

    Despite uncertainty related to student outcomes resulting from remediation (Bettinger & Long, 2009), eleven states mandate remedial education through common placement testing and standardized cutoff scores rather than permitting individual postsecondary institutions to establish remediation guidelines. Colorado, in particular, offers an…

  17. Re-reading nursing and re-writing practice: towards an empirically based reformulation of the nursing mandate.

    PubMed

    Allen, Davina

    2004-12-01

    This article examines field studies of nursing work published in the English language between 1993 and 2003 as the first step towards an empirically based reformulation of the nursing mandate. A decade of ethnographic research reveals that, contrary to contemporary theories which promote an image of nursing work centred on individualised unmediated caring relationships, in real-life practice the core nursing contribution is that of the healthcare mediator. Eight bundles of activity that comprise this intermediary role are described utilising evidence from the literature. The mismatch between nursing's culture and ideals and the structure and constraints of the work setting is a chronic source of practitioner dissatisfaction. It is argued that the profession has little to gain by pursuing an agenda of holistic patient care centred on emotional intimacy and that an alternative occupational mandate focused on the healthcare mediator function might make for more humane health services and a more viable professional future.

  18. Intended and Unintended Effects of State-Mandated High School Science and Mathematics Course Graduation Requirements on Educational Attainment

    PubMed Central

    Plunk, Andrew D.; Tate, William F.; Bierut, Laura J.; Grucza, Richard A.

    2014-01-01

    Mathematics and science course graduation requirement (CGR) increases in the 1980s and 1990s might have had both intended and unintended consequences. Using logistic regression with Census and American Community Survey (ACS) data (n = 2,892,444), we modeled CGR exposure on (a) high school dropout, (b) beginning college, and (c) obtaining any college degree. Possible between-groups differences were also assessed. We found that higher CGRs were associated with higher odds to drop out of high school, but results for the college-level outcomes varied by group. Some were less likely to enroll, whereas others who began college were more likely to obtain a degree. Increased high school dropout was consistent across the population, but some potential benefit was also observed, primarily for those reporting Hispanic ethnicity. PMID:25541563

  19. A Qualitative Meta-Analysis of the Diffusion of Mandated and Subsidized Technology: United States Energy Security and Independence

    ERIC Educational Resources Information Center

    Noah, Philip D., Jr.

    2013-01-01

    The purpose of this research project was to explore what the core factors are that play a role in the development of the smart-grid. This research study examined The Energy Independence and Security Act (EISA) of 2007 as it pertains to the smart-grid, the economic and security effects of the smart grid, and key factors for its success. The…

  20. Intended and Unintended Effects of State-Mandated High School Science and Mathematics Course Graduation Requirements on Educational Attainment

    ERIC Educational Resources Information Center

    Plunk, Andrew D.; Tate, William F.; Bierut, Laura J.; Grucza, Richard A.

    2014-01-01

    Mathematics and science course graduation requirement (CGR) increases in the 1980s and 1990s might have had both intended and unintended consequences. Using logistic regression with Census and American Community Survey (ACS) data (n = 2,892,444), we modeled CGR exposure on (a) high school dropout, (b) beginning college, and (c) obtaining any…

  1. Keep Kids in School: A Collaborative Community Effort to Increase Compliance with State-Mandated Health Requirements

    ERIC Educational Resources Information Center

    Rogers, Valerie; Salzeider, Christine; Holzum, Laura; Milbrandt, Tracy; Zahnd, Whitney; Puczynski, Mark

    2016-01-01

    Background: It is important that collaborative relationships exist in a community to improve access to needed services for children. Such partnerships foster preventive services, such as immunizations, and other services that protect the health and well-being of all children. Methods: A collaborative relationship in Illinois involving an academic…

  2. The Influence of a State Mandated Induction Assistance Program on the Socialization of a Beginning Physical Education Teacher

    ERIC Educational Resources Information Center

    Richards, K. Andrew; Templin, Thomas J.

    2011-01-01

    Using occupational socialization theory, this investigation describes the socialization of Janet, an induction phase physical education (PE) teacher. Special attention was given to the forms of induction assistance Janet was exposed to during her first two years at Liberty Middle School. Data were collected through seven interviews with Janet and…

  3. Comparing State Mandated Test Scores for Students in Programs with and without Fine Arts in the Curriculum

    ERIC Educational Resources Information Center

    Garcia, Cynthia; Jones, Don; Isaacson, Carrie

    2015-01-01

    As a result of the No Child Left Behind Act (NCLB) of 2001, many school districts have reduced instructional time for the arts in order to focus on reading and mathematics. Accordingly, fine arts programs across the nation have become subject to budget cuts or elimination in order to meet federal accountability measures. Hit especially hard are…

  4. Comparing State Mandated Test Scores for Students in Programs with and without Fine Arts in the Curriculum

    ERIC Educational Resources Information Center

    Garcia, Cynthia M.

    2010-01-01

    As a result of the No Child Left Behind Act (NCLB) of 2001, many school districts have reduced instructional time for the arts in order to focus on reading and mathematics. Accordingly, fine arts programs across the nation have become subject to budget cuts or elimination in order to meet federal accountability measures. Hit especially hard are…

  5. Attorney work product privilege trumps mandated child abuse reporting law: The case of Elijah W. v. Superior Court.

    PubMed

    Lareau, Craig R

    2015-01-01

    Forensic psychologists and psychiatrists are licensed in their respective professions, but they perform most of their work with attorneys in the legal arena. Both attorneys and mental health professionals place high value on confidentiality of information, reflected in the ethics of their professions and codified into laws governing their work. In psychology and psychiatry, there are some well-known exceptions to confidentiality; two primary exceptions include the mandated reporting of suspected child abuse and various "Tarasoff" duty to warn or protect laws. Generally, however, the corresponding duty for attorneys to report suspected child abuse or to warn or protect intended victims of threatened harm is not as extensive. This difference in mandated reporting responsibilities can create significant difficulties when attorneys need to retain forensic psychologists and psychiatrists to evaluate their clients, especially in criminal contexts. If the retained psychologist or psychiatrist is required to report suspected abuse or threatened harm, the attorney may be harming his or her client's legal interests by using the forensic psychologist or psychiatrist to evaluate his or her client. This article will briefly review the development of mandated reporting laws for psychologists and psychiatrists and juxtapose those with the legal and ethical requirements of confidentiality for attorneys embodied in the attorney-client privilege and attorney work product privilege. The article will then discuss the California Court of Appeals case in Elijah W. v. Superior Court, where the court addressed the issue of whether retained mental health professionals must report suspected child abuse and threatened harm to others as required by law or if they do not need to report because they come under the umbrella of the attorney work product privilege. This California court ultimately concluded that retained psychologists and psychiatrists work under the attorney work product

  6. Grounded Theory of Barriers and Facilitators to Mandated Implementation of Mental Health Care in the Primary Care Setting

    PubMed Central

    Benzer, Justin K.; Beehler, Sarah; Miller, Christopher; Burgess, James F.; Sullivan, Jennifer L.; Mohr, David C.; Meterko, Mark; Cramer, Irene E.

    2012-01-01

    Objective. There is limited theory regarding the real-world implementation of mental health care in the primary care setting: a type of organizational coordination intervention. The purpose of this study was to develop a theory to conceptualize the potential causes of barriers and facilitators to how local sites responded to this mandated intervention to achieve coordinated mental health care. Methods. Data from 65 primary care and mental health staff interviews across 16 sites were analyzed to identify how coordination was perceived one year after an organizational mandate to provide integrated mental health care in the primary care setting. Results. Standardized referral procedures and communication practices between primary care and mental health were influenced by the organizational factors of resources, training, and work design, as well as provider-experienced organizational boundaries between primary care and mental health, time pressures, and staff participation. Organizational factors and provider experiences were in turn influenced by leadership. Conclusions. Our emergent theory describes how leadership, organizational factors, and provider experiences affect the implementation of a mandated mental health coordination intervention. This framework provides a nuanced understanding of the potential barriers and facilitators to implementing interventions designed to improve coordination between professional groups. PMID:22900158

