Assessing the Potential for a State Medicaid Reform Model to Reduce Disparities

评估国家医疗补助改革模式减少差距的潜力

基本信息

批准号：
9329485
负责人：
Kenneth John McConnell
金额：
$ 56.97万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-08-09 至 2020-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9329485
关键词：
Address Adopted Affordable Care Act Area Caring Communities Community Health Community Health Aides Data Data Set Development Dimensions Effectiveness Electronic Health Record Elements Employment Environment Face Family Funding Geography Goals Grant Health Health Insurance Healthcare Heterogeneity Incentives Individual Insurance Insurance Carriers Insurance Coverage Intention Knowledge Left Liquid substance Low income Measures Medicaid Minority Groups Modeling Oregon Performance Play Policies Population Population Heterogeneity Privatization Research Resources Role Rural Rural Population Services Statutes and Laws Subgroup System Testing Underrepresented Minority Underserved Population United States base beneficiary design disparity reduction effectiveness measure ethnic minority population experimental study falls flexibility health disparity health equity improved member novel programs racial and ethnic disparities racial minority rural disparities socioeconomic disadvantage targeted delivery trend

项目摘要

Project Summary: Provisions in the Affordable Care Act allow states substantial flexibility and opportunity to restructure their Medicaid programs. Given the disproportionate share of racial and ethnic minorities areas covered by the Medicaid program, changes in Medicaid policy provide a unique opportunity to address health disparities. However, Medicaid policies also face significant challenges, particularly in the ways in which this relatively low-reimbursing insurance program has left beneficiaries with problems of access and quality. One of the more ambitious Medicaid transformations has occurred in Oregon, which launched its system of “Coordinated Care Organizations,” or CCOs, in 2012. In legislation outlining the CCO model, the State of Oregon explicitly identified “Health Equity and Eliminating Health Disparities” as a fundamental target for delivery system changes. CCOs are required to: submit Community Health Improvement Plans, with goals for reducing disparities; provide services geographically located close to where members reside and offered in nontraditional settings that are accessible to diverse communities and underserved populations; provide incentives to attract underrepresented minority groups into the healthcare workforce; and broaden the use of community health workers. Using extensive claims and Electronic Health Record data and building on large policy experiment in Oregon, this proposal aims to assess the ways in which racial and ethnic disparities can be reduced through Medicaid reform, while also tracking the extent to which access and quality change for rural populations and the Medicaid program at large during these significant reform and expansion periods.

项目摘要：《平价医疗法案》的条款赋予各州很大的灵活性和机会鉴于少数族裔地区所占比例不成比例，重组其医疗补助计划。在医疗补助计划的涵盖范围内，医疗补助政策的变化为解决健康问题提供了独特的机会然而，医疗补助政策也面临重大挑战，特别是在实现这一目标的方式方面。报销相对较低的保险计划给受益人带来了获取和质量的问题。俄勒冈州发生了更雄心勃勃的医疗补助改革，推出了其医疗补助系统 “协调护理组织”（CCO），2012 年。在概述 CCO 模式的立法中，美国政府俄勒冈州明确将“健康公平和消除健康差距”作为基本目标交付系统变更需要：提交社区健康改善计划，其目标是：减少差异；提供靠近会员居住地和提供地点的服务可供不同社区和服务不足的人群使用的非传统环境；吸引代表性不足的少数群体加入医疗保健队伍并扩大医疗保健人员的使用的激励措施；社区卫生工作者使用广泛的索赔和电子健康记录数据并建立在大规模的基础上俄勒冈州的政策实验，该提案旨在评估种族和民族差异如何能够通过医疗补助改革来减少，同时还跟踪医疗服务的获取和质量变化的程度在这些重要的改革和扩张时期，农村人口和整个医疗补助计划。