What's New with HCFO - May 19, 2006 (Print All Articles)
Health Insurance and Small Businesses: Ways to Make Coverage More Affordable
Health Insurance and Small Businesses: Ways to Make Coverage More Affordable
As policymakers continue to struggle with how best to meet the health care coverage needs of employees of small businesses, legislation has once again stalled in Congress. On May 11, 2006, a bill that would have allowed small businesses to join together and create association health plans (S. 1955) failed to pass in the Senate.
Introduced in November 2005, this bill sponsored by Senate Health, Education, Labor and Pensions Committee Chair Mike Enzi (R-WY) would have allowed small businesses and trade associations to form association health plans across state lines. These association-sponsored Small Business Health Plans (SBHPs) would contract with a licensed insurance carrier to provide health insurance to the association’s members and their employees. Unlike current regulations, insurers would be allowed to sell plans to employers and individuals as part of the SBHP that do not meet current state benefits mandates. They would then, however, also be required to offer a plan with benefits provided under a state employees’ plan in one of the five most populous states (California, Florida, Illinois, New York and Texas). Variation in premiums from one small business to another would be also limited, preempting current state laws.1
Of the three bills currently before Congress, the Enzi bill was widely viewed as having the best chance of passing. Proponents of the Enzi bill, including the Bush administration and trade associations, argued that it would help small businesses by improving affordability to employers and employees, exempting small businesses from having to comply with expensive and varying state requirements.2, 3, 4 Those opposing the Enzi legislation, as well as the formation of association health plans in general, contend that insurers and small businesses will be exempt from state mandated protection, resulting in possible harm and increased costs for sicker workers.5
Group purchasing arrangements, including AHPs, vary widely in their structure, and state regulation of such plans also varies. All such plans seek to achieve cost savings by encouraging employers and/or self-employed individuals to combine their purchasing power to negotiate lower health insurance premiums than they could otherwise achieve. Some group purchasing arrangements are self-insured, and therefore, able to save additional costs, including premium taxes. Group Purchasing Arrangements: Issues for States, an issue brief prepared for the State Coverage Initiatives program, highlights policy and regulatory issues arising from group purchasing arrangements.
In a HCFO-funded study, Mila Kofman, J.D., and colleagues at Georgetown University have been examining the dynamics of pooled purchasing arrangements, including association health plans (AHPs), multiple employer welfare arrangements (MEWAs), and health insurance purchasing coalitions (HIPCs). In particular, she has examined market problems, like the historically high risk of insolvencies in self-insured arrangements and fraudulent health insurance promoted through pooled purchasing arrangements. Kofman’s work suggests that the challenge for policymakers will be to balance the benefits of association health plans with the potential that these arrangements have for financial instability. A searchable database, with information gathered as part of this study, is available at http://www.hcfo.net/mewa/index.cfm.
In an effort to better understand the likely impact of exempting AHPs from state regulation, some analysis of group purchasing arrangements has been done. In particular, Mila Kofman and colleagues at the Health Policy Institute at Georgetown University examined states’ experiences with Multiple Employer Welfare Arrangements (MEWAs), self-insured AHPs, often with less stringent licensing requirements than traditional insurers. As reported in a Commonwealth Fund issue brief, MEWAs have “a troublesome history of financial instability.” Kofman warns that policymakers must be aware of the need for consumer protections, particularly with respect to plan solvency.
Despite the frustration of three failed attempts to establish AHPs to address the health coverage needs of small businesses, in as many years, federal policymakers are likely to revisit this issue. As Senator Joe Lieberman (D-CT) said, the “failure ultimately will signify nothing good for millions of Americans who need health insurance.”6 With this debate remaining on the policy agenda, ongoing and completed HCFO projects can inform discussion and policy proposals addressing the health insurance needs of small businesses, in general, and the merits of association health plans, in particular.
HCFO Funded Research
Title: Private Insurance Markets: The Missing Link—Association Health Plans and Other Pooled Purchasing Arrangements
Institution: Georgetown University
Principal Investigator: Mila Kofman, J.D.
Grant Duration: April, 2003–April, 2005
Paragraph Summary: What are the dynamics of pooled purchasing arrangements? In this study, the researchers were: (1) identifying and describing different types of pooled purchasing arrangements, identifying examples of each type, and discussing how such arrangements are regulated by states and the federal government; (2) describing how coverage sold through such arrangements is regulated, focusing on key market reforms and consumer protections as well as applicable federal standards; (3) providing estimates on the prevalence of such arrangements; (4) summarizing how self-insured arrangements are regulated, identifying weaknesses in the law, discussing recent insolvencies, and identifying successful oversight approaches; and (5) discussing market failures focusing on the recent influx in health insurance scams promoted through pooled purchasing arrangements. The objective of this study was to inform state and federal policy discussions on expanding the role of association health plans and other pooled purchasing arrangements. In addition, it intended to help policymakers address current problems that consumers face such as insolvency and fraud.
