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.

Revisiting E&M visit guidelines--a missing piece of payment reform.

Abstract: The Current Procedural Terminology codes covering evaluation and management ( E&M) services and their interpretive documentation guidelines create serious problems that should be addressed now, lest they be replicated in new approaches to provider payment.

Addressing Coverage Gaps For Low-Income Parents

Abstract: This paper examines how rates of uninsurance for low-income parents have been changing over time and the extent to which expanding coverage to parents through Medicaid and the State Children’s Health Insurance Program (SCHIP) could help them. We find that uninsurance rates have been rising for low-income parents, especially those living in poverty, and that Medicaid and SCHIP could greatly reduce uninsurance among parents and would likely increase their access to care. Such expansions would still leave many noncitizen parents uninsured and would require reaching and enrolling families whose children have remained uninsured despite being eligible for public coverage.

Health policy for low-income people: states' responses to new challenges.

Abstract: The past five years have given states new opportunities in health policy for low-income people, with many changes increasing states' flexibility. However, new pres- sures on state policy also have arisen from a variety of factors, most recently from the eco- nomic downturn that has reduced revenues and increased demand for spending. This pa- per analyzes recent changes in health policy in the thirteen states that are the core of the Urban Institute's Assessing the New Federalism project, focusing on state fiscal conditions, health care coverage, acute care, and long-term care. Implications for the future are discussed. A lthough t he past f ive y ears have given states new opportunities in health policy for low-income people, they have also put new pressures on policy formulation. Many developments have increased states' flexibility, including welfare reform and the delinking of Medicaid from cash assistance, new funding for children's health insurance coverage under the State Children's Health Insurance Program (SCHIP), repeal of federal minimum standards for nursing home and hospital reimbursement that constrained states' control over Medicaid payments, and increased federal willingness to grant waivers under Medicaid (and now under SCHIP as well). Fiscal capacity also rose—from booming revenues during the long economic expansion of the 1990s and from new tobacco settle- ment funds. However, new pressures on revenues and state policy have resulted from recent federal economizing under Medicaid and Medicare, including cuts in safety-net support programs that some states were thought to be abusing; political pressures for state tax cuts; and, starting in 2000, an economic slowdown followed by reces- sion. New pressures also arose from the Supreme Court's Olmstead v. L.C. decision, which established a limited right to home and community-based services under the Americans with Disabilities Act; rapid growth in pharmaceutical spending; and the difficulties faced by Medicaid managed care. Political demands for public

Lesbian, Gay, And Bisexual Adults Making Gains In Health Insurance And Access To Care

Abstract: The uninsurance rate for lesbian, gay, and bisexual (LGB) adults fell dramatically as the Affordable Care Act (ACA) was implemented and many states began recognizing same-sex marriages. LGB adults were also increasingly likely to report a usual source of care, but significant disparities in access and affordability by sexual orientation remain.

Routine Activities of Youth and Neighborhood Violence: Spatial Modeling of Place, Time and Crime

Abstract: This chapter discusses how a geographic information system (GIS) and spatial analysis are used to model the relationship between the daily routine activities of youth and rates of violence, and provides an example of how these techniques can be applied to analytical studies examining violence in places. Most research informing hotspots and related crime prevention efforts focuses on the contribution of places and the physical environment to crime levels. Yet very little is known about how time influences patterns of crime across places and environments. This chapter discusses how time of day, week and year can be incorporated into spatial analysis of crime patterns to further inform crime prevention. A model of opportunity factors is developed to predict the spatial and temporal relationship among violence, schools, youth hangouts, retail properties IDEA GROUP PUBLISHING This chapter appears in the book, Geographic Information Systems and Crime Analysis, edited by Fahui Wang. © 2005, Idea Group Inc. 701 E. Chocolate Avenue, Suite 200, Hershey PA 17033-1240, USA Tel: 717/533-8845; Fax 717/533-8661; URL-http://www.idea-group.com ITB10855