  7. Optimal Mandates and The Welfare Cost of Asymmetric Information: Evidence from The U.K. Annuity Market*

    PubMed Central

    Einav, Liran; Finkelstein, Amy; Schrimpf, Paul

    2009-01-01

    Much of the extensive empirical literature on insurance markets has focused on whether adverse selection can be detected. Once detected, however, there has been little attempt to quantify its welfare cost, or to assess whether and what potential government interventions may reduce these costs. To do so, we develop a model of annuity contract choice and estimate it using data from the U.K. annuity market. The model allows for private information about mortality risk as well as heterogeneity in preferences over different contract options. We focus on the choice of length of guarantee among individuals who are required to buy annuities. The results suggest that asymmetric information along the guarantee margin reduces welfare relative to a first best symmetric information benchmark by about £127 million per year, or about 2 percent of annuitized wealth. We also find that by requiring that individuals choose the longest guarantee period allowed, mandates could achieve the first-best allocation. However, we estimate that other mandated guarantee lengths would have detrimental effects on welfare. Since determining the optimal mandate is empirically difficult, our findings suggest that achieving welfare gains through mandatory social insurance may be harder in practice than simple theory may suggest. PMID:20592943

  8. State Regulations for School Nursing Practice

    ERIC Educational Resources Information Center

    Praeger, Susan; Zimmerman, Barbara

    2009-01-01

    The purpose of this article is to present a state-by-state summary of rules and regulations governing school nursing practice in the United States. Official government and agency sites were reviewed to determine providers of services in schools, criteria for becoming a school nurse, protection of titling, mandates for school nursing, and the…

  9. I strong administrative buy-in, firm mandates can push flu vaccination rates up to more than 99% among health care workers.

    PubMed

    2014-11-01

    While flu vaccination rates are inching up among health care workers, there is still room for improvement. The Centers for Disease Control and Prevention reports that slightly more than 75% of health care workers received the flu vaccination during the 2013-14 season--an increase of roughly 3% over the 2012-13 season. However, some hospitals have been able to achieve vaccination rates in excess of 99%. The apparent key to these efforts is a firm mandate that all personnel receive a flu shot as a condition of employment. There is always pushback to such policies, but hospitals report that most personnel eventually come around. While flu vaccination rates are on the increase among health, care personnel, data from the Centers for Medicare and Medicaid Services (CMS) note that rates vary widely from state to state. For example, the vaccination rate for health care workers in New Jersey stood at just 62% last year. In contrast, more than 95% of health care workers in Maryland received the shot during the 2013-14 flu season. Both Loyola University Medical Center and Henry Ford Hospital have been able to boost flu vaccination rates among their health care workers to more than 99% with the implementation of policies that require flu shots as a condition of employment. Experts say successful flu vaccination campaigns require strong administration buy-in and physician leadership.

  10. Using Mandated Speed Limits to Measure the Value of a Statistical Life

    ERIC Educational Resources Information Center

    Ashenfelter, Orley; Greenstone, Michael

    2004-01-01

    In 1987 the federal government permitted states to raise the speed limit on their rural interstate roads, but not on their urban interstate roads, from 55 mph to 65 mph. Since the states that adopted the higher speed limit must have valued the travel hours they saved more than the fatalities incurred, this institutional change provides an…

  11. Florida's Mandated Educational Leadership Program Redesign: The William Cecil Golden Touch

    ERIC Educational Resources Information Center

    Mountford, Meredith; Acker-Hocevar, Michele A.

    2013-01-01

    In 2007, educational leadership programs in Florida were notified by Florida's Department of Education of a law requiring all programs to align with new legislation, State Rule 6A-5.081. Previously, most state-approved preparation programs were based on Florida's Leadership Preparation Standards, a version of the 1996 Interstate School…

  12. Mandated College Students’ Response to Sequentially-Administered Alcohol Interventions in a Randomized Clinical Trial Using Stepped Care

    PubMed Central

    Borsari, Brian; Magill, Molly; Mastroleo, Nadine R.; Hustad, John T.P.; Tevyaw, Tracy O’Leary; Barnett, Nancy P.; Kahler, Christopher W.; Eaton, Erica; Monti, Peter M.

    2015-01-01

    Objective Students referred to school administration for alcohol policies violations currently receive a wide variety of interventions. This study examined predictors of response to two interventions delivered to mandated college students (N = 598) using a stepped care approach incorporating a peer-delivered 15-minute BA session (BA; Step 1) and a 60–90 minute brief motivational intervention delivered by trained interventionists (BMI; Step 2). Method Analyses were completed in two stages. First, three types of variables (screening variables, alcohol-related cognitions, mandated student profile) were examined in a logistic regression model as putative predictors of lower-risk drinking (defined as 3 or fewer heavy episodic drinking [HED] episodes and/or 4 or fewer alcohol-related consequences in the past month) six weeks following the BA session. Second, we used generalized estimating equations to examine putative moderators of BMI effects on HED and peak blood alcohol content (pBAC) compared to assessment-only control (AO) over the 3, 6, and 9 month follow-ups. Results Participants reporting lower scores on the Alcohol Use Disorders Identification Test (AUDIT), more benefits to changing alcohol use, and those who fit the ‘Bad Incident’ profile at baseline were more likely to report lower risk drinking 6 weeks after the BA session. Moderation analyses revealed that ‘Bad Incident’ students who received the BMI reported more HED at 9-month follow up than those who received AO. Conclusion Current alcohol use as well as personal reaction to the referral event may have clinical utility in identifying which mandated students benefit from treatments of varying content and intensity. PMID:26460571

  13. Paying for the Orphan Drug System: break or bend? Is it time for a new evaluation system for payers in Europe to take account of new rare disease treatments?

    PubMed

    Hughes-Wilson, Wills; Palma, Ana; Schuurman, Ad; Simoens, Steven

    2012-01-01

    higher price-points claimed by orphan drugs are unlikely to meet current cost-effectiveness thresholds. The authors propose the development of a new assessment system based on several evaluation criteria, which would serve as a tool for Member State governments to evaluate each new orphan drug at the time of pricing and reimbursement. These should include rarity, disease severity, the availability of other alternatives (level of unmet medical need), the level of impact on the condition that the new treatment offers, whether the product can be used in one or more indications, the level of research undertaken by the developer, together with other factors, such as manufacturing complexity and follow-up measures required by regulatory or other authorities. This will allow governments to value an orphan drug that fulfilled all the criteria very differently from one that only met some of them. An individual country could determine the (monetary) value that it places on each of the different criteria, according to societal preferences, the national healthcare system and the resources at its disposal - each individual government deciding on the weighting attributed to each of the criteria in question, based on what each individual society values most. Such a systematic and transparent system will help frame a more structured dialogue between manufacturers and payers, with the involvement of the treating physicians and the patients; and foster a more certain environment to stimulate continued investment in the field. A new approach could also offer pricing and reimbursement decision-makers a tool to handle the different characteristics amongst new orphan drugs and to redistribute the national budgets in accordance with the outcome of a differentiated assessment. The authors believe that this could, therefore, facilitate the approach for all stakeholders. PMID:23013790

  14. Paying for the Orphan Drug System: break or bend? Is it time for a new evaluation system for payers in Europe to take account of new rare disease treatments?

    PubMed Central

    2012-01-01

    that the higher price-points claimed by orphan drugs are unlikely to meet current cost-effectiveness thresholds. The authors propose the development of a new assessment system based on several evaluation criteria, which would serve as a tool for Member State governments to evaluate each new orphan drug at the time of pricing and reimbursement. These should include rarity, disease severity, the availability of other alternatives (level of unmet medical need), the level of impact on the condition that the new treatment offers, whether the product can be used in one or more indications, the level of research undertaken by the developer, together with other factors, such as manufacturing complexity and follow-up measures required by regulatory or other authorities. This will allow governments to value an orphan drug that fulfilled all the criteria very differently from one that only met some of them. An individual country could determine the (monetary) value that it places on each of the different criteria, according to societal preferences, the national healthcare system and the resources at its disposal – each individual government deciding on the weighting attributed to each of the criteria in question, based on what each individual society values most. Such a systematic and transparent system will help frame a more structured dialogue between manufacturers and payers, with the involvement of the treating physicians and the patients; and foster a more certain environment to stimulate continued investment in the field. A new approach could also offer pricing and reimbursement decision-makers a tool to handle the different characteristics amongst new orphan drugs and to redistribute the national budgets in accordance with the outcome of a differentiated assessment. The authors believe that this could, therefore, facilitate the approach for all stakeholders. PMID:23013790

  15. Healthcare workers under a mandated H1N1 vaccination policy with employment termination penalty: a survey to assess employee perception.