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Title: The Anatomy of ERISA Health Plans: Describing their Basic Structure and Key Areas of Variation
Institution: George Washington University, Center for Health Services Research and Policy
Principal Investigator: Phyllis Borzi, J.D.
Grant Duration: October, 2001–August, 2002
Paragraph Summary: How do variations in ERISA health plans affect the formation of policy? The researchers examined the anatomy of key types of ERISA health plans (i.e. identifying the fundamental characteristics, features, and structures that distinguish the plans), focusing on those distinctions that are relevant to the current “patients’ rights” and “defined contribution” debates. In addition, they attempted to correct “prevalent public misconceptions” that may impede legislative development (i.e. the misconception that HMO’s are making health plan decisions, when, in fact, decisions may be made by the administrators or fiduciaries of an ERISA plan.) The researchers hypothesized that “there exist important areas of variation among different types of ERISA health plans that might present policymakers with cause to consider crafting flexible laws and regulations that take into account this variation.” The objective of the project was to provide policymakers with information on variations in ERISA health plans that are relevant to current debates on health plan regulation.
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Title: Sustaining Individual Health Insurance Markets Under Community Rating and Open Enrollment
Institution: Rutgers, The State University of New Jersey
Principal Investigator: Joel Cantor, Sc.D.
Grant Duration: April, 2002 - September, 2003
Paragraph Summary: What is the current extent of risk selection in New Jersey’s Individual Health Coverage Program (IHCP), which was implemented in 1992 as part of the state’s individual market reforms? What are the policy options for sustaining access to individual health plans and describe the role of the non-group coverage in New Jersey’s health care insurance market? Using data from The Robert Wood Johnson Foundation-funded New Jersey Family Health Survey (NJFHS), the researchers aimed to answer the following questions: (1) How has the distribution of risk changed in the IHCP since 1995-6 and what are the implications of those changes for the viability of community rating and related reforms? (2) What is the potential impact on current or potential IHCP enrollees of adopting modified community rating? and (3) What role does the IHCP play in the continuum of coverage in New Jersey? The objective of this study was to analyze changes in New Jersey’s small group market in order to inform state policymakers who are considering reforms to make the non-group markets accessible and viable. The researchers supplemented the NJFHS data with a sample of 600 non-group subscribers (subscriber lists provided by top 4 or 5 carriers in state who cover 95% of lives in the individual market). Using the same methodological approach utilized by Swartz and Garnick in the early years of the IHCP, they assessed the risk of medical expenditures of adult IHCP enrollees compared to that of a contrast population comprised of individuals with non-small-group employment-based insurance. They also compared the IHCP enrollees with the entire employer-group market and the uninsured.
Grantee Publications:
Title: Market Watch: Community Rating and Sustainable Individual Health Insurance Markets in New Jersey
Author(s): Monheit AC, Cantor JC, Koller M, and Fox KS
Journal: Health Affairs
Volume: 23(4)
Date: July/August 2004
Title: Simulation of the Impact of Modified Community Rating in the New Jersey Individual Health Coverage Program
Author(s): Monheit A, Cantor J, and Banerjee P
Journal: Rutgers Center for State Health Policy
Volume: N/A
Date: March 2005
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Title: State Health Care Purchasing Practices
Institution: JSI Research and Training Institute
Principal Investigator: James H. Maxwell, Ph.D.
Grant Duration: December, 2001 - February, 2004
Paragraph Summary: What are the implications of state employers’ purchasing practices for employees and future purchasing? This study continued their earlier HCFO-funded work looking at purchasing among Fortune 500 employers and built on earlier HCFO work conducted by Bryan Dowd. Specifically the researchers pursued five objectives. They were: 1) documenting the health care purchasing practices among state employers; 2) exploring the relationship between health care purchasing and procurement for other goods and services; 3) studying the effects of public sector unions and collective bargaining on health benefits; 4) comparing the results from this study to the findings from the Fortune 500 study; and, 5) examining innovation in purchasing among state employers. This study provides state executives and other decision makers with more information about the purchasing behavior of state employers.
