Browsing by Subject "State policy"

Now showing 1 - 3 of 3
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    Medicaid Administrative Costs: Trends, Expansion Effects, and Express Lane Eligibility
    (2020-07) Balio, Casey Patricia; Menachemi, Nir; Blackburn, Justin; Yeager, Valerie A.; Simon, Kosali
    Medicaid covers 21% of Americans which includes over 65 million children and adults, making it the largest single source of health insurance for Americans. As a public program jointly administered between the federal and state governments, states exhibit substantial control over the structure of their programs, with the intention of modifying programs to fit the needs of the state and population. Medicaid has experienced numerous changes at both the state and federal levels in recent years which have created novel ways of modifying their structures, many of which may have implications for administrative expenditures. As publicly funded programs and given the state autonomy over such, it is important to consider the relationships and effects of such decisions on the performance of these programs. The purpose of this dissertation is to consider numerous variations in state Medicaid programs and the state contexts in which they operate, and the relationship to administrative spending. This dissertation focuses on three studies including 1) a panel analysis of the trends and correlates of state Medicaid administrative expenditures, 2) a quasi-experimental study of the effects of Medicaid expansion on administrative expenditures, and finally 3) a quasi-experimental study of the effects of the use of Express Lane Eligibility on administrative expenditures. Overall, this dissertation provides a better understanding of the variations, correlates, and drivers of Medicaid administrative expenditures.
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    Pain clinic definitions in the medical literature and U.S. state laws: an integrative systematic review and comparison
    (BMC, 2018-05-22) Andraka-Christou, Barbara; Rager, Joshua B.; Brown-Podgorski, Brittany; Silverman, Ross D.; Watson, Dennis P.; Social and Behavioral Sciences, School of Public Health
    BACKGROUND: In response to widespread opioid misuse, ten U.S. states have implemented regulations for facilities that primarily manage and treat chronic pain, called "pain clinics." Whether a clinic falls into a state's pain clinic definition determines the extent to which it is subject to oversight. It is unclear whether state pain clinic definitions model those found in the medical literature, and potential differences lead to discrepancies between scientific and professionally guided advice found in the medical literature and actual pain clinic practice. Identifying discrepancies could assist states to design laws that are more compatible with best practices suggested in the medical literature. METHODS: We conducted an integrative systematic review to create a taxonomy of pain clinic definitions using academic medical literature. We then identified existing U.S. state pain clinic statutes and regulations and compared the developed taxonomy using a content analysis approach to understand the extent to which medical literature definitions are reflected in state policy. RESULTS: In the medical literature, we identified eight categories of pain clinic definitions: 1) patient case mix; 2) single-modality treatment; 3) multidisciplinary treatment; 4) interdisciplinary treatment; 5) provider supervision; 6) provider composition; 7) marketing; and 8) outcome. We identified ten states with pain clinic laws. State laws primarily include the following definitional categories: patient case mix; single-modality treatment, and marketing. Some definitional categories commonly found in the medical literature, such as multidisciplinary treatment and interdisciplinary treatment, rarely appear in state law definitions. CONCLUSIONS: This is the first study to our knowledge to develop a taxonomy of pain clinic definitions and to identify differences between pain clinic definitions in U.S. state law and medical literature. Future work should explore the impact of different legal pain clinic definitions on provider decision-making and state-level health outcomes.
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    State and Institutional Policies on In-State Resident Tuition and Financial Aid for Undocumented Students: Examining Constraints and Opportunities
    (Arizona State University, 2017-02) Serna, Gabriel R.; Cohen, Joshua M.; Nguyễn, David Hòa Khoa; School of Education
    In this article, we examine policies related to in-state resident tuition and state financial aid policies aimed at undocumented students. To help frame the discussion and spark further debate and research in this area the article seeks to do three things. First, it provides a comprehensive review of state and institutional in-state tuition policies aimed at undocumented students as well as state college or university system responses. Second, it charts the policy landscape for state financial aid access for this population. Third, it examines the numerous implications that such policies engender and highlights the role of the federal government and the proposed Dream Act in mitigating some of these concerns. It closes by underscoring the important financial role played by the critical interaction of state, institutional, and federal policies in making college going a reality for these students while proposing avenues for future study around the issue.