Devolution of Power: An Interim Report Card

Health Affairs

Volumn 17, Issue 3, 1998, Pages 7-16

  Sparer, Michael S ^a  

^a Och Spine at New York Presbyterian Hospitals   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; BEHAVIOR; CHILD; ECONOMICS; GOVERNMENT; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; LEGAL ASPECT; LONG TERM CARE; MANAGEMENT; MEDICAID; UNITED STATES;

CHILD; HEALTH BENEFIT PLANS, EMPLOYEE; HEALTH POLICY; HUMANS; INSURANCE, HEALTH; LONG-TERM CARE; MANAGED CARE PROGRAMS; MEDICAID; POLICY MAKING; POWER (PSYCHOLOGY); STATE GOVERNMENT; STATE HEALTH PLANS; UNITED STATES;

EID: 0037621659     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.17.3.7     Document Type: Article

References (20)

1. A. Kondratas, A. Weil, and N. Goldstein, "Assessing the New Federalism: An Introduction," Health Affairs (May/June 1998): 17-24.
2. During the nineteenth century, for example, the only federal social welfare program was a pension program for Union veterans of the Civil War.
3. The only beneficiaries that cannot be enrolled in managed care without a federal waiver are children with special needs and those clients enrolled both in Medicaid and Medicare (dual eligibles).
4. J. Holahan et al., "Medicaid Managed Care in Thirteen States," Health Affairs (May/June 1998): 43-63.
5. Ibid.
6. "Washington State Abandons SSI Managed Care," State Health Watch (January 1998): 1.
7. This trend in not universal. New York has slashed capitation rates even though it is about to begin a large mandatory managed care initiative.
8. The main exception are efforts to target specific populations, such as asthmatics, diabetics, and women with high-risk pregnancies.
9. "Provider Readiness," Currents: Medicaid Managed Care (Summer 1997): 1.
10. S. Rajan, "Publicly Subsidized Health Insurance: A Typology of State Approaches," Health Affairs (May/June 1998): 101-117.
11. T. Riley, C. Pernice, and R. Mollica, "How Will States Implement Children's Health Insurance Programs?" Health Affairs (May/June 1998): 265-268.
12. State Health Notes (8 December 1997).
13. L.M. Nichols and L.J. Blumberg, "A Different Kind of 'New Federalism'? The Health Insurance Portability and Accountability Act of 1996," Health Affairs (May/June 1998): 25-42.
14. Ibid.
15. D. Liston and M.P. Patterson, Analysis of the Number of Workers Covered by Self-Insured Health Plans under the Employee Retirement Income Security Act of 1974-1993 and 1995 (Menlo Park, Calif.: Henry J. Kaiser Family Foundation, August 1996).
16. Five percent of the aged have long-term care insurance. J.M. Wiener and D.G. Stevenson, "State Policy on Long-Term Care for the Elderly," Health Affairs (May/June 1998): 81-100.
17. This system also encourages individuals to transfer their assets prior to nursing home admission, to qualify for Medicaid.
18. As Wiener and Stevenson point out, research suggests that the increased use of home and community-based care may cost more than the savings from reduced nursing home use. Wiener and Stevenson, "State Policy on Long-Term Care for the Elderly."
19. The key ingredient in these partnerships is to allow persons who purchase private long-term care insurance to receive Medicaid coverage when their insurance expires even if they have more assets than are generally allowed. In 1993, however, Congress declared that any protected assets would be subject to later estate recovery.
20. One example is a study by researchers at the Rockefeller Institute that examines states' management capacity in health and welfare programs.