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Health and Health Care

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The Patient Protection and Affordable Care Act—health care reform—fundamentally changed health insurance and access to health care. Our researchers are unpacking the landmark law, studying the challenges of implementation, and using our Health Insurance Policy Simulation Model to estimate how its proposals will affect children, seniors, and families, as well as doctors, small businesses, and the national debt.

The Urban Institute also studies cost, coverage, and reform options for Medicare and Medicaid and analyzes trends and underlying causes of changes in health insurance coverage, access to care, and Americans’ use of health care services. Read more.

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Joint SNAP and Medicaid/CHIP Program Eligibility and Participation in 2011 (Research Report)
Laura Wheaton, Victoria Lynch, Pamela J. Loprest, Erika Huber

More than one-third of all children were eligible for both Supplemental Nutrition Assistance Program (SNAP) and Medicaid/Children’s Health Insurance Program (CHIP) benefits in 2011, the most recent year of data available. Far fewer adults were jointly eligible. Reasons for the difference include children’s high poverty rates and state eligibility policies. However, joint participation rates (the percent of eligibles receiving benefits) suggest that many eligibles were not participating. In four out of five of states with available data, less than three-quarters of those jointly eligible (adults and children) were receiving both benefits. Efforts to streamline and integrate application systems have the potential to improve program reach to families in need.

Posted to Web: September 29, 2014Publication Date: September 29, 2014

Disability and Care Needs Among Older Americans (Article)
Vicki Freedman, Brenda Spillman

Estimates from the new National Health and Aging Trends Study indicate that nearly half of Medicare enrollees age 65 or older had difficulty or received help in the last month with daily activities in 2011. Of those receiving help, 10% were in a nursing homes, 15% were in alternative supportive care settings, and the rest lived in the community (75%). Persons with low incomes were a disproportionate share of those receiving help with at least 3 self-care or mobility activities in settings other than nursing homes. Informal care, primarily from family members, was substantial—164 hours monthly for older persons receiving help in the community and 50 for those in alternative supportive settings. Adverse consequences related to unmet need affected nearly a third of persons with difficulty or help in all settings other than nursing homes and nearly twice that proportion of persons receiving paid help in the community. Results suggest that policies to improve services and supports and reduce unmet need could benefit both older adults and those who care for them.

Posted to Web: September 25, 2014Publication Date: September 09, 2014

Implementation of the Affordable Care Act: Cross-Cutting Issues : Six-State Case Study on Network Adequacy (Research Report)
Sabrina Corlette, Kevin Lucia, Sandy Ahn

During the transition to new health insurance marketplaces, insurers revamped their approach to network design, and many now offer narrower provider networks. Researchers assessed network changes and efforts at regulatory oversight in six states. Researchers found that insurers made significant changes to the networks of their individual market plans. Insurers and state officials reported confusion about which plan networks included which providers, but most received few complaints about consumers' ability to obtain in-network services. While half these states have taken action to improve provider directories, it appears unlikely that states will dramatically change network standards, at least in the short-term.

Posted to Web: September 24, 2014Publication Date: September 24, 2014

Interim Outcome Study Report: National Implementation Evaluation of the Health Profession Opportunity Grants (HPOG) to Serve TANF Recipients and Other Low-Income Individuals (Research Report)
Pamela J. Loprest, Allison Stolte

The Health Profession Opportunity Grants (HPOG) Program funds training programs in high-demand healthcare professions, targeted to Temporary Assistance for Needy Families (TANF) recipients and other low-income individuals. This report is part of the HPOG National Implementation Evaluation (NIE) and provides interim results on the key outcomes of HPOG healthcare training completion and employment, as well as on participants’ pre-training activities and receipt of support services and employment assistance. This study includes 27 HPOG grantees and the report provides information about the first 12 months of HPOG participation for 8,634 individuals.

Posted to Web: September 24, 2014Publication Date: September 11, 2014

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