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.

When the nest egg cracks: financial consequences of health problems, marital status changes, and job layoffs at older ages

Abstract: The risk of falling into poor health, losing the ability to work or live independently, becoming widowed, and experiencing other negative events that threaten financial security increase with age. This report computes the incidence of these negative events at older ages and examines their impact on economic well-being. Over a 10-year period, more than three-quarters of adults age 51 to 61 at the beginning of the period experience job layoffs, widowhood, divorce, new health problems, or the onset of frailty among parents or in-laws. More than two-thirds of adults age 70 and older experience at least one negative shock over a nine-year period. Incidence rates are even higher at the household level for married people, who face the added risk that their spouses could develop health problems or lose their jobs. Financial consequences are especially serious for older adults who develop work disabilities or long-term care needs, or who become unemployed.

Consumer-driven health care may not be what patients need--caveat emptor.

Abstract: In addition to policy concerns that consumer-directed health care, based on high deductibles and tax-advantaged health savings accounts will lead patients to forgo needed care and would not reduce costs for those with high annual health care costs, this health reform model poses a major threat to the role of physician-patient trust as a fundamental underpinning of the health care system. Although physicians have deviated from ideals of professionalism in various ways, patients still rely on physicians, as professionals, to serve their patients' best interests. In a commentary in the Journal of the American Medical Association , Urban Institute Senior Fellow Bob Berenson and Christine Cassel argue that the competitive vision that is core to consumer-driven care would inevitably replace professional ethics with, at best, commercial ethics, a development that should be resisted as health care reform proceeds.

States’ Use Of Medicaid UPL And DSH Financing Mechanisms

Abstract: Using data from a 2002 survey, we look at the design and operation of disproportionate-share hospital (DSH) and upper payment limit (UPL) programs in thirty-four states. We find that more of the available DSH gains are paid to safety-net hospitals than occurred in the late 1990s. By contrast, survey data suggest that the bulk of available UPL gains are being kept by states and not by providers. Using simulation analyses, we estimate that because of DSH and UPL practices among the survey states, the effective 2001 federal Medicaid match rate was about three percentage points higher on average in these states than it would have been otherwise.

An American Approach to Health System Reform

Abstract: THE MAJOR problems in the United States' health care system today are the large number of uninsured Americans, the high and rising costs of the system, and the system's administrative complexity. With over 32 million Americans lacking health insurance at any time and 63 million Americans lacking health insurance at some point during a recent 28-month period, the problem of being uninsured is faced by a large percentage of the population. 1-5 Despite this lack of coverage, the United States spends more on health care, per capita and as a percentage of gross national product (GNP), than any other country. In addition, we also have one of the highest rates of increase—over 4% per year after adjusting for inflation. 6,7 Finally, it is estimated that the annual administrative expenses borne by insurance companies, physicians, hospitals, and other providers are about $80 billion, or 1.5% of GNP. 8 This does not

Post-ACA, More Than One-Third Of Women With Prenatal Medicaid Remained Uninsured Before Or After Pregnancy.

Abstract: Medicaid has a long history of serving pregnant women, but many women are not eligible for Medicaid before pregnancy or after sixty days postpartum. We used data for new mothers with Medicaid-cover...