Grantee Publications:
Title: Managed Competition versus Industrial Purchasing of Health Care among the Fortune 500
Author(s): Maxwell J and Temin P
Journal: Journal of Health Politics, Policy and Law
Volume: 27(1)
Date: February 2002
Title: Corporate Health Care Purchasing Among Fortune 500 Firms
Author(s): Maxwell J, Temin P, and Watts C
Journal: Health Affairs
Volume: 20(3)
Date: May/June 2001
Title: Managed Competition in Practice: 'Value Purchasing' by Fourteen Employers
Author(s): Maxwell J, Briscoe F, Davidson S, Eisen L, Robbins M, Temon P, and Young C
Journal: Health Affairs
Volume: 17(3)
Date: May/June 1998
Title: Corporate Health Care Purchasing Among The Fortune 500
Author(s): Maxwell J, Briscoe F, Watts C, Zama S, Temin P
Journal: National Health Care Purchasing Institute
Volume: N/A
Date: May 2001
Title: The Benefits Divide: Health Care Purchasing in Retail versus Other Sectors
Author(s): Maxwell J, et al.
Journal: Health Affairs
Volume: 21(5)
Date: September/October 2002
Title: Private Health Purchasing Practices in the Public Sector: A Comparison of State Employers and the Fortune 500
Author(s): Maxwell J, Temin P, and Petigara, T
Journal: Health Affairs
Volume: 23(2)
Date: March/April 2004
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Title: Guaranteed Renewability in Individual and Group Health Insurance: Functioning and Future Prospects
Institution: University of Pennsylvania, The Wharton School
Principal Investigator: Mark V. Pauly, Ph.D
Grant Duration: November, 2001 - October, 2002
Paragraph Summary: If private insurers can be encouraged to improve the protection offered by their products, is it possible that those improvements can benefit consumers and obviate the need for regulation with undesirable side effects? This project focused on the individual and small group insurance markets; namely, the sharp increases in premiums which occur when an individual incurs large medical expenses. The researchers carried out three research tasks, summarized as follows: 1) Estimated the age profile of premiums for an “optimal,” benchmark guaranteed renewability (GR) policy that would cover claims (including the expenses of high-risk insureds) but not be priced so high that low-risks would leave for a cheaper policy. 2) Used data from MEPS, longitudinal claims data bases, and the Health and Retirement Survey to calibrate an empirically based, “exploratory” model derived from the optimal policy described in (1) that they can use in task #3. 3) Simulated hypothetical case studies that members of the Society of Financial Service Professionals, participating in “virtual focus groups,” evaluated on the basis of degree of realism. This study determines the effects of guaranteed risk on public policy, (particularly if GR could provide protection to high risks in a population) and informs insurance firms and insurance regulators on how to make GR work better.
Grantee Publications:
Title: Guaranteed Renewability and the Problem of Risk Variation in Individual Health Insurance Markets
Author(s): Patel V, Pauly MV
Journal: Health Affairs Web Exclusive
Volume: N/A
Date: September 2002
Title: The Non-Group Health Insurance Market: Short on Facts, Long on Opinions and Policy Disputes
Author(s): Pauly MV, Nichols LM
Journal: Health Affairs Web Exclusive
Volume: N/A
Date: October 2002
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Title: Studies of the Working Uninsured, Their Dependents and Insurance Reform on Their Behalf
Institution: The Urban Institute
Principal Investigator: Linda J. Blumberg, Ph.D.
Grant Duration: June, 2000 - July, 2002
Paragraph Summary: What are the effects of certain insurance market reforms that were designed to expand coverage? Researchers at the Urban Institute conducted several analyses looking at the working uninsured and these effects using the Current Population Survey (CPS), the National Survey of America’s Families (NSAF), and the National Health Interview Survey. In particular, they aimed to answer the following five questions: 1) Who are the working uninsured? 2) Why do employer-sponsored coverage rates vary across the 50 states? 3) Have health insurance market reforms affected the composition of insured risk pools? 4) Did HIPAA have any effect in the small group market? and 5) Why do so many workers in large firms lack health insurance? The objective of this series of studies was to provide a better understanding of the working uninsured in order to better inform the policy debate about coverage expansions and identify those interventions most likely to work.
Grantee Publications:
Title: Subgroups of Working Uninsured Require Different Enrollment Strategies
Author(s): HCFO
Journal: AcademyHealth
Volume: 6(6)
Date: December 2003
Title: Exploring State Variation in Uninsurance Rates Among Low-Income Workers
Author(s): Blumberg L and Davidoff A
Journal: New Federalism Policy Brief, The Urban Institute
Volume: B-56
Date: October 2003
Title: Consider the Source: Studying Low-Income Uninsured Workers Using Three Different Surveys
Author(s): Blumberg L and Davidoff A
Journal: The Urban Institute
Volume: N/A
Date: 2002
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Title: An Evaluation of the Primary and Secondary Effects of Insurance Market Reform
Institution: Bowman Gray School of Medicine
Principal Investigator: Mark A. Hall, J.D.
