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From page 189... ... Index A Accountability, 19, 21, 155-156, 163168 Medicaid, 89-90, 94 SCHIP, 2, 14, 18, 42, 105, 118, 168 technical aspects, 22, 163-168 see also Performance measures Acute illness, 5, 22, 47, 55, 72, 120, 121-122, 124-126, 137 see also Emergency care; Injuries Administrative barriers, 20, 54, 56, 113 Children's Medical Security Plan, 113 information technology and, 133 Medicaid, 87-88, 103, 113, 115, 150 special needs children, 127 taxation, IRS, 150-151, 152 vouchers, 150 Adults, 1 coverage trends, 22, 24-29, 151 disabled, defined, 131 homeless, 61, 68 Medicaid, 81, 82 needs, vs children, 19, 136, 151, 164 SCHIP, 70 state programs, subsidy structure, 111, 121 subsidies, 151 Supplemental Security Income, 130 uninsured, 4, 24, 26, 27, 68, 70 parents, 107, 151 AFDC, see Aid to Families with Dependent Children African Americans access to care, 41, 49, 51, 53, 54 insurance coverage, 3, 27, 32-33 Age factors access to health care, 44 diseases, 121, 122 employer-based insurance, 27, 30 31 insurance coverage status, 21, 27, 30-31 Medicaid eligibility, 5, 83-84, 114 poverty thresholds, 38 state programs, 106, 114 see also Adults Agency for Health Care Policy and Research, 17, 52, 157-158, 163 Aid to Families with Dependent Children, 12, 88, 96, 97 see also TAN F AIDS, see Human immunodeficiency virus Alcohol and drug abuse, see Substance abuse Alcohol tax, 104, 108 Allergies, 5, 120 Ambulatory care, see Emergency care; Outpatient care; Primary care Ambulatory Care Access Project, 47 American Academy of Pediatrics, 17, 55,60 American Indians, see Native see also Employer-based insurance; Americans Parents Arizona, 79 189 Asians/Pacific Islanders, 27, 32-33, 34, 53-54 Assessment, see Accountability; Evaluation Asthma, 3, 5, 46, 48, 53, 115, 117, 124, 125, 166 Attitudes health beliefs, 25, 54 welfare recipients, embarrassment, 87-88, 104, 113 see also Health beliefs Auditory disabilities, see Hearing impairments B Balanced Budget Act of 1997, 38, 68, 72, 85, 98-99, 128, 167 see also SCHIP Behavioral disorders, 60, 98, 124, 128 Benchmark coverage, 61, 137, 140 Black persons, see African Americans Block grants, 2, 4, 14, 69, 75, 79, 124, 125, 127, 128-129 Blue Cross/glue Shield, 103,115, 116, 126, 137 Bureau of Primary Health Care Programs, 69 Buy-in, Medicaid, 98 See also Cost sharing; Sliding scale C California, 79,103,106,109,1 1 1, 1 15 116, 117 Read the entire page →
From page 190... ... , 57, 120 safety net providers, 4, 68 severe/chronic medical conditions, 5 special needs children, 127-128, 129, 132, 136 state-sponsored programs, 109, 1: 114, 115, 147-148 tax credits, 153 tax subsidies, 16 treatment delays, 3, 23, 25,38, 44, 56 uncompensated care, 68, 70, 71, 79, 114 Disproportionate Share Hospital payments, 4, 38, 68, 69, 70, 82, 85, 89 uninsured persons, costs to, 146 see also Accountability Cost sharing, 5, 19,34, 41, 42, 51, 52, 88, 99, 110, 113, 144, 145-146, 150 Cost-shifting, 3, 68 Counseling, 58, 59, 60, 78, 121, 124, 167 Crowd-out, see Substitution of coverage Cultural factors, access to care, 52, 5354, 129 language, 53, 54 safety net providers, 68 see also Health beliefs Culturally sensitive cervices, 3, 7,54,56 Disproportionate Share Hospital Current Population Survey, 2, 17, 25, 156, 157 federal data collection, 157-160; see also Current Population Survey rural areas, 54, 90 urbanareas,54, 115 see also Age factors; Families and households; Gender factors; Racial/ethnic factors; Socioeconomic status; specific racial/ethrlic groups Dental health and services, 3, 44, 50, 90, 91, 108, 123, 156, 161, 166 Developmental disabilities, 124, 125, 134, 166 Diabetes mellitus, 5, 46, 120, 125, 167 Digestive system diseases, 122 L2, Digital Equipment Corporation, 162, 164-165 Disabled persons definitions, legal, 125, 128, 130, 131 developmental disabilities, 124, 125 Medicaid, 13, 82, 84, 98, 99 private programs, 117 rehabilitative care, 55 SCHIP, Medicaid eligibility, 13 Supplemental Security Income, 128, 130 state benefits, 108 utilization rates, 21 see also Special needs children Diseases and disorders acute illness, 5, 22, 47, 55, 72, 120, 121-122, 124-126, 137 age factors, 121, 122 cost factors, general, 57 injuries, 3, 5, 19, 46, 55, 92, 120, 122, 125, 158, 166 see also Chronic conditions; Disabled persons; Special needs children; specific diseases, organs, arid body systems D Data collection and dissemination, see Current Population Survey; Evaluation; Information infrastructure Deductibles, 19, 52, 127, 129, 145, 146, 148-152 (passim) Delaware, 111 Demographic factors educational attainment of parents, 34-37 payments, 4, 38, 68, 69, 70, 82, 85, 89 Doctors, see Family physicians; Pediatric specialists; Physicians Drug-Free Schools and Communities Act, 79 Drugs, see Prescription medication; Substance abuse Ear infections, 3, 5, 46, 56, 120, 161 Early and Periodic Screening, Diagnosis, and Treatment Program, see EPSDT Read the entire page →
From page 191... ... Supplemental Security Income, 131 see also Outreach EPSDT, 50, 77, 81, 83, 84, 92-94, 127, 155-156 Evaluation, 5, 7, 20-21 clinical assessments, 58, 75, 84, 92, 93, 133 EPSDT, 156 managed care, 133 performance measures, 155, 156, 162-168 federal efforts, 157-160, 163, 167- 145; 146, 149(n.32) , 150-154 HEDIS, 54, 156, 161-162 managed care, 54, 94 Medicaid, 94 private sector, 163- 166 SCHIP, 6, 18, 21 special needs children, 127, 128 state programs, other, 112, 118, 167-168 SCHIP, 6, 18, 21 special needs children, programs, 21, 127, 128 see also Accountability; Information infrastructure Evidence-based approach, 2, 14, 16, 18, 167, 168 F Families and households, 34,35-38, 5253, 136 emotionally disturbed children, 125 employer-based coverage, 18, 149, 151 single-parent families, 34-37, 152 see also Parents Family physicians, 121, 131, 164 Family planning, 58, 60, 61, 90, 91, 160 Federal government data sources, 2, 17, 156, 157-169 Current Population Survey, 2, 17, 25, 156, 157 employer-based coverage, mandated, 148-149, 151 Disproportionate Share Hospital payments, 4, 38, 68, 69, 70, 82, 85, 89 funding, 2, 4, 68 community health care centers, 70 local services, 68 matching funds, 12, 13, 68, 84, 90, 103 SCHIP, 13, 42, 79-80, 85, 108 school-based centers, 79 special needs children, 127, 128 see also Block grants performance measures, 157- 160, 163, 167-168 preemption of state insurance laws, 147-148 public health departments, 76 safety net providers, 68, 70, 74 state cooperation with, general, 14, 147-148, 167 tax policy, 1, 14, 22, 108, 116, 144, Read the entire page →