    PubMed

    Winston, Lori; Wagner, Stephanie; Chan, Shu

    2014-08-20

    The ethical debate over mandatory healthcare worker (HCW) influenza vaccination is a heated one. Our study hospital instituted a mandatory employee influenza vaccination policy for the 2009-2010 influenza season during the highly publicized pandemic of the H1N1 "Swine Flu." Under this mandate there was no informed declination option, and termination of employment was the consequence for noncompliance. Our objective was to examine HCW perceptions of the H1N1 influenza virus, the vaccine, and the strict mandated vaccination policy. A survey was designed, distributed, and anonymously collected. In total, 202 completed questionnaires were obtained via accidental sampling by the investigators achieving a 100% response rate. Data analysis showed that 31.7% of surveyed HCWs felt the mandate was an infringement on their rights and 3.5% of HCWs would electively seek employment elsewhere. Significantly more nurses and clerks/technicians were opposed to the mandate compared to other types of employees. 96% felt that the mandating hospital should be liable should a significant adverse effect occur from receiving the vaccine. While the mandate helped to increase HCW influenza vaccination rates dramatically, the strict consequence of employment termination created negative feelings of coercion. Adopting a policy that includes a declination option with mandatory masking during influenza season might be a more widely acceptable and still adequate approach.

  16. The dynamic model on the impact of biodiesel blend mandate (B5) on Malaysian palm oil domestic demand: A preliminary finding

    NASA Astrophysics Data System (ADS)

    Abidin, Norhaslinda Zainal; Applanaidu, Shri-Dewi; Sapiri, Hasimah

    2014-12-01

    Over the last ten years, world biofuels production has increased dramatically. The biodiesel demand is driven by the increases in fossil fuel prices, government policy mandates, income from gross domestic product and population growth. In the European Union, biofuel consumption is mostly driven by blending mandates in both France and Germany. In the case of Malaysia, biodiesel has started to be exported since 2006. The B5 of 5% blend of palm oil based biodiesel into diesel in all government vehicles was implemented in February 2009 and it is expected to be implemented nationwide in the nearest time. How will the blend mandate will project growth in the domestic demand of palm oil in Malaysia? To analyze this issue, a system dynamics model was constructed to evaluate the impact of blend mandate implementation on the palm oil domestic demand influence. The base run of simulation analysis indicates that the trend of domestic demand will increase until 2030 in parallel with the implementation of 5 percent of biodiesel mandate. Finally, this study depicts that system dynamics is a useful tool to gain insight and to experiment with the impact of changes in blend mandate implementation on the future growth of Malaysian palm oil domestic demand sector.

  17. Twentieth anniversary of the European Union health mandate: taking stock of perceived achievements, failures and missed opportunities – a qualitative study

    PubMed Central

    2013-01-01

    responsibilities defined in the EU health mandate, one can identify that these responsibilities were only partly fulfilled or acknowledged by the respondents. In general, the EU is a recognized public health player in Europe which over the past two decades, has begun to develop competencies in supporting, coordinating and supplementing member state health actions. However, the assurance of health protection in other European policies seems to require further development. PMID:24225055

  18. State Plans for Implementing Programs of Study

    ERIC Educational Resources Information Center

    Lewis, Morgan V.; Overman, Laura

    2008-01-01

    This article examines how the states plan to implement the Programs of Study (POS) that were mandated by the 2006 reauthorization of the federal legislation for career and technical education. A coding system was developed for summarizing the methods described in the plans of all 50 states, the District of Columbia, Guam, and the Virgin Islands.…

  19. States as Change Agents under ESSA

    ERIC Educational Resources Information Center

    Weiss, Joanne; McGuinn, Patrick

    2016-01-01

    Under the Every Student Succeeds Act (ESSA), federal education mandates will be decreasing, which means states will have more flexibility and authority than they've had in decades. State education agency (SEA) leaders are confronting great change and great opportunity as many agencies move away from a focus on compliance with federal regulations,…

  20. Washington State Board of Education Strategic Plan, 2010-2011

    ERIC Educational Resources Information Center

    Washington State Board of Education, 2011

    2011-01-01

    In 2005, the Washington State Legislature significantly changed the role of the State Board of Education (SBE). While the Board retains some administrative duties, SBE is now mandated to play a broad leadership role in strategic oversight and policy for K-12 education in the state. This paper presents the strategic plan of Washington State Board…

  1. CMS's proposed rule implementing the ACA-mandated Medicaid DSH reductions.

    PubMed

    Linehan, Kathryn

    2013-06-25

    State Medicaid programs make Medicaid disproportionate share hospital (DSH) payments to hospitals to help offset costs of uncompensated care for Medicaid and uninsured patients. Unlike most Medicaid spending, annual DSH allotments for each state are capped. Under the Patient Protection and Affordable Care Act of 2010 (ACA), DSH payments will decrease starting in fiscal year (FY) 2014 and continuing through FY 2020. This paper describes the proposed rule for reducing these federal allotments, which was released on May 15, 2013, by the Centers for Medicare & Medicaid Services (CMS). Comments on the proposed rule are due July 12, 2013. PMID:23882724

  2. What Makes Group MET Work? A Randomized Controlled Trial of College Student Drinkers in Mandated Alcohol Diversion

    PubMed Central

    LaChance, Heather; Feldstein Ewing, Sarah W.; Bryan, Angela D.; Hutchison, Kent E.

    2009-01-01

    Nationally, college drinkers exhibit the highest rates of alcohol consumption and represent the largest percentage of problem drinkers. Group motivational enhancement therapy (GMET) has been found to catalyze problem drinking reductions among college student samples. While research supporting the use of single-session GMET in college samples (general and mandated) is emergent, no studies have evaluated a comprehensive model of the potential active ingredients of this group intervention. College students (N = 206; 88% Caucasian; 63% male; M age = 18.6) mandated to a university alcohol diversion program were randomly assigned to one of three conditions: the standard-of-care two-session ‘Focus on Alcohol Concerns’ education group (FAC), a single group motivational enhancement therapy (GMET), or a single Alcohol Information-only control group (AI) to evaluate the role of five putative mediators: readiness to change, self-efficacy, perceived risk, norm estimates, and positive drinking expectancies. At three and six month follow-ups, GMET students demonstrated greater reductions in problem drinking outcomes (drinks per drinking day, hazardous drinking symptoms, and alcohol-related problems). Of the five mediators proposed, only self-efficacy emerged as a significant mediator. PMID:20025366

  3. Which strengths-based practice? Reconciling strengths-based practice and mandated authority in child protection work.

    PubMed

    Oliver, Carolyn; Charles, Grant

    2015-04-01

    The recent application of strengths-based practice in child protection settings has been accompanied by evidence of inconsistent implementation and concerns that the approach is incompatible with statutory work. Few studies have moved beyond asking whether child protection workers are implementing strengths-based practice to explore why the approach is enacted as it is. This article describes a mixed methods study using an online survey and interviews to elicit from 225 statutory child protection workers in a large Canadian agency how they applied strengths-based ideas and why they did what they did. The authors found that although strengths-based practice was popular, 70 percent of participants believed that it was not always applicable to child protection work. Participants described five distinct versions of the approach, only one of which was fully congruent with their mandated role. The study suggests that the common conflation of strengths-based and solution-focused approaches ignores important differences in the conceptualization of practitioner authority and leaves practitioners attempting to implement versions ofstrengths-based practice that do not fit statutory child protection work. Only when practitioners choose solution-focused models that support their use of mandated authority is consistent implementation a reasonable expectation.

  4. What makes group MET work? A randomized controlled trial of college student drinkers in mandated alcohol diversion.

    PubMed

    LaChance, Heather; Feldstein Ewing, Sarah W; Bryan, Angela D; Hutchison, Kent E

    2009-12-01

    Nationally, college drinkers exhibit the highest rates of alcohol consumption and represent the largest percentage of problem drinkers. Group motivational enhancement therapy (GMET) has been found to catalyze problem drinking reductions among college student samples. Although research supporting the use of single-session GMET in college samples (general and mandated) is emergent, no studies have evaluated a comprehensive model of the potential active ingredients of this group intervention. College students (N = 206; 88% White; 63% men; M age = 18.6) mandated to a university alcohol diversion program were randomly assigned to 1 of 3 conditions: the standard-of-care 2-session "Focus on Alcohol Concerns" education group (FAC), a single GMET, or a single alcohol information-only control group (AI) to evaluate the role of 5 putative mediators: readiness to change, self-efficacy, perceived risk, norm estimates, and positive drinking expectancies. At 3- and 6-month follow-ups, GMET students demonstrated greater reductions in problem drinking outcomes (drinks per drinking day, hazardous drinking symptoms, and alcohol-related problems). Of the 5 mediators proposed, only self-efficacy emerged as a significant mediator.