Grant Duration: September, 1996 - December, 2000
Paragraph Summary: What are the effects of state health reforms? Researchers at the Bowman Gray School of Medicine evaluated insurance market reforms in 12 states. The effects within a single carrier's various lines of business will be compared among carriers within a given state, and these statewide patterns were compared across states. The study consisted of intensive case studies of insurance market reforms and their effects in a non-random sample of six states that have enacted varying reforms, and a less intensive study of an additional six states. The researchers: 1) conducted two rounds of open-ended interviews of key informants; 2) conducted participant observational studies of insurance agents; 3) did content analyses of sales literature and news articles; and 4) conducted statistical analyses of archival documents and secondary data. The objective of this study was to inform lawmakers and the public policy community on whether and how these reforms have achieved their multiple purposes or caused any negative consequences, and how these reforms might be improved.
Grantee Publications:
Title: HealthMarts, HIPCs, MEWAs, and Association Health Plans: A Guide for the Perplexed
Author(s): Hall M, Wicks E, and Lawlor J
Journal: Health Affairs
Volume: 20(1)
Date: January/February 2001
Title: The Geography and Health Insurance Regulation: A Guide to Identifying, Exploiting, and Policing Market Boundaries
Author(s): Hall M
Journal: Health Affairs
Volume: 19(2)
Date: March/April 2000
Title: Purchasing Cooperatives for Small Employers: Performance and Prospects
Author(s): Wicks E and Hall M
Journal: Milbank Quarterly
Volume: 78(4)
Date: December 2000
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1 “Senate Democrats Block Cloture Motion on Association Health Plan Bill; Measure Now Stalled”. Kaiser Daily Health Policy Report, Friday May 12, 2006. http://www.kaisernetwork.org/daily_reports/print_report.cfm?DR_ID=37234&dr_cat=3
2 Appleby, Julie. “Bill to Help Small Business with Health Insurance Criticized.” USA Today. April 26, 2006.
3 Alliance for Health Reform, “Ideas for Making Health Insurance More Affordable for Small Businesses,’ April 24, 2006.
4 “Senate Democrats Block Cloture Motion on Association Health Plan Bill; Measure Now Stalled”. Kaiser Daily Health Policy Report, Friday May 12, 2006. http://www.kaisernetwork.org/daily_reports/print_report.cfm?DR_ID=37234&dr_cat=3
5 Ibid.
6 Ibid.
This Month in the News
This Month in the News
Susan Zahner, Ph.D., an assistant professor of nursing at the University of Wisconsin-Madison, was recently presented the Van Hise Outreach Award as part of the 2006 Distinguished Teaching Awards. The award, which carries a $5,000 stipend, was presented at a ceremony on April 18th.
Richard Johnson, Ph.D., a principal research associate at the Urban Institute, was quoted in an April 18, 2006 article in the Sacramento Bee that examined the increasing trend of older women living alone into their final years. The article states that according to the U.S. Census Bureau, “older women are nearly twice as likely as older men to live alone and in poverty.” Johnson states that “most frail older people rely on an informal network of unpaid caregivers” because “Medicare covers only limited long-term care, and Medi-Cal (California’s version of Medicaid) is insufficient and limited to those with low incomes and few assets.”
Glen Mays, Ph.D., M.P.H., a professor at the College of Public Health at the University of Arkansas for Medical Sciences, was quoted in an April 19, 2006 article in the Arkansas Democrat-Gazette that detailed the expansion of the Arkansas Surgical Hospital. The article describes a $10 million expansion, which includes increasing the number of beds from 16 to 33, and adding six operating rooms. The expansion was announced only one year after the hospital’s opening. Mays states that although the number of beds is still fairly small, “that kind of growth certainly would attract the attention of hospitals in the market. If that continues, they ultimately are going to be competing more head to head.”
Mila Kofman, J.D., an associate research professor at Georgetown University’s Health Policy Institute, was quoted in an April 24, 2006 article in the Dallas-Fort Worth Star-Telegram that examined how health care costs burden small businesses. The article states that many small businesses are asking employees to contribute more towards their health insurance or attempting to offer health plans options with stingier benefits to reduce their costs. Kofman states that, “the rising cost of drugs, the development of new medical treatments and the aging population’s greater need for health services all contribute to the rising price of health coverage.”
