The Commission had three basic alternatives for giving effect to its policy recommendations: (1) voluntary compliance; (2) statutory creation of rights, interests, or responsibilities enforceable through either individual or governmental action; and (3) establishment of ongoing governmental mechanisms to investigate, study, and report on privacy p
Issues of public policy rarely, if ever, emerge on the political scene fully developed and fully articulated. Rather, they result from gradual changes in the social and economic environment, which are then identified and intensively debated. This has been the pattern with the subject of this report. The relationships between individuals and variou
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Appendix B: Site Visit Discussion Guide
Site Visits to FEHB Health Plans Conducted through a contract between the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services and in conjunction with the U.S. Office of Personnel Management; and subcontracts between ROW Sciences and the University of Maryland School of Medicine, RAND Health, Harvar
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Summary of Findings on Implementing Parity in the FEHB Program
Descriptive findings on FEHB plans’ parity implementation were obtained using data for two time periods (pre- and post-parity) from the Parity Reporting Requirement (PRR), which was completed by all FEHB plans that remained in the FEHB Program continuously from 1999 to 2002. 37 Findings on FEHB plans’ benefit design changes in response to the
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Research Questions and Findings in Brief
Implementation of the Parity Policy Key Implementation Research Questions Did all FEHB plans comply with the parity policy? How did the FEHB parity policy affect MH/SA benefit design and management? How did the FEHB parity policy affect the benefit design and management for general medical care? Did FEHB plans incur additional expense
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Overview
This chapter addresses the intermediate and long-term impacts of the parity policy on access to care, service use, cost, and quality of care, as illustrated in the evaluation logic model in Figure II-I. The research questions, data sources and collection methods, and analysis methods relating to cost, access, utilization, and quality that we summa
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Summary of Findings on the Implementation of Parity in the FEHB Program
All FEHB plans complied with the parity policy. No plan left the FEHB Program to avoid implementing the parity policy, and plans enhanced their MH/SA nominal benefits as required by the policy change. According to most (two-thirds) of the FEHB plans, they incurred no added administrative cost in implementing the parity policy.
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. FEHB Network Providers’ Experience Implementing Parity
Provider focus groups were conducted to assess providers’ awareness and perceptions of the parity benefit implementation. Each focus group was audiotaped and verbatim transcripts prepared from these tapes. The transcripts were then systematically analyzed for key themes. Key Research Questions PERT researchers developed a discussion guide fo
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Overview of the Evaluation Methodology
The design of the evaluation was quasi-experimental. Plan data on nominal benefits (for all FEHB plans) and archival (claims) data on access, utilization, and cost (for nine selected plans) were studied before and after the implementation of parity.Changes in these measures were compared to changes in matched non-FEHB comparison group plans from t
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Goals and Objectives of the Evaluation
The Federal Employees Health Benefits (FEHB) Program evaluation addressed changes in cost, access, utilization, and quality as a result of the parity policy. Additionally, the evaluation focused on adverse selection arising from the managed competition that exists in the FEHB Program. Adverse selection refers to the tendency for individuals to c
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Findings
How was the FEHB Parity Policy Implemented? All of the FEHB plans complied with the parity policy, most incurred no added administrative costs, and none reported major problems with implementation. The policy change enhanced MH/SA benefits for FEHB Program enrollees. Table 1 shows the key research questions regarding how the parity policy was im
Toward Understanding Homelessness: The 2007 National Symposium on Homelessness Research. Homeless Youth in the United States: Recent Research Findings and Intervention Approaches. Prevention Research
In addition to research on how to best address the needs of youth who are already homeless, other studies have focused on preventive interventions.
One of the challenges faced by the PHLs is that their routine services - while clearly important contributions to the maintenance of public health - are generally outside of the public eye. Indeed, typical PHL operations imply that PHLs will rarely take center stage in any standard public health activities.
Public Health Laboratories and Health System Change . Shape the Delivery System Through Dialogue / Collaboration
We uncovered some innovative models to stimulate dialogue and collaboration among laboratory stakeholders, often originating with, and guided by, forward-looking PHL directors. These models hold promise for ensuring private sector awareness and understanding of key public sector functions in laboratory testing. The most advanced example of this ap
The initial purpose of the study was to characterize the relationships between PHLs and managed care organizations in the context of health system change. There is universal concern in the public health community about managed care. Despite some isolated examples of positive effects of managed care on PHLs, such as increased reference testing for
In the State of Washington, a public-private venue called the Clinical Lab Advisory Council (CLAC) is shaping the laboratory delivery system. The CLAC was created by the PHL director in cooperation with the Office of Laboratory Quality Assurance and a range of private laboratory interests in the state. The CLAC was initially conceived as a respons
Before discussing the specific activities of PHLs, it is first important to characterize the larger public health infrastructure in which PHLs reside. In a 1988 report entitled The Future of Public Health by the Institute of Medicine (IOM), the report attributed many of the major improvements in the health of the American people to the success o
Public Health Laboratories and Health System Change: Executive Summary. Competition from large commercial labs
The laboratory industry is rapidly consolidating, with the historical dominance of hospital-based labs giving way to increasing market power of large, national reference labs. These labs take advantage of scale, quick turn-around, powerful IT systems, and full service packages to garner exclusive contracts from MCOs and their associated providers.
Public Health Laboratories and Health System Change: Executive Summary. Reduced reporting of diseases
Several PHLs believe that MCOs' lack of awareness of and responsiveness to disease reporting requirements are negatively affecting the PHLs' disease reporting efforts. We did not uncover any formal information to support this contention, but it may well be correct – establishing this link is beyond any of the data that we encountered in conducti
As part of its ongoing research program in public health infrastructure, The Office of the Assistant Secretary for Planning and Evaluation (ASPE) of the Department of Health and Human Services (DHHS) commissioned The Lewin Group to study the relationship between public health laboratories (PHLs) and managed care organizations (MCOs). As the study