  5. Do brief personalized feedback interventions work for mandated students or is it just getting caught that works?

    PubMed

    White, Helene Raskin; Mun, Eun Young; Morgan, Thomas J

    2008-03-01

    Studies evaluating the efficacy of brief interventions with mandated college students have reported declines in drinking from baseline to short-term follow-up regardless of intervention condition. A key question is whether these observed changes are due to the intervention or to the incident and/or reprimand. This study evaluates a brief personalized feedback intervention (PFI) for students (N = 230) who were referred to a student assistance program because of infractions of university rules regarding substance use to determine whether observed changes in substance use are attributable to the intervention. Half the students received immediate feedback (at baseline and after the 2-month follow-up), and half received delayed feedback (only after the 2-month follow-up). Students in both conditions generally reduced their drinking and alcohol-related problems from baseline to the 2-month follow-up and from the 2-month to the 7-month follow-up; however, there were no significant between-group differences at either follow-up. Therefore, it appears that the incident and/or reprimand are important instigators of mandated student change and that written PFIs do not enhance these effects on a short-term basis but may on a longer term basis.

  6. Making the Case for Primary Care and Mandated Suicide Prevention Education

    ERIC Educational Resources Information Center

    Stuber, Jennifer; Quinnett, Paul

    2013-01-01

    During its 2012 legislative session, Washington State passed ESHB 2366, otherwise known as the Matt Adler Suicide Assessment, Treatment, and Management Act of 2012. ESHB 2366 is a significant legislative achievement as it is the first law in the country to require certain health professionals to obtain continuing education in the assessment,…

  7. The Administrative Aspects of P.L. 94-142: Dealing with Federal Mandates and Compliances.

    ERIC Educational Resources Information Center

    Abbruzzese, John A., Jr.

    Although Pennsylvania has long made programming for all handicapped children mandatory, the passage of P.L. 94-142 has necessitated some changes even in this state. The major hurdle in the implementation of such a law is confusion and misinterpretation. Educators fear that the handicapped may be dumped into regular classes in an arbitrary manner.…

  8. From Policy to Practice: Parent Perceptions of the 2010 Federal School Lunch Mandate

    ERIC Educational Resources Information Center

    Golembiewski, Elizabeth H.; Askelson, Natoshia M.; Elchert, Daniel M.; Leicht, Erika A.; Scheidel, Carrie A.; Delger, Patti J.

    2015-01-01

    Purpose/Objectives: The purpose of this study was to investigate parent awareness and perceptions of changes to the National School Lunch Program (NSLP) implemented as a result of the Healthy, Hunger-Free Kids Act (HHKA) of 2010. Methods: An online survey of parents of school age (K-12) children in a Midwestern state was conducted (n = 2,189). The…

  9. Education Reform: Federal Initiatives and National Mandates, 1963-1993. Occasional Paper 1993-3.

    ERIC Educational Resources Information Center

    Levitan, Sar A.; Gallo, Frank

    The federal government initiated educational reform measures in the United States long before the subject became a matter of national concern. In recent decades, reform has focused on helping children whose special needs were neglected by the school system. Evidence shows that these efforts have improved services to neglected groups, but without…

  10. Puppets and Puppeteers: External Mandates and the Instructional Practice of Two First-Year Teachers

    ERIC Educational Resources Information Center

    Bengtson, Ed; Connors, Sean P.

    2014-01-01

    This longitudinal study examined how the approach leaders in two schools took to implementing the Common Core State Standards shaped the way that two first-year teachers constructed meaning related to being a teacher. Instructional leadership constructs and threat rigidity theory were used to analyze qualitative data gathered over a nine-month…

  11. Constitutional Mandate for Free and Compulsory Education: New Light on the Intention of the "Founding Fathers"

    ERIC Educational Resources Information Center

    Juneja, Nalini

    2015-01-01

    The original constitutional provision for free and compulsory education, granted under Article 45 stated that it was to be available for "all children until they complete the age of fourteen years", but it did not specify the lower age limit nor the stage of education (whether elementary or primary) that would be free and compulsory.…

  12. Internal Evaluation in American Public School Districts: The Importance of Externally Driven Accountability Mandates

    ERIC Educational Resources Information Center

    King, Jean A.; Rohmer-Hirt, Johnna A.

    2011-01-01

    From the 1980s to the present, educational accountability in the United States has grown dramatically. Such accountability in U.S. school districts, although driven primarily by external demands, has internal manifestations as well. The chapter traces the historical development of internal evaluation in American school districts, then highlights…

  13. Mandating responsible flagging practices as a strategy for reducing the risk of coastal oil spills.

    PubMed

    Miller, Dana D; Hotte, Ngaio; Sumaila, U Rashid

    2014-04-15

    As human civilization is becoming more aware of the negative impact our actions can inflict upon the natural world, the intensification of fossil fuel extraction and industrial development is being met with increasing opposition. In Western Canada, proposals that would increase the volume of petroleum transported by pipelines and by tankers through the coastal waters of British Columbia have engaged the province in debate. To ease public concern on the risk of a coastal oil spill, there are additional commitments that involved parties could make. There is evidence to show that the practice of registering vessels under foreign flags of states that have exhibited failure in compliance with international obligations is more common amongst petroleum tankers that have been involved in large-scale oil spills. To prove that they are committed to reducing the risk of oil spills, businesses need to stop registering their vessels under flags of foreign, non-compliant states.

  14. Conflicted Identification in the Sex Education Classroom: Balancing Professional Values With Organizational Mandates.

    PubMed

    Williams, Elizabeth A; Jensen, Robin E

    2016-09-01

    Despite enormous resources spent on sex education, the United States faces an epidemic of unplanned pregnancy and sexually transmitted infections among young people. Little research has examined the role sex educators play in alleviating or exacerbating this problem. In this study, we interviewed 50 sex educators employed by public schools throughout a Midwestern, U.S. state about their experiences in the sex education classroom. Twenty-two interviewees communicated feelings of conflicted identification and provided examples of the ways in which they experienced this subjectivity in the context of their employment. We find these interviews shed light on the as-yet-understudied communicative experience of conflicted identification by delineating key sources of such conflict and discursive strategies used in its negotiation. Our results suggest that those who experience conflicted identification and who have a sense of multiple or nested identifications within their overarching professional identity may be safeguarded to some extent from eventual organizational disidentification.

  15. Biosafety, biosecurity and internationally mandated regulatory regimes: compliance mechanisms for education and global health security

    PubMed Central

    Sture, Judi; Whitby, Simon; Perkins, Dana

    2015-01-01

    This paper highlights the biosafety and biosecurity training obligations that three international regulatory regimes place upon states parties. The duty to report upon the existence of such provisions as evidence of compliance is discussed in relation to each regime. We argue that such mechanisms can be regarded as building blocks for the development and delivery of complementary biosafety and biosecurity teaching and training materials. We show that such building blocks represent foundations upon which life and associated scientists – through greater awareness of biosecurity concerns – can better fulfil their responsibilities to guard their work from misuse in the future. PMID:24494580

  16. Collaborations between the State and Local Colleges: Sleeping with the Enemy?

    ERIC Educational Resources Information Center

    Brand, Elizabeth Cox

    2014-01-01

    This chapter describes the characteristics of successful partnerships between a state-level department and local community colleges. Particular focus is paid to the lack of mandated collaboration between the entities and the elements necessary for motivation and sustainability.

  17. Enhancing user acceptance of mandated mobile health information systems: the ePOC (electronic point-of-care project) experience.