From page 192... ... Firewalls, 42, 114 Florida, 79, 106-112 Food aid, see Nutrition Food Stamp program, 97, 149 Foundation for Accountability, 162, 166 Funding community health centers, 70, 72, 73-74 federal, 2, 4, 68 community health care centers, 70 local services, 68 matching funds, 12, 13, 68, 84, 90, 103 SCHIP, 13, 42, 79-80, 85, 108 school-based centers, 79 special needs children, 127, 128 Medicaid, 83, 85, 90 mental health services, 124 patchwork, 25, 77 public health departments, 78 safety net providers, 68-70, 72, 73 74, 79-80 SCHIP, 13, 79-80, 85, 108 school-based health centers, 79 state programs, 2, 13, 79-80, 85, 108, 110, 112, 113, 114 copayments, 103, 108, 110, 112, 113, 114 premiums, 104,108,110, 112, 113, 114, 116 Supplemental Nutrition Program for Women, Infants, and Children, 69, 78, 129 see also Balanced Budget Act of 1997; Block grants; Personal Responsibility and Work Opportunity Reconciliation Act of 1996 INDEX G Gender factors emergency room visits, 51 single-parent families, 35, 36, 37 Georgia, 115 Government role, see Federal government; Local government; State government Hawaii, 106,109,111, 148 Health beliefs Hispanics, 53 parental, 25 Southeast Asians, 54 Health Care Financing Health Insurance Portability and Accountability Act of 1996, 133 Health maintenance organizations, 133, 136, 137 Digital Equipment Corporation, 162, 164-165 HealthPartner, 127 Healthplan Employer Data Information System, see H HEDIS Health Resources and Services Administration, 25, 94, 155, 157 Health education, 20, 21, 58, 61, 93, 115, 117, 121, 129, 133, 134, 162, 165 counseling, 58, 59, 60, 78, 121, 167 Health insurance, general, 1-2, 13-14, 16, 17, 136-137 access to care and, 46-51 African Americans, 3, 27, 3 2-33 age factors, 21, 27, 30-3 1 Asians/Pacific Islanders, 27, 32-33, 34 catastrophic, 84, 108, 146, 148, 150 copayments, 19, 51, 52, 103, 108, 110, 112, 113, 114, 129, 145 deductibles, 19, 52, 127, 129, 145, 146, 148-152 (passim) entitlement to, 6, 19 Hispanics, 3, 27 information infrastructure, 20-21, 22, 25-27, 155-163 market-based approaches, 143-154 risk adjustment, 123, 136, 145 risk pools, 110 standards, benefits, 3, 5, 58, 60, 91, 92, 99, 133, 148-150 benchmark coverage, 61, 137, 140 Healthy People 2000, 166-167 HMOs, 162-165 see also Eligibility; Employer-based insurance; Enrollment; Medicaid; Medicare; Premiums; Private health insurance; SCHIP; Tax policy; Uninsured adults; Uninsured The Future of Public Health, 75 children Administration, see Maternal and Child Health Care Services Block Grant Health Security Act, 148 Health services, availability and access, 1, 2, 3, 11, 13-14, 16, 17, 23, 25, 44-61, 120-139 African Americans, 41, 49, 51, 53, 54 age factors, 44 continuity of care, 50, 55, 162 cultural factors, 52, 53-54, 129 culturally sensitive services, 3, 7, 54, 56 safety net providers, 68 defined, 44, 55 equipment, 5, 58, 60, 61, 120, 128, 129, 130, 131, 132, 136 financial barriers, 44-52; see also Employment status; Poverty; Socioeconomic status framework for, 45 Hispanics, 32-33, 41, 53 managed care, 54-55, 79, 133, 136 military health care, 24, 26 nonfinancial barriers, 7, 20, 45, 53, 129-132, 136 child care (day care) Read the entire page →
From page 193... ... . Organlzatlons Home health care, 67, 75, 90, 115, 158 Homeless persons, 67, 68 Hospitals and hospitalization, 1, 46-48, 116, 159 asthmatics, 53 children's hospitals, 1, 14, 67, 72, 75-77, 131, 134 developmentally disabled children, 125 length of stay, 77 poor persons, 47, 53, 61, 68, 70, 77, 89 rehabilitation, 58, 60, 72, 75, 76 safety net services, 68, 72, 75, 76 Disproportionate Share Hospital payments, 4, 38, 68, 69, 70, 82, 85, 89 state programs, 108, 112, 113, 114, 115, 116 see also Emergency care Human immunodeficiency virus, 5, 115, 120, 128-129 193 L Language factors, 53, 54 Legislation, 22, 96-99 Balanced Budget Act of 1997, 12, 38, 68, 72, 85, 98-99, 128, 167; see also SCHIP Drug-Free Schools and Communities Act, 79 Health Insurance Portability and Accountability Act of 1996, 133 Health Security Act, 148 history of Medicaid legislation, 84 85 Medicaid Voluntary Contribution and Provider-Specific Tax Amendments of 1991, 85 Medicare Catastrophic Coverage Act of 1988, 84 Omnibus Budget Reconciliation Acts, 84, 85, 155-156 Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 12, 85, 96, 125, 131 preemption of state insurance laws, federal, 147-148 Public Health Service Act, 70, 128 safety net providers, 68 Social Security Act of 1965, 13, 69, 75, 84; see also listings under "Social Security Act of 1965" Tax PayerReliefActofl997, 151 Length of stay, 77 Local factors special needs children, 127, 136 state programs responsive to, 104 racial/ethnic factors, 34 see also Community health centers Local government community health centers, funding, 70, 72 public health departments, 77, 78 special needs children, 127 Low-income persons, see Poverty Internet, 133, 134-135, 156, 165 Iowa, 106, 109, 116 Joint Commission on Accreditation of Healthcare Organizations, 161-162, 166 K M Kaiser Permanente, 116-117 Maine, 103 Kansas, 106, 109, 116 Managed care, 4, 137 AFDC population, 12 cost and cost-effectiveness, 4, 136 193 Read the entire page →
