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Best Practices in Care Management for Senior Populations

Care Management is a service designed to help patients and their caregivers manage medical conditions more effectively, in order to improve health and reduce the need for hospitalizations and emergency department visits. The concept arose in the past decade from disease management programs of the 1990s, which focused on individual diseases rather than more comprehensive consideration of patients’ needs. Care …

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Premium cost changes attributable to the Affordable Care Act

The Affordable Care Act (ACA) expands health insurance coverage to millions of uninsured Americans and introduces several reforms to the health insurance market, particularly for people who purchase coverage on their own or receive it through employment at a small business. These reforms standardize benefits, limit insurance rating practices, prohibit coverage denials, limit out-of-pocket costs, and levy new taxes on …

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Medicaid and Medicare Disproportionate Share Hospital programs

Congress created the Disproportionate Share Hospital (DSH) program in the early 1980s to help hospitals offset the costs of providing care to low-income individuals. Medicaid and Medicare each have a distinct DSH program, with a unique structure and financing mechanism. In addition to giving a brief overview of the Medicaid and Medicare Disproportionate Share Hospital programs, this document will: Discuss …

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Care transitions: Best practices and evidence-based programs

Poorly coordinated care transitions from the hospital to other care settings cost an estimated $12 billion to $44 billion per year. Poor transitions also often result in poor health outcomes. The most common adverse effects associated with poor transitions are injuries due to medication errors, complications from procedures, infections, and falls. Providers are focused on improving transitions, due in part …

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Affordable Care Act funding: An analysis of grant programs under health care reform

This brief examines grant programs funded by the Affordable Care Act (ACA), how funds have been distributed to states and local organizations, and the effects of budget sequestration on future ACA funding. The ACA aims to expand health insurance coverage and introduce health care delivery reforms that improve quality and lower costs. The ACA is designed to reduce the number …

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Access to mental health care in Michigan

One in five Michigan residents report having been diagnosed with depression at some point in their lives. Mental health disorders cause more disability among Americans than any other illness group. Using data from the Cover Michigan Survey and the Michigan Primary Care Physician Survey, both fielded in calendar year 2012, this brief explores issues related to the prevalence of mental …

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Impact of benefit design on cost, use, and health: Literature review

Many employers use cost-sharing in their health insurance benefit designs as a means to reduce costs and, for some designs, encourage improved enrollee health behaviors. This paper summarizes the literature on the impact that three commonly used benefit designs have on cost, use of services, and health status: High-deductible health plans, which include consumer-directed health plans; Value-based insurance design; and …

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An introduction to health care payment reform: Research foundations, implementation, operational strengths and challenges

Policymakers across the country are currently engaged in discussions on how to improve the way that health care providers are paid for the services they deliver. These discussions involve how to shift payment systems away from traditional fee for services and toward rewarding providers that achieve excellent outcomes and deliver value to their patients. While both private and public payers …

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Emerging health insurance products in an era of health reform

At least in part in response to the health coverage changes of the Affordable Care Act (ACA), many health plans are making significant changes to products that they plan to offer in the employer and individual market. While insurers were already moving away from paying for volume and toward paying for value prior to health reform, the ACA has been …

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Employee cost-sharing for health insurance in Michigan and the United States

This brief reports on trends in health insurance premiums and cost-sharing among private-sector employers in Michigan and the United States from 2002 to 2012, and provides a focused look at high-deductible health plans by employer size. From 2002 through 2012, average total premiums in the United States increased by approximately 80 percent. While employer cost-control efforts in the 1990s could …

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