    PubMed

    Burgess, Lois; Sargent, Jason

    2007-01-01

    From a clinical perspective, the use of mobile technologies, such as Personal Digital Assistants (PDAs) within hospital environments is not new. A paradigm shift however is underway towards the acceptance and utility of these systems within mobile-based healthcare environments. Introducing new technologies and associated work practices has intrinsic risks which must be addressed. This paper contends that intervening to address user concerns as they arise throughout the system development lifecycle will lead to greater levels of user acceptance, while ultimately enhancing the deliverability of a system that provides a best fit with end user needs. It is envisaged this research will lead to the development of a formalised user acceptance framework based on an agile approach to user acceptance measurement. The results of an ongoing study of user perceptions towards a mandated electronic point-of-care information system in the Northern Illawarra Ambulatory Care Team (TACT) are presented. PMID:17911883

  18. Mandate a Man to Fish?: Technological advance in cooling systems at U.S. thermal electric plants

    NASA Astrophysics Data System (ADS)

    Peredo-Alvarez, Victor M.; Bellas, Allen S.; Trainor-Guitton, Whitney J.; Lange, Ian

    2016-02-01

    Steam-based electrical generating plants use large quantities of water for cooling. The potential environmental impacts of water cooling systems have resulted in their inclusion in the Clean Water Act's (CWA) Sections 316(a), related to thermal discharges and 316(b), related to cooling water intake. The CWA mandates a technological standard for water cooling systems. This analysis examines how the performance-adjusted rates of thermal emissions and water withdrawals for cooling units have changed over their vintage and how these rates of change were impacted by imposition of the CWA. Results show that the rate of progress increased for cooling systems installed after the CWA whilethere was no progress previous to it.

  19. Six Stories about Six States: Programs of Study

    ERIC Educational Resources Information Center

    Shumer, Rob; Digby, Cynthia

    2011-01-01

    The purpose of this investigation is to tell the story of how six states are developing Programs of Study (POS) as mandated by the Perkins IV federal legislation. The authors' effort focuses on how states' technical assistance systems evolved and what successes and challenges existed for states developing POS. There was no intent to compare one…

  20. An Analysis of Bullying Legislation among the Various States

    ERIC Educational Resources Information Center

    Hallford, Abby Jane Swanson

    2009-01-01

    Scope and method of study. The purpose of this study is to understand the existing state legislation concerning bullying in schools to determine whether the development, structure, and content of these state mandates parallel any change in reported incidents of bullying by public schools in each of those states. This is a descriptive and…

  1. AZ State Profile. Arizona: Arizona's Instrument to Measure Standards (AIMS)

    ERIC Educational Resources Information Center

    Center on Education Policy, 2010

    2010-01-01

    This paper provides information about the Arizona's Instrument to Measure Standards (AIMS). The purpose of the test is to determine prospective high school graduates' mastery of the state curriculum and to meet a state mandate. [For the main report, "State High School Tests: Exit Exams and Other Assessments", see ED514155.

  2. Diazinon in surface waters before and after a federally-mandated ban.

    PubMed

    Banks, Kenneth E; Hunter, David H; Wachal, David J

    2005-11-01

    Samples collected from rural and urban streams in the City of Denton, Texas, USA were analyzed for the organophosphorus pesticide diazinon during the years preceding and following a United States Environmental Protection Agency ban on many diazinon uses. A network of 70 monitoring stations, based mainly on topography and hydrological considerations, were established within the three main watersheds of Denton. Monitoring stations were sampled monthly from March through August during periods of normal flow (baseflow), resulting in a total of 1243 samples collected during the years of 2001-2004. Pesticide concentrations were determined using commercially available enzyme-linked immunosorbent assays (ELISAs) specific for diazinon. Results from this temporally and spatially dense monitoring effort illustrated the impacts of a decrease in diazinon production during 2002, followed by a ban on most outdoor, non-agricultural diazinon retail sales imposed during 2003. The total number of samples exhibiting diazinon concentrations above the lower limits of detection (LLD) significantly decreased between 2001 through 2004 (Mantel-Haenszel Chi-Square test, p<0.0001, n=1243) and decreased significantly during the four monitoring years (Cochran-Armitage Trend test, z=-17.94, p<0.0001, n=1243). The total number of stations exhibiting at least one sample above the LLD during the four monitoring years showed similar patterns (Mantel-Haenszel Chi-Square test, p<0.0001; Cochran-Armitage Trend test, z=-3.21, p=0.0007; n=276). Results indicate that the phased reduction of outdoor, non-agricultural diazinon uses led to a highly significant decrease in surface water occurrences of this pesticide.

  3. Midwest U.S. landscape change to 2020 driven by biofuel mandates.

    PubMed

    Mehaffey, Megan; Smith, Elizabeth; Van Remortel, Rick

    2012-01-01

    Meeting future biofuel targets set by the 2007 Energy Independence and Security Act (EISA) will require a substantial increase in production of corn. The Midwest, which has the highest overall crop production capacity, is likely to bear the brunt of the biofuel-driven changes. In this paper, we set forth a method for developing a possible future landscape and evaluate changes in practices and production between base year (BY) 2001 and biofuel target (BT) 2020. In our BT 2020 Midwest landscape, a total of 25 million acres (1 acre = 0.40 ha) of farmland was converted from rotational cropping to continuous corn. Several states across the Midwest had watersheds where continuous corn planting increased by more than 50%. The output from the Center for Agriculture and Rural Development (CARD) econometric model predicted that corn grain production would double. In our study we were able to get within 2% of this expected corn production. The greatest increases in corn production were in the Corn Belt as a result of conversion to continuous corn planting. In addition to changes to cropping practices as a result of biofuel initiatives we also found that urban growth would result in a loss of over 7 million acres of productive farmland by 2020. We demonstrate a method which successfully combines economic model output with gridded land cover data to create a spatially explicit detailed classification of the landscape across the Midwest. Understanding where changes are likely to take place on the landscape will enable the evaluation of trade-offs between economic benefits and ecosystem services allowing proactive conservation and sustainable production for human well-being into the future. PMID:22471072

  4. State Energy Efficiency Program Evaluation Inventory

    EIA Publications

    2013-01-01

    The focus of this inventory, some of which has been placed into a searchable spreadsheet, is to support the National Energy Modeling System (NEMS) and to research cost information in state-mandated energy efficiency program evaluations – e.g., for use in updating analytic and modeling assumptions used by the U.S. Energy Information Administration (EIA).

  5. Florida: State of the Foreign Language Arts.

    ERIC Educational Resources Information Center

    Valdes, Gabriel M.

    In Florida, foreign language teaching has consistently followed national trends. Currently, there is a renaissance in language study. Enrollment has increased dramatically at all educational levels, due to a mandated state university system entrance requirement and two programs, the Florida Academic Scholars Program and Foreign Languages in the…

  6. State Teacher Evaluation and Teacher Education

    ERIC Educational Resources Information Center

    Marchant, Gregory J.; David, Kristine A.; Rodgers, Deborah; German, Rachel L.

    2015-01-01

    Current accountability trends suggest an increasing role in state mandates regarding teacher evaluation. With various evaluation models and components serving as the basis for quality teaching, teacher education programs need to recognize the role teacher evaluation plays and incorporate aspects where appropriate. This article makes that case and…

  7. Special Report on the Impact of the Change in the Definition of Developmental Disabilities (Mandated in P.L. 95-602, Sec. 502(b) (2)).

    ERIC Educational Resources Information Center

    Office of Human Development Services (DHHS), Washington, DC.

    The report analyzes the impact of the change from a categorical definition of developmental disabilities to one which emphasizes functional limitations and the accompanying need for services as mandated by the 1978 Developmental Disabilities Assistance and Bill of Rights Act (P.L. 95-602, Section 502). Part I is an introduction with sections on…

  8. Separating Wheat from Chaff: How Secondary School Principals' Core Values and Beliefs Influence Decision-Making Related to Mandates

    ERIC Educational Resources Information Center

    Larsen, Donald E.; Hunter, Joseph E.

    2014-01-01

    Research conducted by Larsen and Hunter (2013, February) identified a clear pattern in secondary school principals' decision-making related to mandated change: more than half of participants' decisions were based on core values and beliefs, requiring value judgments. Analysis of themes revealed that more than half of administrative…

  9. Examining Mandated Testing, Teachers' Milieu, "and" Teachers' Knowledge and Beliefs: Gaining a Fuller Understanding of the Web of Influence on Teachers' Classroom Practices

    ERIC Educational Resources Information Center

    Neumann, Jacob W.