From page 194... ... , 2-5, 6, 21, 23, 27, 28, 34,36, 81-99, 116, 136-137 access to care, 44, 46-51 accountability, 89-90, 94 administrative barriers, 87-88, 103, 113, 115, 150 age factors, 27, 30-31, 41 buy-in, 98 community health centers, 70, 72, 73 coverage estimates, 24-33,36, 81 83 disabled persons, 13, 82, 84, 98, 99 EPSDT, 77, 78, 81, 83, 84, 92-94 eligibility, 4-5, 12-14, 42, 80, 83-88, 90, 96-98, 99, 103, 104, 113, 127 age factors, 5, 83-84, 114 income thresholds, 5, 6, 13, 27, 79, 96, 150 SCHIP and, 5, 13, 20, 13, 42 welfare and, 4-5, 12, 88, 89, 96 99 employer-based insurance vs. 27, 41, 149 enrollment, 3, 4-5, 13, 22, 25, 41, 50,72,79,83-84,87-88,90, 93,94,95,98,99, 128 evaluation, 21 funding, 83, 85, 90 history, 81-83, 84-85 INDEX injuries, 46 litigation by beneficiaries, 168 managed care, 4, 11, 12- 13, 68, 72, 83, 89, 94-96, 98-99, 128, 137 primary care, 83, 117 public health departments, 78 race/ethnicity, 27-28, 32-34, 41 safety net providers, 4, 12-13, 67, 68,69,70,72,73,77,78,79 SCHIP and, 2, 5, 6, 12, 13, 20, 42, 61, 83, 102, 107, 137 school-based health centers, 79 special needs children, 127-128, 136 state programs, 2, 3, 11, 83, 85, 86, 90, 93, 96, 98-99, 102-104, 107, 112, 113, 115, 137 substitution of coverage, 27, 41-42, 105-108 welfare delinking, 4-5, 12, 89, 96-98 see also Disproportionate Share Hospital payments; Medicaid; Medicare Medicaid Data System, 157 Medicaid Voluntary Contribution and Provider-Specific Tax Amendments of 1991, 85 Medi-Cal, 116- 117 Medical equipment, 5, 58, 60, 61, 120, 128, 129, 130, 131, 132, 136 Medical Expenditure Panel Survey, 157 Medical home, see Usual source of care Medical Savings Accounts, 2, 14 Medicare community health centers, 70, 73 safety net providers, 67, 69 statistical trends, 24, 25, 26 Medicare Catastrophic Coverage Act of 1988, 84 Mental health and illness, 123, 124125, 127, 131, 137, 166 behavioral disorders, 60, 98, 124, 128 school-based care, 79 state benefits, 108, 112, 137 substance abuse, 115, 123, 124-125, 127, 166 Mercy Health Plan, 117 Michigan, 79, 103, 106, 109, 117 Military health care, 24, 25, 26 Minnesota, 103, 106, 109, 110, 111 Minority groups, see RaciaVethnic factors; specific groups Missouri, 116 Montana, 103, 106, 109, 116 N National Ambulatory Medical Care Survey, 157 National Association of Children's Hospitals and Related Institutions, 75, 77 National Cancer Institute, 126 National Center for Health Statistics, 44 National Committee for Quality Assurance, 161, 166 National Employer Health Insurance Survey, 159 National Forum on the Future of Children and Families, 58 National Health and Nutrition Examination Survey, 158 National Health Interview Survey, 158 National Health Provider Inventory, 158 National Home and Hospice Care Survey, 158 National Hospital Ambulatory Medical Care Survey, 159 National Hospital Discharge Survey, 159 National Immunization Survey, 159 National Institute of Mental Health, 124 National Medical Expenditure Survey, 34, 46, 146 National Nursing Home Survey, 159 National Survey of Ambulatory Surgery, 159 National Survey of Family Growth, 160 National Vital Statistics System, 160 Native Americans, 27 Neural system disorders, 5, 120, 125, 134-135 New Hampshire, 103, 106, 109 New Jersey, 103, 105, 109, 111 New York State, 79, 103, 106, 109, 111 North Carolina, 106, 109, 115, 116 Nurses and nursing services, 58, 60, 61, 75, 79, 90, 91, 115, 123, 127, 131, 132 Nutrition, 69, 78, 121, 125, 135, 158, 166 Food Stamps, 97, 149 o Ohio, 115, 117 Omnibus Budget Reconciliation Acts (OBRA) Read the entire page →
From page 195... ... , 5, 19, 47, 53, 55, 57-59, 120, 121, 128, 133, 161 cost factors, 57, 120 counseling, 58, 59, 60, 78, 121, 124, 167 dental, 50 EPSDT, 77, 78, 81, 83, 84, 92-94 family planning, 58, 60, 61, 90, 91, 160 federal role, 148 Healthy People 2000, 78, 123, 128, 162, 166-167 poor persona, general,3,47,133, 136 private insurers, 115, 116, 164, 165 safety net providers, 68, 78 standards, 3, 148 state programs, 104, 113, 114, 137 utilization rates, 21 see also Immunization Preventive Health Block Grant, 79 Primary care, 120, 124, 131 access/use, 1, 5, 14,34, 47, 118, 121, 124, 125, 132, 164, 165, 167 HEDIS, 161 managed care, 126, 131, 136, 164 Medicaid, 83, 117 private insurers, 116, 117, 164, 165 safety net providers, 4, 67, 68, 70, 79 state programs, 112- 115 (passim) Private health insurance, 2, 4, 5, 6, 18, 21-22, 24, 26, 115-118, 137, 144-145 Blue Cross/glue Shield, 103, 115, 116, 126, 137 community health centers, 73 enrollment, 116, 117, 144-145 managed care, commercial, 21, 54, 72, 89, 93, 94, 99 HMOs, 137, 164, 165 Kaiser Permanente, 116- 117 Medicaid, reimbursement vs. Read the entire page →
From page 196... ... , 2, 5, 6, 12 13, 14, 18, 40, 61, 99, 102, 107, 110, 112, 118, 137, 168 accountability, 2, 14, 18, 42, 105, 118, 168 adults, 70 disabled persons, 13 eligibility, 5, 6, 13, 20, 42, 88, 99, 105, 106, 118, 168 enrollment, 5, 6, 13, 21, 43, 79, 88, 168 evaluation, 6, 18, 21 funding, 13, 42, 79-80, 85, 108 managed care and, 99 Medicaid and, 2, 5, 6, 12, 13, 20, 42, 61, 83, 102, 107, 137 outreach, 88 poverty, 2, 13 S federal poverty level and, 13, 105, 106 performance measures, 6, 18, 21 safety net providers, 6, 70, 79-80 subsidies, 6, 118 145(n.11) , 148, 149 Social Security Act of 1965 Title V, see Maternal and Child Health Care Services Block Grant Title XVI, see Supplemental Security Income Program Title XIX, see Medicaid Title XXI, see SCHIP Socioeconomic status, 23, 34-37 access to care, 44, 48-49 ~ . Read the entire page →
From page 197... ... poor persons, 4, 79, 103, 104, 150, 153 private insurers, 116, 117, 148 safety net providers, 4, 68, 70, 79 SCHIP, 6, 118 state programs, 5, 42, 99, 101-115 (passim) , 118, 148 tax policy and, 16, 144, 145, 146, 149-153 see also Vouchers Substance abuse, 115, 123, 124-125, 127, 166 Substance Abuse and Mental Health Services Administration, 124 Substitution of coverage, 27, 41-42, 105-108 premiums, 104,108,1 10,1 12,1 13, Supplemental Nutrition Program for 114, 116 Women, Infants, and Children funding, 69, 78, 129 Supplemental Security Income preventive care, 104, 113, 114, 137 primary care, 1 12-1 15 (passim) Read the entire page →
From page 198... ... , see Medicaid Title XXI (Social Security Act) , see SCHIP Tobacco tax, 104, 108, 113, 116 Transportation, 7, 20, 21, 53 safety net providers, 67 special needs children, 5, 129, 132, 136 U Uncompensated care, 68, 70, 71, 79, 114 Disproportionate Share Hospital payments, 4, 38, 68, 69, 70, 82, 85, 89 UniHealth, 117 INDEX Uninsured adults, 4, 24, 26, 27, 68, 70 parents, 107, 151 see also Safety net providers; SCHIP Uninsured children, 2, 7, 13, 16, 23, 24, 34, 42, 83, 89-90 access to care, 44, 46-52, 56, 146 age factors, 27, 30-3 1, 41 community health centers, 73 employed parents with, 23, 34, 149 extent of, 3, 11, 23-33, 41, 70 race/ethnicity, 27, 41 school-based health centers, 79 state/regional patterns, 3, 38, 40, 113, 115, 116, 117 study methodology, 1 temporal factors, duration, 34, 38, 39, 107 waiting periods, 114 see also Safety net providers; SCHIP United HealthCare of Ohio, 117 Urbanareas,54, 115 U.S. Read the entire page →

