Urban Institute

About: Urban Institute is a nonprofit organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Medicaid & Population. The organization has 927 authors who have published 2330 publications receiving 86426 citations.

National estimates of the effects of mandatory Medicaid managed care programs on health care access and use, 1997-1999.

Abstract: This study explores how mandatory Medicaid managed care (MMC) programs affect access to care and use among full-year Medicaid beneficiaries, using data from the 1997 and 1999 National Survey of America?s Families. The authors compare Medicaid enrollees in FFS and MMC counties. To control for unobserved county differences, the authors estimate difference-in-difference models using a comparison group of privately insured individuals. The effects of MMC vary by type of program, with weaker effects for PCCM programs relative to programs that require mandatory HMO enrollment. The strongest finding is that HMO programs lower emergency room use by Medicaid adults. (Garrett, Bowen, and Zuckerman, Stephen. July 2005. National Estimates of the Effects of Mandatory Medicaid Managed Care Programs on Health Care Access and Use, 1997-1999. (Medical Care 43(7):649-657.)

Coverage, access, and affordability under health reform: learning from the Massachusetts model.

Abstract: While the impacts of the Affordable Care Act will vary across the states given their different circumstances, Massachusetts' 2006 reform initiative, the template for national reform, provides a preview of the potential gains in insurance coverage, access to and use of care, and health care affordability for the rest of the nation. Under reform, uninsurance in Massachusetts dropped by more than 50%, due, in part, to an increase in employer-sponsored coverage. Gains in health care access and affordability were widespread, including a 28% decline in unmet need for doctor care and a 38% decline in high out-of-pocket costs.

Change Over Time in Caregiving Networks for Older Adults With and Without Dementia.

Abstract: Objectives We provide national estimates of caregiving networks for older adults with and without dementia and examine how these networks develop over time. Most prior research has focused on primary caregivers and rarely on change over time. Method We identify a cohort of older adults continuously followed in the National Health and Aging Trends Study between 2011 and 2015 and receiving help from family members or unpaid caregivers in 2015 (n = 1,288). We examine differences by dementia status in network size, types of assistance and task sharing, and composition-differentiating between "specialist" and "generalist" caregivers helping in one versus multiple activity domains. Multinomial regression is used to estimate change over time in network task sharing and composition. Results In 2015, older adults with dementia had larger caregiving networks involving more task sharing than those without dementia and more often relied on generalist caregivers, especially the subset assisting with medical, household, and mobility or self-care activities. Uniformly greater reliance over time on these more intensely engaged generalist caregivers chiefly accounts for larger dementia networks. Discussion Findings lend support to the need for caregiver training on managing multiple task domains and-for dementia caregivers in particular-task-sharing skills. More generally, the design of new approaches to better support older adults and their caregivers should consider the complexity, heterogeneity, and change over time in caregiving networks.

The Effects of Holding Assets on Social and Economic Outcomes of Families: A Review of Theory and Evidence

Abstract: This report examines the effects of asset-holding and asset accumulation on individuals and families from theoretical and empirical perspectives. The report pays special attention to the way assets affect low-income families, while recognizing that research on this topic is limited. The goal of the report is to distill the main findings from the vast theoretical and empirical literature on how assets influence economic and social well-being. The first step is to present a conceptual framework based largely on our classification of existing literature in economics, psychology, and sociology. The second step is to bring together the empirical findings relevant to the categories specified in the conceptual framework. The report concludes with suggestions for future research, especially related to the role of assets in the lives of low-income families.