    2016-01-01

    Background: Much research has been done on the factors that influence teachers' work. Yet, the nature and scope of those factors, and their impact on teachers, remain unclear. Indeed, different literature bases on teachers' work present different and often contradictory conclusions. For example, some researchers claim that mandated accountability…

  10. Portraiture of Cultural Responsive Leadership in Title 1 School Principals Implementing Mandates of No Child Left Behind Act within the Context of Parent Involvement

    ERIC Educational Resources Information Center

    Conley, Loraine

    2012-01-01

    The signing of the No Child Left Behind Act in 2001 created a need for Title 1 principals to conceptualize and operationalize parent engagement. This study examines how three urban principals in Arizona implemented the mandates of the Act as it pertains to parent involvement. The purpose of this qualitative case study is to examine how principals…

  11. The Impact of a Universal Class-Size Reduction Policy: Evidence from Florida's Statewide Mandate. Program on Education Policy and Governance Working Papers Series. PEPG 10-03

    ERIC Educational Resources Information Center

    Chingos, Matthew M.

    2010-01-01

    Class-size reduction (CSR) mandates presuppose that resources provided to reduce class size will have a larger impact on student outcomes than resources that districts can spend as they see fit. I estimate the impact of Florida's statewide CSR policy by comparing the deviations from prior achievement trends in districts that were required to…

  12. Prescribing Proficiency: The Intersection of Teacher, Students and a Mandated Reading Program in One Elementary School Classroom in the Climate of High-Stakes Testing

    ERIC Educational Resources Information Center

    Bien, Andrea Caroline

    2013-01-01

    This dissertation addresses questions about the impact and consequences of current school reforms by examining how mandated packaged reading programs contribute to a commodification of knowledge that is changing conceptualizations of literacy, teaching, and learning. Grounded in cultural-historical theories of literacy and learning, this work…

  13. A Text Message Program as a Booster to In-Person Brief Interventions for Mandated College Students to Prevent Weekend Binge Drinking

    ERIC Educational Resources Information Center

    Suffoletto, Brian; Merrill, Jennifer E.; Chung, Tammy; Kristan, Jeffrey; Vanek, Marian; Clark, Duncan B.

    2016-01-01

    Objective: To evaluate a text message (SMS) program as a booster to an in-person alcohol intervention with mandated college students. Participants: Undergraduates (N = 224; 46% female) who violated an on-campus alcohol policy over a 2-semester period in 2014. Methods: The SMS program sent drinking-related queries each Thursday and Sunday and…

  14. Meeting the Needs of Migrant Students in Schoolwide Programs. Technical Report of the Congressionally Mandated Study of Migrant Student Participation in Schoolwide Programs.

    ERIC Educational Resources Information Center

    Siler, Amy; Stolzberg, Simeon; von Glatz, Adrienne; Strang, William

    In response to a legislative mandate, this report examines the ways in which migrant students are served in schoolwide program schools and the involvement of migrant representatives and migrant program staff in the schoolwide process. A survey was sent to a nationally representative sample (696) of the 2,770 Title I schools that implemented the…

  15. Co-Teaching: An Educational Promise for Children with Disabilities or a Quick Fix to Meet the Mandates of No Child Left Behind?

    ERIC Educational Resources Information Center

    Nichols, Joe; Dowdy, Alana; Nichols, Cindy

    2010-01-01

    As educational leaders continue to struggle with the "Highly Qualified Teacher" mandate of the No Child Left Behind (NCLB) legislation, many are turning to co-teaching models that are designed to incorporate regular education and special education teachers into the same classroom to deliver instruction. This model appears to address the issue of…

  16. Athletes' Perceptions of National Collegiate Athletic Association--Mandated Sickle Cell Trait Screening: Insight for Academic Institutions and College Health Professionals

    ERIC Educational Resources Information Center

    Lawrence, Raymona H.; Shah, Gulzar H.

    2014-01-01

    Objective: The study objective was to explore athletes' perspectives of National Collegiate Athletic Association (NCAA)--mandated sickle cell trait (SCT)--screening policy by examining race- and gender-related differences in athletes' perceptions regarding risk of having SCT and concern about loss of playing time. Participants:…

  17. Toward Understanding Suicide Among Youths: Results From the White Mountain Apache Tribally Mandated Suicide Surveillance System, 2001–2006

    PubMed Central

    Barlow, Allison; Goklish, Novalene; Larzelere-Hinton, Francene; Cwik, Mary; Craig, Mariddie; Walkup, John T.

    2009-01-01

    Objectives. We examined suicide and suicide attempt rates, patterns, and risk factors among White Mountain Apache youths (aged < 25 years) from 2001 to 2006 as the first phase of a community-based participatory research process to design and evaluate suicide prevention interventions. Methods. Apache paraprofessionals gathered data as part of a tribally mandated suicide surveillance system. We compared findings to other North American populations. Results. Between 2001 and 2006, 61% of Apache suicides occurred among youths younger than 25 years. Annual rates among those aged 15 to 24 years were highest: 128.5 per 100 000, 13 times the US all-races rate and 7 times the American Indian and Alaska Native rate. The annual suicide attempt incidence rate in this age group was 3.5%. The male-to-female ratio was 5:1 for suicide and approximately 1:1 for suicide attempts. Hanging was the most common suicide method, and third most common attempt method. The most frequently cited attempt precipitants were family or intimate partner conflict. Conclusions. An innovative tribal surveillance system identified high suicide and attempt rates and unique patterns and risk factors of suicidal behavior among Apache youths. Findings are guiding targeted suicide prevention programs. PMID:19696377

  18. State Norms for the North Carolina Testing Program. 1998 Edition.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Instruction, Raleigh. Div. of Accountability/Testing.

    This publication provides a reference for educators and others interested in conducting comparative studies relative to North Carolina tests. It includes norms, tables, and other statistical information for all state-developed tests (state-mandated and local-option tests for which baseline data are available) that were administered during the…

  19. Analyzing Sustainability Themes in State Science Standards: Two Case Studies

    ERIC Educational Resources Information Center

    Miller, Hannah K.; Jones, Linda Cronin

    2014-01-01

    Due to the interdisciplinary nature of environmental education, addressing the range of socioscientific issues included under the umbrella of sustainability can be challenging for educators working within the context of mandated state subject area standards. Two states (Washington and Vermont) have been recognized as leaders in incorporating…

  20. Constitutional Obligations for Public Education: 50-State Review

    ERIC Educational Resources Information Center

    Parker, Emily

    2016-01-01

    Within the constitution of each of the 50 states, there is language that mandates the creation of a public education system. The authority for public education falls to states because of a 1973 Supreme Court case which determined that the federal government has no responsibility to provide systems of public education. These constitutional…

  1. The State Data Analysis Gap: A Threat to Education Reform

    ERIC Educational Resources Information Center

    Sheeky, Art

    2011-01-01

    Ever since the 2001 passage of the No Child Left Behind Act (NCLB), states have faced a federal mandate to improve their ability to collect and analyze education data for the purpose of tracking and reporting the progress of their education reform efforts. With the assistance of federal funds, virtually all of the states are developing…

  2. Teacher Education Policy in the States; A 50-State Survey of Legislative and Administrative Actions.

    ERIC Educational Resources Information Center

    American Association of Colleges for Teacher Education, Washington, DC.

    This, the 15th and final survey, updates information from prior surveys on: (1) entrance requirements for teacher education programs; (2) requirements for regular licensure, including standards for an initial or advanced teaching credential; (3) professional development, covering state-sponsored or mandated programs and plans for those persons…

  3. A Randomized Evaluation of Motivational Interviewing Training for Mandated Implementation of Alcohol Screening and Brief Intervention in Trauma Centers.

    PubMed

    Darnell, Doyanne; Dunn, Christopher; Atkins, David; Ingraham, Leah; Zatzick, Douglas

    2016-01-01

    The American College of Surgeons has mandated that level I and level II trauma centers implement universal alcohol screening and brief intervention (SBI) for injured patients. This study was a secondary analysis of a national, 20-hospital, cluster-randomized implementation trial focusing on practical issues of training and supervising alcohol SBI providers in motivational interviewing (MI). The purpose of this study was to examine whether real-world trauma center providers can be trained to provide higher quality counseling using MI as part of brief interventions for alcohol and whether MI skills can be maintained over time. Sites were randomly assigned to receive a 1day workshop training in MI for alcohol SBI or not, and all providers regardless of training completed up to seven standardized patient assessments of MI fidelity over 27months. Six domains on the Motivational Interviewing Treatment Integrity (MITI) coding system were assessed and compared to proficiency criteria. Providers in the intervention training group showed substantially improved MITI scores over the course of the 27-month time period. Domains that had particularly strong improvement were MI spirit and empathy; however, despite the overall improvement in the intervention group scores, expert-derived proficiency criteria were attained only for the global scores. Routine trauma center providers who receive MI training can deliver higher quality counseling in alcohol brief interventions, but may not, however, attain previously derived proficiency standards. Future implementation efforts in real-world acute care medical settings could further elucidate provider characteristics that predict training response and also strive to demonstrate that higher quality alcohol SBI implementation is associated with improved patient-level outcomes.