From page 189...

... Index A Accountability, 19, 21, 155-156, 163168 Medicaid, 89-90, 94 SCHIP, 2, 14, 18, 42, 105, 118, 168 technical aspects, 22, 163-168 see also Performance measures Acute illness, 5, 22, 47, 55, 72, 120, 121-122, 124-126, 137 see also Emergency care; Injuries Administrative barriers, 20, 54, 56, 113 Children's Medical Security Plan, 113 information technology and, 133 Medicaid, 87-88, 103, 113, 115, 150 special needs children, 127 taxation, IRS, 150-151, 152 vouchers, 150 Adults, 1 coverage trends, 22, 24-29, 151 disabled, defined, 131 homeless, 61, 68 Medicaid, 81, 82 needs, vs children, 19, 136, 151, 164 SCHIP, 70 state programs, subsidy structure, 111, 121 subsidies, 151 Supplemental Security Income, 130 uninsured, 4, 24, 26, 27, 68, 70 parents, 107, 151 AFDC, see Aid to Families with Dependent Children African Americans access to care, 41, 49, 51, 53, 54 insurance coverage, 3, 27, 32-33 Age factors access to health care, 44 diseases, 121, 122 employer-based insurance, 27, 30 31 insurance coverage status, 21, 27, 30-31 Medicaid eligibility, 5, 83-84, 114 poverty thresholds, 38 state programs, 106, 114 see also Adults Agency for Health Care Policy and Research, 17, 52, 157-158, 163 Aid to Families with Dependent Children, 12, 88, 96, 97 see also TAN F AIDS, see Human immunodeficiency virus Alcohol and drug abuse, see Substance abuse Alcohol tax, 104, 108 Allergies, 5, 120 Ambulatory care, see Emergency care; Outpatient care; Primary care Ambulatory Care Access Project, 47 American Academy of Pediatrics, 17, 55,60 American Indians, see Native see also Employer-based insurance; Americans Parents Arizona, 79 189 Asians/Pacific Islanders, 27, 32-33, 34, 53-54 Assessment, see Accountability; Evaluation Asthma, 3, 5, 46, 48, 53, 115, 117, 124, 125, 166 Attitudes health beliefs, 25, 54 welfare recipients, embarrassment, 87-88, 104, 113 see also Health beliefs Auditory disabilities, see Hearing impairments B Balanced Budget Act of 1997, 38, 68, 72, 85, 98-99, 128, 167 see also SCHIP Behavioral disorders, 60, 98, 124, 128 Benchmark coverage, 61, 137, 140 Black persons, see African Americans Block grants, 2, 4, 14, 69, 75, 79, 124, 125, 127, 128-129 Blue Cross/glue Shield, 103,115, 116, 126, 137 Bureau of Primary Health Care Programs, 69 Buy-in, Medicaid, 98 See also Cost sharing; Sliding scale C California, 79,103,106,109,1 1 1, 1 15 116, 117

