What’s In, What’s Out: Designing Benefits for Universal Health Coverage

What’s In, What’s Out: Designing Benefits for Universal Health Coverage. Center for Global Development. Amanda Glassman, Ursula Giedion and Peter C. Smith. July 3, 2017.

What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time. [Note: contains copyrighted material].

[PDF format, 378 pages, 5.48 MB].

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Impacts of Onshore Oil and Gas Development: Managing Societal and Environmental Risks

Impacts of Onshore Oil and Gas Development: Managing Societal and Environmental Risks. Center for Strategic & International Studies. Frank A. Verrastro et al. June 27, 2017

This note provides highlights from a one-day CSIS workshop held April 26, 2017, with government, state regulators, industry, and policy experts exploring ongoing efforts to minimize and manage upstream environmental, health, safety, and societal risks associated with U.S. onshore oil and gas production. The workshop was the second in a three-part workshop series, with the first part covering key issues concerning the role of U.S. tight oil production in global markets and the final installment to target global natural gas markets. [Note: contains copyrighted material].

[PDF format, 15 pages, 395.88 KB].

Informing Pittsburgh’s Options to Address Lead in Water

Informing Pittsburgh’s Options to Address Lead in Water. RAND Corporation. Linnea Warren May, Jordan R. Fischbach, Michele Abbott. June 27, 2017.

Pittsburgh, Pennsylvania is currently struggling to manage and improve its aging water system, with a focus on elevated lead levels for many customers. The issue is well covered in the local media, and several steps are being taken or proposed for remediating lead in Pittsburgh’s tap water. Under federal and state regulatory action and pressure from residents, the city is at a critical decision point for addressing the issue of lead in its water. This Perspective reviews the history and recent developments related to the use of lead in Pittsburgh’s water system and the policy options for lead remediation currently being weighed by local decisionmakers.

The authors review the costs, regulatory barriers, and feasibility of the various options under consideration, including the City of Pittsburgh’s new Safe Water Program and multiple pipe replacement options. They conclude with recommendations, including ensuring optimal pipe corrosion control and filtering in the immediate term and pursuing innovations from other cities to reduce the public and private costs of the permanent solution of full lead service line replacement. [Note: contains copyrighted material].

[PDF format, 33 pages, 821.51 KB].

Federal Health Centers: An Overview

Federal Health Centers: An Overview. Congressional Research Service, Library of Congress. Elayne J. Heisler. May 19, 2017

The federal Health Center Program is authorized in Section 330 of the Public Health Service Act (PHSA) (42 U.S.C. §254b) and administered by the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services. The program awards grants to support outpatient primary care facilities that provide care to primarily low-income individuals or individuals located in areas with few health care providers.

Federal health centers are required to provide health care to all individuals, regardless of their ability to pay, and to be located in geographic areas with few health care providers. These requirements make health centers part of the health safety net—providers that serve the uninsured, the underserved, or those enrolled in Medicaid. Data compiled by HRSA demonstrate that health centers serve the intended safety net population, as the majority of patients are uninsured or enrolled in Medicaid. Some research also suggests that health centers are cost-effective; researchers have found that patients seen at health centers have lower health care costs than those served in other settings. In general, research has found that health centers, among other outcomes, improve health, reduce costs, and provide access to health care for populations that may otherwise not obtain health care.

[PDF format, 38 pages, 1 MB].

Frequently Asked Questions About Prescription Drug Pricing and Policy

Frequently Asked Questions About Prescription Drug Pricing and Policy. Congressional Research Service, Library of Congress. Suzanne M. Kirchhoff, Judith A. Johnson, Susan Thaul. May 2, 2017

Prescription drugs play an important role in the U.S. health care system. Innovative, breakthrough drugs are providing cures for diseases such as hepatitis C and helping individuals with chronic conditions lead fuller lives. Studies show that prescription drug therapy can produce health care savings by reducing the number of hospitalizations and other costly medical procedures.

Congress has attempted to ensure that Americans have access to pharmaceuticals by enacting the Medicare Part D prescription drug benefit as part of the Medicare Modernization and Prescription Drug Act of 2003 (MMA; P.L. 108-173) and expanding drug coverage under the 2010 Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). Congress also has enacted laws to encourage manufacturing of lower-cost generic drugs, as well as cutting-edge biologics and biosimilars.

Americans are using more prescription drugs, and for longer periods of time, than in past decades. Still, access to prescription drugs remains a real issue for a number of consumers, particularly those without insurance; those prescribed expensive specialty drugs for treating serious or rare diseases; or those enrolled in private insurance or public health plans with high cost-sharing requirements, such as drug deductibles and coinsurance.

[PDF format, 37 pages, 1.14 MB].

Urban Blight and Public Health: Addressing the Impact of Substandard Housing, Abandoned Buildings, and Vacant Lots

Urban Blight and Public Health: Addressing the Impact of Substandard Housing, Abandoned Buildings, and Vacant Lots. Urban Institute. Erwin de Leon, Joseph Schilling. April 11, 2017

We spend more than 2/3rds of our time where we live; thus, housing and neighborhood conditions invariably affect our individual and family’s well-being. The health impacts from blighted properties—substandard housing, abandoned buildings, and vacant lots—are often not immediately visible or felt. This report—Urban Blight and Public Health—synthesizes recent studies on the complexities of how blight affects the health of individuals and neighborhoods while offering a blend of policy and program recommendations to help guide communities in taking a more holistic and coordinated approach, such as expanding the use of health impact assessments, tracking health outcomes, and infusing public health into housing policies, codes and practices. [Note: contains copyrighted material].

[PDF format, 44 pages, 858.33 KB].

The Evolving Role of Retail Clinics

The Evolving Role of Retail Clinics. RAND Corporation. November 10, 2016.

Retail clinics are medical clinics located in pharmacies, grocery stores, and “big box” stores, such as Target and Walmart. These clinics offer extended weekend and evening hours, walk-in availability, and short wait times. Many visits to retail clinics are in the evenings and weekends, when primary care offices are not available. The clinics treat a limited range of health conditions, such as minor infections and injuries, and provide vaccines and other preventive care. Care is delivered by a nurse practitioner or physician assistant. Prices are typically fixed and transparent.
Retail clinics have been proposed as an alternative to costly emergency department care for nonemergency conditions. It has been estimated that up to 20 percent of emergency department visits for a nonemergency condition could take place at a retail clinic or urgent care center, potentially generating cost savings as high as $4.4 billion annually. [Note: contains copyrighted material].

[PDF format, 4 pages, 128.5 KB].