  4. Mitigating the health impacts of pollution from oceangoing shipping: an assessment of low-sulfur fuel mandates.

    PubMed

    Winebrake, J J; Corbett, J J; Green, E H; Lauer, A; Eyring, V

    2009-07-01

    Concerns about health effects due to emissions from ships have magnified international policy debate regarding low-sulfur fuel mandates for marine fuel. Policy discussions center on setting sulfur content levels and the geographic specification of low-sulfur fuel use. We quantify changes in premature mortality due to emissions from ships under several sulfur emissions control scenarios. We compare a 2012 No Control scenario (assuming 2.7% or 27 000 ppm S) with three emissions control scenarios. Two control scenarios represent cases where marine fuel is limited to 0.5% S (5000 ppm) and 0.1% S (1000 ppm) content, respectively, within 200 nautical miles of coastal areas. The third control scenario represents a global limit of 0.5% S. We apply the global climate model ECHAMSSy-MESSy1-MADE to geospatial emissions inventories to determine worldwide concentrations of particular matter (PM2.5) from ocean going vessels. Using those PM2.5 concentrations in cardiopulmonary and lung cancer concentration-risk functions and population models, we estimate annual premature mortality. Without control, our central estimate is approximately 87 000 premature deaths annually in 2012. Coastal area control scenarios reduce premature deaths by approximately 33 500 for the 0.5% case and approximately 43 500 for the 0.1% case. Where fuel sulfur content is reduced globally to 0.5% S, premature deaths are reduced by approximately 41 200. These results provide important support that global health benefits are associated with low-sulfur marine fuels, and allow for relative comparison of the benefits of alternative control strategies.

  5. One-third of pregnant and lactating women may not be meeting their folate requirements from diet alone based on mandated levels of folic acid fortification.

    PubMed

    Sherwood, Kelly L; Houghton, Lisa A; Tarasuk, Valerie; O'Connor, Deborah L

    2006-11-01

    Many women are advised to consume a folic acid-containing prenatal supplement for the duration of pregnancy and lactation. Whether this remains necessary after folic acid fortification of the food supply in North America has yet to be determined. Our objective was to assess the dietary folate intake of a sample of pregnant and lactating women at mandated and predicted folic acid-fortification levels and determine the prevalence of inadequate and excessive intakes. Weighed food records (for 3 d) were collected from predominantly university-educated women (32 +/- 4 y of age) at 36 wk of pregnancy (n = 61) and at 4 and 16 wk of lactation (n = 60). Dietary folate intakes during pregnancy and lactation, assuming fortification at mandated levels (140-150 micro g/100 g), were 562 +/- 106 and 498 +/- 99 micro g/d dietary folate equivalents (DFE), respectively. The prevalence of inadequacy for folate, or the proportion of individuals with usual folate intakes less than their nutrient requirement, was 36% for women during pregnancy (estimated average requirement of 520 micro g/d DFE), and 32% during lactation (estimated average requirement of 450 micro g/d DFE). Assuming fortification at twice the mandated level, mean dietary intakes during pregnancy and lactation were 786 +/- 132 and 716 +/- 150 micro g/d DFE, respectively, producing only a 3% prevalence of folate inadequacy. Grains contributed approximately 41% of total folate intake followed by fruits and vegetables (approximately 21%). To conclude, at mandated levels of fortification many pregnant and lactating women are unlikely to meet their folate requirements from dietary sources alone; however, the actual level of inadequacy cannot be determined until the level of folic acid in the food supply is known with greater precision.

  6. Pharmacogenomic and pharmacogenetic-guided therapy as a tool in precision medicine: current state and factors impacting acceptance by stakeholders.

    PubMed

    Hess, Gregory P; Fonseca, Eileen; Scott, Rachel; Fagerness, Jesen

    2015-01-01

    Pharmacogenetic/pharmacogenomic (PGx) testing is currently available for a wide range of health problems including cardiovascular disease, cancer, diabetes, autoimmune disorders, mental health disorders and infectious diseases. PGx contributes important information to the field of precision medicine by clarifying appropriate treatments for specific disease subtypes. Tangible benefits to patients including improved outcomes and reduced total health care costs have been observed. However, PGx-guided therapy faces many barriers to full integration into clinical practice and acceptance by stakeholders, whether practitioner, patient or payer. Each stakeholder has a unique perspective on the role of PGx testing, although all are similarly challenged with demonstrating or appraising its cost-to-benefit value. Coverage by insurers is a critical step in achieving widespread adoption of PGx testing. The acceleration of adoption of precision medicine in general and for PGx testing in particular will be determined by how quickly robust evidence can be accumulated that shows a return on investment for payers in terms of real dollars, for clinicians in terms of patient clinical responses, and for patients in terms of economic, health and quality of life outcomes. Trends in PGx testing utilization and uptake by payers in real-world practice are discussed; the role of pharmacoeconomics in assessing cost-effectiveness is highlighted using a case study in psychiatric care, and several issues that will affect adoption of PGx testing in the United States (US) over the next few years are reviewed. PMID:26030725

  7. Pharmacogenomic and pharmacogenetic-guided therapy as a tool in precision medicine: current state and factors impacting acceptance by stakeholders.

    PubMed

    Hess, Gregory P; Fonseca, Eileen; Scott, Rachel; Fagerness, Jesen

    2015-01-01

    Pharmacogenetic/pharmacogenomic (PGx) testing is currently available for a wide range of health problems including cardiovascular disease, cancer, diabetes, autoimmune disorders, mental health disorders and infectious diseases. PGx contributes important information to the field of precision medicine by clarifying appropriate treatments for specific disease subtypes. Tangible benefits to patients including improved outcomes and reduced total health care costs have been observed. However, PGx-guided therapy faces many barriers to full integration into clinical practice and acceptance by stakeholders, whether practitioner, patient or payer. Each stakeholder has a unique perspective on the role of PGx testing, although all are similarly challenged with demonstrating or appraising its cost-to-benefit value. Coverage by insurers is a critical step in achieving widespread adoption of PGx testing. The acceleration of adoption of precision medicine in general and for PGx testing in particular will be determined by how quickly robust evidence can be accumulated that shows a return on investment for payers in terms of real dollars, for clinicians in terms of patient clinical responses, and for patients in terms of economic, health and quality of life outcomes. Trends in PGx testing utilization and uptake by payers in real-world practice are discussed; the role of pharmacoeconomics in assessing cost-effectiveness is highlighted using a case study in psychiatric care, and several issues that will affect adoption of PGx testing in the United States (US) over the next few years are reviewed.

  8. Occupant injury and fatality in general aviation aircraft for which dynamic crash testing is certification-mandated.

    PubMed

    Boyd, Douglas D

    2015-06-01

    Towards further improving general aviation aircraft crashworthiness, multi-axis dynamic tests have been required for aircraft certification (14CFR23.562) since 1985. The objective of this study was to determine if occupants in aircraft certified to these higher crashworthiness standards show a mitigated fraction of fatal accidents and/or injury severity. The NTSB aviation database was queried for accidents occurring between 2002 and 2012 involving aircraft certified to, or immune from, dynamic crash testing and manufactured after 1999. Only operations conducted under 14CFR Part 91 were considered. Statistical analysis employed proportion tests and logistic regression. Off-airport landings are associated with high decelerative forces; however for off-airport landings, the fraction of fatal accidents for aircraft subject to, or exempt from, dynamic crash testing was similar (0.53 and 0.60, respectively). Unexpectedly, for on-airport landings a higher fraction of fatalities was evident for aircraft whose certification mandated dynamic crash testing. Improved crashworthiness standards would be expected to translate into a reduced severity of accident injuries. For all accidents, as well as for those deemed survivable, the fraction of minor and serious injuries was reduced for occupants in aircraft certified to the higher crashworthiness standards. Surprisingly, the fraction of occupants fatally injured was not decreased for aircraft subject to dynamic crash tests. To shed light on this unexpected finding flight history, airman demographics and post-impact fires for aircraft for which dynamic crash testing is mandatory or exempt was examined. For the former cohort the median distance of the accident flight was nearly 44% higher. Aircraft subject to dynamic crash testing were also involved in a greater fraction (0.25 versus 0.12, respectively) of post-impact fires. Our data suggest that while the more stringent crashworthiness standards have mitigated minor and serious