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From page 190...

... , 57, 120 safety net providers, 4, 68 severe/chronic medical conditions, 5 special needs children, 127-128, 129, 132, 136 state-sponsored programs, 109, 1: 114, 115, 147-148 tax credits, 153 tax subsidies, 16 treatment delays, 3, 23, 25,38, 44, 56 uncompensated care, 68, 70, 71, 79, 114 Disproportionate Share Hospital payments, 4, 38, 68, 69, 70, 82, 85, 89 uninsured persons, costs to, 146 see also Accountability Cost sharing, 5, 19,34, 41, 42, 51, 52, 88, 99, 110, 113, 144, 145-146, 150 Cost-shifting, 3, 68 Counseling, 58, 59, 60, 78, 121, 124, 167 Crowd-out, see Substitution of coverage Cultural factors, access to care, 52, 5354, 129 language, 53, 54 safety net providers, 68 see also Health beliefs Culturally sensitive cervices, 3, 7,54,56 Disproportionate Share Hospital Current Population Survey, 2, 17, 25, 156, 157 federal data collection, 157-160; see also Current Population Survey rural areas, 54, 90 urbanareas,54, 115 see also Age factors; Families and households; Gender factors; Racial/ethnic factors; Socioeconomic status; specific racial/ethrlic groups Dental health and services, 3, 44, 50, 90, 91, 108, 123, 156, 161, 166 Developmental disabilities, 124, 125, 134, 166 Diabetes mellitus, 5, 46, 120, 125, 167 Digestive system diseases, 122 L2, Digital Equipment Corporation, 162, 164-165 Disabled persons definitions, legal, 125, 128, 130, 131 developmental disabilities, 124, 125 Medicaid, 13, 82, 84, 98, 99 private programs, 117 rehabilitative care, 55 SCHIP, Medicaid eligibility, 13 Supplemental Security Income, 128, 130 state benefits, 108 utilization rates, 21 see also Special needs children Diseases and disorders acute illness, 5, 22, 47, 55, 72, 120, 121-122, 124-126, 137 age factors, 121, 122 cost factors, general, 57 injuries, 3, 5, 19, 46, 55, 92, 120, 122, 125, 158, 166 see also Chronic conditions; Disabled persons; Special needs children; specific diseases, organs, arid body systems D Data collection and dissemination, see Current Population Survey; Evaluation; Information infrastructure Deductibles, 19, 52, 127, 129, 145, 146, 148-152 (passim) Delaware, 111 Demographic factors educational attainment of parents, 34-37 payments, 4, 38, 68, 69, 70, 82, 85, 89 Doctors, see Family physicians; Pediatric specialists; Physicians Drug-Free Schools and Communities Act, 79 Drugs, see Prescription medication; Substance abuse Ear infections, 3, 5, 46, 56, 120, 161 Early and Periodic Screening, Diagnosis, and Treatment Program, see EPSDT

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From page 191...

... Supplemental Security Income, 131 see also Outreach EPSDT, 50, 77, 81, 83, 84, 92-94, 127, 155-156 Evaluation, 5, 7, 20-21 clinical assessments, 58, 75, 84, 92, 93, 133 EPSDT, 156 managed care, 133 performance measures, 155, 156, 162-168 federal efforts, 157-160, 163, 167- 145; 146, 149(n.32) , 150-154 HEDIS, 54, 156, 161-162 managed care, 54, 94 Medicaid, 94 private sector, 163- 166 SCHIP, 6, 18, 21 special needs children, 127, 128 state programs, other, 112, 118, 167-168 SCHIP, 6, 18, 21 special needs children, programs, 21, 127, 128 see also Accountability; Information infrastructure Evidence-based approach, 2, 14, 16, 18, 167, 168 F Families and households, 34,35-38, 5253, 136 emotionally disturbed children, 125 employer-based coverage, 18, 149, 151 single-parent families, 34-37, 152 see also Parents Family physicians, 121, 131, 164 Family planning, 58, 60, 61, 90, 91, 160 Federal government data sources, 2, 17, 156, 157-169 Current Population Survey, 2, 17, 25, 156, 157 employer-based coverage, mandated, 148-149, 151 Disproportionate Share Hospital payments, 4, 38, 68, 69, 70, 82, 85, 89 funding, 2, 4, 68 community health care centers, 70 local services, 68 matching funds, 12, 13, 68, 84, 90, 103 SCHIP, 13, 42, 79-80, 85, 108 school-based centers, 79 special needs children, 127, 128 see also Block grants performance measures, 157- 160, 163, 167-168 preemption of state insurance laws, 147-148 public health departments, 76 safety net providers, 68, 70, 74 state cooperation with, general, 14, 147-148, 167 tax policy, 1, 14, 22, 108, 116, 144,

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From page 192...

... Firewalls, 42, 114 Florida, 79, 106-112 Food aid, see Nutrition Food Stamp program, 97, 149 Foundation for Accountability, 162, 166 Funding community health centers, 70, 72, 73-74 federal, 2, 4, 68 community health care centers, 70 local services, 68 matching funds, 12, 13, 68, 84, 90, 103 SCHIP, 13, 42, 79-80, 85, 108 school-based centers, 79 special needs children, 127, 128 Medicaid, 83, 85, 90 mental health services, 124 patchwork, 25, 77 public health departments, 78 safety net providers, 68-70, 72, 73 74, 79-80 SCHIP, 13, 79-80, 85, 108 school-based health centers, 79 state programs, 2, 13, 79-80, 85, 108, 110, 112, 113, 114 copayments, 103, 108, 110, 112, 113, 114 premiums, 104,108,110, 112, 113, 114, 116 Supplemental Nutrition Program for Women, Infants, and Children, 69, 78, 129 see also Balanced Budget Act of 1997; Block grants; Personal Responsibility and Work Opportunity Reconciliation Act of 1996 INDEX G Gender factors emergency room visits, 51 single-parent families, 35, 36, 37 Georgia, 115 Government role, see Federal government; Local government; State government Hawaii, 106,109,111, 148 Health beliefs Hispanics, 53 parental, 25 Southeast Asians, 54 Health Care Financing Health Insurance Portability and Accountability Act of 1996, 133 Health maintenance organizations, 133, 136, 137 Digital Equipment Corporation, 162, 164-165 HealthPartner, 127 Healthplan Employer Data Information System, see H HEDIS Health Resources and Services Administration, 25, 94, 155, 157 Health education, 20, 21, 58, 61, 93, 115, 117, 121, 129, 133, 134, 162, 165 counseling, 58, 59, 60, 78, 121, 167 Health insurance, general, 1-2, 13-14, 16, 17, 136-137 access to care and, 46-51 African Americans, 3, 27, 3 2-33 age factors, 21, 27, 30-3 1 Asians/Pacific Islanders, 27, 32-33, 34 catastrophic, 84, 108, 146, 148, 150 copayments, 19, 51, 52, 103, 108, 110, 112, 113, 114, 129, 145 deductibles, 19, 52, 127, 129, 145, 146, 148-152 (passim) entitlement to, 6, 19 Hispanics, 3, 27 information infrastructure, 20-21, 22, 25-27, 155-163 market-based approaches, 143-154 risk adjustment, 123, 136, 145 risk pools, 110 standards, benefits, 3, 5, 58, 60, 91, 92, 99, 133, 148-150 benchmark coverage, 61, 137, 140 Healthy People 2000, 166-167 HMOs, 162-165 see also Eligibility; Employer-based insurance; Enrollment; Medicaid; Medicare; Premiums; Private health insurance; SCHIP; Tax policy; Uninsured adults; Uninsured The Future of Public Health, 75 children Administration, see Maternal and Child Health Care Services Block Grant Health Security Act, 148 Health services, availability and access, 1, 2, 3, 11, 13-14, 16, 17, 23, 25, 44-61, 120-139 African Americans, 41, 49, 51, 53, 54 age factors, 44 continuity of care, 50, 55, 162 cultural factors, 52, 53-54, 129 culturally sensitive services, 3, 7, 54, 56 safety net providers, 68 defined, 44, 55 equipment, 5, 58, 60, 61, 120, 128, 129, 130, 131, 132, 136 financial barriers, 44-52; see also Employment status; Poverty; Socioeconomic status framework for, 45 Hispanics, 32-33, 41, 53 managed care, 54-55, 79, 133, 136 military health care, 24, 26 nonfinancial barriers, 7, 20, 45, 53, 129-132, 136 child care (day care)

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From page 193...