  9. Occupant injury and fatality in general aviation aircraft for which dynamic crash testing is certification-mandated.

    PubMed

    Boyd, Douglas D

    2015-06-01

    Towards further improving general aviation aircraft crashworthiness, multi-axis dynamic tests have been required for aircraft certification (14CFR23.562) since 1985. The objective of this study was to determine if occupants in aircraft certified to these higher crashworthiness standards show a mitigated fraction of fatal accidents and/or injury severity. The NTSB aviation database was queried for accidents occurring between 2002 and 2012 involving aircraft certified to, or immune from, dynamic crash testing and manufactured after 1999. Only operations conducted under 14CFR Part 91 were considered. Statistical analysis employed proportion tests and logistic regression. Off-airport landings are associated with high decelerative forces; however for off-airport landings, the fraction of fatal accidents for aircraft subject to, or exempt from, dynamic crash testing was similar (0.53 and 0.60, respectively). Unexpectedly, for on-airport landings a higher fraction of fatalities was evident for aircraft whose certification mandated dynamic crash testing. Improved crashworthiness standards would be expected to translate into a reduced severity of accident injuries. For all accidents, as well as for those deemed survivable, the fraction of minor and serious injuries was reduced for occupants in aircraft certified to the higher crashworthiness standards. Surprisingly, the fraction of occupants fatally injured was not decreased for aircraft subject to dynamic crash tests. To shed light on this unexpected finding flight history, airman demographics and post-impact fires for aircraft for which dynamic crash testing is mandatory or exempt was examined. For the former cohort the median distance of the accident flight was nearly 44% higher. Aircraft subject to dynamic crash testing were also involved in a greater fraction (0.25 versus 0.12, respectively) of post-impact fires. Our data suggest that while the more stringent crashworthiness standards have mitigated minor and serious

  10. 76 FR 44508 - Acceptance of Public Submissions for a Study on International Swap Regulation Mandated by Section...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... States, Asia, and Europe and to identify areas of regulation that are similar and other areas of... a study on swap regulation and clearinghouse regulation in the United States, Asia, and Europe and... United States, Asia, and Europe; and (ii) clearing house and clearing agency regulation in the...

  11. The status of state-wide policies for neonatal hearing screening.

    PubMed

    Blake, P E; Hall, J W

    1990-04-01

    During the process of establishing follow-up procedures for our neonatal hearing program, we became interested in the current status of screening programs nationwide. Fifty states and the District of Columbia were surveyed to determine the extent and content of legislatively mandated neonatal hearing screening programs. Fourteen states have legislative mandates for screening and, at this point, approximately 50 percent of the states have no state-wide policy regarding neonatal hearing screening. Among the various state-wide protocols two basic approaches emerged: (1) the high-risk register and (2) in-hospital screening. In addition, information was obtained on screening methods, the level of program implementation, and some of the pros and cons for mandating neonatal hearing screening. PMID:2132588

  12. Automation a vital component of new Minnesota networks.

    PubMed

    Goedert, J

    1994-05-01

    Faced with state legislation aimed at controlling health care cost increases, providers and payers in Minnesota are joining forces to form capitated managed care networks. Mandated universal claim forms, standards development and data reporting requirements will virtually require that the newly emerging networks make extensive use of electronic data interchange. The health care industry is watching closely to see whether the state's experience can serve as a model.

  13. Teacher Performance Plays Growing Role in Employment Decisions. Teacher Tenure: Trends in State Laws

    ERIC Educational Resources Information Center

    Thomsen, Jennifer

    2014-01-01

    An increasing number of states are mandating teacher performance be considered in educator employment decisions, including awarding tenure and layoffs, according to a 50-state policy review of teacher tenure laws. Tenure laws have historically granted job protections based on years of employment. The Education Commission of the States (ECS)…

  14. Postsecondary Education and "The Best Interests of the People of the States."

    ERIC Educational Resources Information Center

    Millard, Richard M.

    The Constitution mandates that the states take primary responsibility for education. Except for a few specialized institutions, such as the service academies, educational institutions have been chartered, incorporated, licensed and/or authorized to operate by the states. This historical relationship between the states and higher education is…

  15. Settling a U.S. Senatorial Debate: Understanding Declines in State Higher Education Funding

    ERIC Educational Resources Information Center

    Klein, Michael W.

    2015-01-01

    This paper examines the debate in the U.S. Senate over the reasons why state governments have decreased funding for higher education. One side believes that federal mandates on states to pay for Medicaid have forced them to reduce spending on higher education. The other side believes that states unwisely reduced taxes, which decreased their…

  16. A Comprehensive Analysis of High School Genetics Standards: Are States Keeping Pace with Modern Genetics?

    ERIC Educational Resources Information Center

    Dougherty, M. J.; Pleasants, C.; Solow, L.; Wong, A.; Zhang, H.

    2011-01-01

    Science education in the United States will increasingly be driven by testing and accountability requirements, such as those mandated by the No Child Left Behind Act, which rely heavily on learning outcomes, or "standards," that are currently developed on a state-by-state basis. Those standards, in turn, drive curriculum and instruction. Given the…

  17. Costs of Chronic Diseases at the State Level: The Chronic Disease Cost Calculator

    PubMed Central

    Murphy, Louise B.; Khavjou, Olga A.; Li, Rui; Maylahn, Christopher M.; Tangka, Florence K.; Nurmagambetov, Tursynbek A.; Ekwueme, Donatus U.; Nwaise, Isaac; Chapman, Daniel P.; Orenstein, Diane

    2015-01-01

    Introduction Many studies have estimated national chronic disease costs, but state-level estimates are limited. The Centers for Disease Control and Prevention developed the Chronic Disease Cost Calculator (CDCC), which estimates state-level costs for arthritis, asthma, cancer, congestive heart failure, coronary heart disease, hypertension, stroke, other heart diseases, depression, and diabetes. Methods Using publicly available and restricted secondary data from multiple national data sets from 2004 through 2008, disease-attributable annual per-person medical and absenteeism costs were estimated. Total state medical and absenteeism costs were derived by multiplying per person costs from regressions by the number of people in the state treated for each disease. Medical costs were estimated for all payers and separately for Medicaid, Medicare, and private insurers. Projected medical costs for all payers (2010 through 2020) were calculated using medical costs and projected state population counts. Results Median state-specific medical costs ranged from $410 million (asthma) to $1.8 billion (diabetes); median absenteeism costs ranged from $5 million (congestive heart failure) to $217 million (arthritis). Conclusion CDCC provides methodologically rigorous chronic disease cost estimates. These estimates highlight possible areas of cost savings achievable through targeted prevention efforts or research into new interventions and treatments. PMID:26334712

  18. A Comprehensive Fifty-One Jurisdiction Review of Statutes Mandating and Encouraging the Teaching of History in K-12 Schools

    ERIC Educational Resources Information Center

    Cutting, A. Edward

    2012-01-01

    This is a linear review of the education statutes of each state for the purpose of identifying those statutes which require the state's history to be taught in its K-12 schools, with further analysis for trends and outliers. The intent is to first serve as a benchmark as to where both each state and the nation as a whole is at this point in…

  19. Survey of Mandatory Education Policies in State Penal Institutions.

    ERIC Educational Resources Information Center

    Di Vito, Robert J.

    1991-01-01

    Of the 50 states, 37 do not mandate education in prisons, although 8 are considering a policy change. Many programs include incentives and sanctions, and various evaluation criteria, such as General Educational Development achievement, test scores, and retention in the program are used. (SK)

  20. California Community Colleges State and Federal Legislative Programs, 1993.

    ERIC Educational Resources Information Center

    California Community Colleges, Sacramento. Board of Governors.

    A major component of the legislative function of the Board of Governors (BOG) of the California Community Colleges (CCC), as mandated in Assembly Bill 1725, is the adoption of an annual state and federal legislative program. This program formalizes the legislative thrust of the BOG and is intended to set forth systematic legislative and budgetary…