... . Organlzatlons Home health care, 67, 75, 90, 115, 158 Homeless persons, 67, 68 Hospitals and hospitalization, 1, 46-48, 116, 159 asthmatics, 53 children's hospitals, 1, 14, 67, 72, 75-77, 131, 134 developmentally disabled children, 125 length of stay, 77 poor persons, 47, 53, 61, 68, 70, 77, 89 rehabilitation, 58, 60, 72, 75, 76 safety net services, 68, 72, 75, 76 Disproportionate Share Hospital payments, 4, 38, 68, 69, 70, 82, 85, 89 state programs, 108, 112, 113, 114, 115, 116 see also Emergency care Human immunodeficiency virus, 5, 115, 120, 128-129 193 L Language factors, 53, 54 Legislation, 22, 96-99 Balanced Budget Act of 1997, 12, 38, 68, 72, 85, 98-99, 128, 167; see also SCHIP Drug-Free Schools and Communities Act, 79 Health Insurance Portability and Accountability Act of 1996, 133 Health Security Act, 148 history of Medicaid legislation, 84 85 Medicaid Voluntary Contribution and Provider-Specific Tax Amendments of 1991, 85 Medicare Catastrophic Coverage Act of 1988, 84 Omnibus Budget Reconciliation Acts, 84, 85, 155-156 Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 12, 85, 96, 125, 131 preemption of state insurance laws, federal, 147-148 Public Health Service Act, 70, 128 safety net providers, 68 Social Security Act of 1965, 13, 69, 75, 84; see also listings under "Social Security Act of 1965" Tax PayerReliefActofl997, 151 Length of stay, 77 Local factors special needs children, 127, 136 state programs responsive to, 104 racial/ethnic factors, 34 see also Community health centers Local government community health centers, funding, 70, 72 public health departments, 77, 78 special needs children, 127 Low-income persons, see Poverty Internet, 133, 134-135, 156, 165 Iowa, 106, 109, 116 Joint Commission on Accreditation of Healthcare Organizations, 161-162, 166 K M Kaiser Permanente, 116-117 Maine, 103 Kansas, 106, 109, 116 Managed care, 4, 137 AFDC population, 12 cost and cost-effectiveness, 4, 136 193

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From page 194...

... , 2-5, 6, 21, 23, 27, 28, 34,36, 81-99, 116, 136-137 access to care, 44, 46-51 accountability, 89-90, 94 administrative barriers, 87-88, 103, 113, 115, 150 age factors, 27, 30-31, 41 buy-in, 98 community health centers, 70, 72, 73 coverage estimates, 24-33,36, 81 83 disabled persons, 13, 82, 84, 98, 99 EPSDT, 77, 78, 81, 83, 84, 92-94 eligibility, 4-5, 12-14, 42, 80, 83-88, 90, 96-98, 99, 103, 104, 113, 127 age factors, 5, 83-84, 114 income thresholds, 5, 6, 13, 27, 79, 96, 150 SCHIP and, 5, 13, 20, 13, 42 welfare and, 4-5, 12, 88, 89, 96 99 employer-based insurance vs. 27, 41, 149 enrollment, 3, 4-5, 13, 22, 25, 41, 50,72,79,83-84,87-88,90, 93,94,95,98,99, 128 evaluation, 21 funding, 83, 85, 90 history, 81-83, 84-85 INDEX injuries, 46 litigation by beneficiaries, 168 managed care, 4, 11, 12- 13, 68, 72, 83, 89, 94-96, 98-99, 128, 137 primary care, 83, 117 public health departments, 78 race/ethnicity, 27-28, 32-34, 41 safety net providers, 4, 12-13, 67, 68,69,70,72,73,77,78,79 SCHIP and, 2, 5, 6, 12, 13, 20, 42, 61, 83, 102, 107, 137 school-based health centers, 79 special needs children, 127-128, 136 state programs, 2, 3, 11, 83, 85, 86, 90, 93, 96, 98-99, 102-104, 107, 112, 113, 115, 137 substitution of coverage, 27, 41-42, 105-108 welfare delinking, 4-5, 12, 89, 96-98 see also Disproportionate Share Hospital payments; Medicaid; Medicare Medicaid Data System, 157 Medicaid Voluntary Contribution and Provider-Specific Tax Amendments of 1991, 85 Medi-Cal, 116- 117 Medical equipment, 5, 58, 60, 61, 120, 128, 129, 130, 131, 132, 136 Medical Expenditure Panel Survey, 157 Medical home, see Usual source of care Medical Savings Accounts, 2, 14 Medicare community health centers, 70, 73 safety net providers, 67, 69 statistical trends, 24, 25, 26 Medicare Catastrophic Coverage Act of 1988, 84 Mental health and illness, 123, 124125, 127, 131, 137, 166 behavioral disorders, 60, 98, 124, 128 school-based care, 79 state benefits, 108, 112, 137 substance abuse, 115, 123, 124-125, 127, 166 Mercy Health Plan, 117 Michigan, 79, 103, 106, 109, 117 Military health care, 24, 25, 26 Minnesota, 103, 106, 109, 110, 111 Minority groups, see RaciaVethnic factors; specific groups Missouri, 116 Montana, 103, 106, 109, 116 N National Ambulatory Medical Care Survey, 157 National Association of Children's Hospitals and Related Institutions, 75, 77 National Cancer Institute, 126 National Center for Health Statistics, 44 National Committee for Quality Assurance, 161, 166 National Employer Health Insurance Survey, 159 National Forum on the Future of Children and Families, 58 National Health and Nutrition Examination Survey, 158 National Health Interview Survey, 158 National Health Provider Inventory, 158 National Home and Hospice Care Survey, 158 National Hospital Ambulatory Medical Care Survey, 159 National Hospital Discharge Survey, 159 National Immunization Survey, 159 National Institute of Mental Health, 124 National Medical Expenditure Survey, 34, 46, 146 National Nursing Home Survey, 159 National Survey of Ambulatory Surgery, 159 National Survey of Family Growth, 160 National Vital Statistics System, 160 Native Americans, 27 Neural system disorders, 5, 120, 125, 134-135 New Hampshire, 103, 106, 109 New Jersey, 103, 105, 109, 111 New York State, 79, 103, 106, 109, 111 North Carolina, 106, 109, 115, 116 Nurses and nursing services, 58, 60, 61, 75, 79, 90, 91, 115, 123, 127, 131, 132 Nutrition, 69, 78, 121, 125, 135, 158, 166 Food Stamps, 97, 149 o Ohio, 115, 117 Omnibus Budget Reconciliation Acts (OBRA)

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From page 195...

... , 5, 19, 47, 53, 55, 57-59, 120, 121, 128, 133, 161 cost factors, 57, 120 counseling, 58, 59, 60, 78, 121, 124, 167 dental, 50 EPSDT, 77, 78, 81, 83, 84, 92-94 family planning, 58, 60, 61, 90, 91, 160 federal role, 148 Healthy People 2000, 78, 123, 128, 162, 166-167 poor persona, general,3,47,133, 136 private insurers, 115, 116, 164, 165 safety net providers, 68, 78 standards, 3, 148 state programs, 104, 113, 114, 137 utilization rates, 21 see also Immunization Preventive Health Block Grant, 79 Primary care, 120, 124, 131 access/use, 1, 5, 14,34, 47, 118, 121, 124, 125, 132, 164, 165, 167 HEDIS, 161 managed care, 126, 131, 136, 164 Medicaid, 83, 117 private insurers, 116, 117, 164, 165 safety net providers, 4, 67, 68, 70, 79 state programs, 112- 115 (passim) Private health insurance, 2, 4, 5, 6, 18, 21-22, 24, 26, 115-118, 137, 144-145 Blue Cross/glue Shield, 103, 115, 116, 126, 137 community health centers, 73 enrollment, 116, 117, 144-145 managed care, commercial, 21, 54, 72, 89, 93, 94, 99 HMOs, 137, 164, 165 Kaiser Permanente, 116- 117 Medicaid, reimbursement vs.

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From page 196...

... , 2, 5, 6, 12 13, 14, 18, 40, 61, 99, 102, 107, 110, 112, 118, 137, 168 accountability, 2, 14, 18, 42, 105, 118, 168 adults, 70 disabled persons, 13 eligibility, 5, 6, 13, 20, 42, 88, 99, 105, 106, 118, 168 enrollment, 5, 6, 13, 21, 43, 79, 88, 168 evaluation, 6, 18, 21 funding, 13, 42, 79-80, 85, 108 managed care and, 99 Medicaid and, 2, 5, 6, 12, 13, 20, 42, 61, 83, 102, 107, 137 outreach, 88 poverty, 2, 13 S federal poverty level and, 13, 105, 106 performance measures, 6, 18, 21 safety net providers, 6, 70, 79-80 subsidies, 6, 118 145(n.11) , 148, 149 Social Security Act of 1965 Title V, see Maternal and Child Health Care Services Block Grant Title XVI, see Supplemental Security Income Program Title XIX, see Medicaid Title XXI, see SCHIP Socioeconomic status, 23, 34-37 access to care, 44, 48-49 ~ .

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From page 197...

... poor persons, 4, 79, 103, 104, 150, 153 private insurers, 116, 117, 148 safety net providers, 4, 68, 70, 79 SCHIP, 6, 118 state programs, 5, 42, 99, 101-115 (passim) , 118, 148 tax policy and, 16, 144, 145, 146, 149-153 see also Vouchers Substance abuse, 115, 123, 124-125, 127, 166 Substance Abuse and Mental Health Services Administration, 124 Substitution of coverage, 27, 41-42, 105-108 premiums, 104,108,1 10,1 12,1 13, Supplemental Nutrition Program for 114, 116 Women, Infants, and Children funding, 69, 78, 129 Supplemental Security Income preventive care, 104, 113, 114, 137 primary care, 1 12-1 15 (passim)

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From page 198...

... , see Medicaid Title XXI (Social Security Act) , see SCHIP Tobacco tax, 104, 108, 113, 116 Transportation, 7, 20, 21, 53 safety net providers, 67 special needs children, 5, 129, 132, 136 U Uncompensated care, 68, 70, 71, 79, 114 Disproportionate Share Hospital payments, 4, 38, 68, 69, 70, 82, 85, 89 UniHealth, 117 INDEX Uninsured adults, 4, 24, 26, 27, 68, 70 parents, 107, 151 see also Safety net providers; SCHIP Uninsured children, 2, 7, 13, 16, 23, 24, 34, 42, 83, 89-90 access to care, 44, 46-52, 56, 146 age factors, 27, 30-3 1, 41 community health centers, 73 employed parents with, 23, 34, 149 extent of, 3, 11, 23-33, 41, 70 race/ethnicity, 27, 41 school-based health centers, 79 state/regional patterns, 3, 38, 40, 113, 115, 116, 117 study methodology, 1 temporal factors, duration, 34, 38, 39, 107 waiting periods, 114 see also Safety net providers; SCHIP United HealthCare of Ohio, 117 Urbanareas,54, 115 U.S.

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Index Pages 189-198

Index
Pages 189-198