Bruce Stuart, Ph.D., director of the Peter Lamy Center on Drug Therapy & Aging at the University of Maryland, was quoted in a May 1, 2006 article in BusinessWeek Online that examined why some seniors will temporarily lose drug coverage through Medicare Part D. The article states that many seniors were stunned when they unknowingly fell into what policymakers refer to as the “doughnut hole,” the $2,850 gap in coverage by many Medicare prescription drug plans. Stuart said that “about 38 percent of Medicare beneficiaries are at risk” of losing drug coverage in this gap.
David Blumenthal, M.D. , a health policy professor at Harvard Medical School, was recently named one of the 50 most powerful physicians in the United States by Modern Healthcare, according to a May 1, 2006 article in the Boston Globe.
Grantee Spotlight - Thomas C. Buchueller, Ph.D.
Grantee Spotlight May 2006 Thomas C. Buchmueller, Ph.D. Tom Buchmueller is professor of Economics and Public Policy in the Paul Merage School of Business at the University of California at Irvine (UCI), where he is also director of the Center for Healthcare Management and Policy. In addition, Buchmueller is a faculty research associate of the National Bureau of Economic Research and is currently a visiting scholar at the Federal Research Bank of San Francisco. His research focuses on health economics, particularly the economics of insurance and interactions between public programs and private markets. In 2005, he and co-author Tony LoSasso received AcademyHealth’s Article-of-the-Year Award for their work on the effect of SCHIP on public and private insurance coverage. Buchmueller was recently awarded a Packer Policy Fellowship through the Commonwealth Fund and the Australian Department of Health and Ageing to study the effect of rating rules on the market for health insurance in Australia. To conduct this research he will spend the 2006-07 academic year at the Centre for Health Economics Research and Evaluation in Sydney. Buchmueller has received two HCFO grants. The first, awarded in November 1996, examined employee health plan choice and switching behavior under managed competition. Using data on the open enrollment choices for over 100,000 University of California (UC) employees and retirees, Buchmueller and his colleagues Paul Feldstein and Bruce Strombom analyzed the effect of price on health plan choice and switching behavior and the implications of these choices on risk selection among competing plans. They found that the competitive approach was effective in controlling health spending for the UC active employee population. In the three years immediately after UC altered its contribution policy to emphasize price difference among competing health plans, per-employee spending on health benefits fell by 26 percent. However, there was considerable variation in the response to price across employees in different risk categories. Older employees with serious health conditions were much less sensitive to price than younger, healthier ones. Similarly, employees with longer job tenure were less likely to switch health plans in response to a change in premiums than new employees. As a result of this pattern, the higher cost fee-for-service plan that was preferred by older employees and those in poor health experienced a classic adverse selection death spiral. As lower cost employees left the plan, its premiums skyrocketed leading to further declines in enrollment. Buchmueller concluded that without risk adjustment, plans that are more attractive to higher risk individuals may not be viable in a competitive market.1 Buchmueller’s second HCFO grant used a similar research design applied to different data to further investigate the price sensitivity of retirees in a multiple option “managed competition” setting. The data for this research came from a large employer-sponsored health benefit program where the premium contributions required of retirees varied according to when a person retired and years of service at that point in time. This variation created an excellent natural experiment for estimating price effects. Because the structure of the program resembled “premium support” models that have been proposed for the Medicare program, the results have implications for the effect of such reforms. In the first paper using these data, Buchmueller estimated the effect of out-of-pocket premiums on plan choice. He found a statistically significant, but economically modest, effect. The estimated premium elasticities are slightly larger in magnitude than those from his earlier research on UC employees and smaller than results from the literature on active employees. The second paper from this grant, which is forthcoming, was co-authored with Sabina Ohri and examines the effect of premiums on the decision by early retirees who are not yet eligible for Medicare to take up coverage offered by their former employer. In light of the decline in employer-sponsored retiree health insurance, this population is increasingly vulnerable. Consistent with other research in this area, Buchmueller’s results suggest that the take-up decision is less price sensitive than the choice among plans. Simulations suggest that if Medicare coverage were extended to adults between the ages of 55 to 64, as has been proposed, the number of people enrolling would not be particularly sensitive to the extent to which coverage was subsidized. Publications from HCFO-Sponsored Work: Buchmueller, T.C., “Does a Fixed-Dollar Contribution Lower Spending,” Health Affairs, 17(6), 1998. Buchmueller, T.C., “The Health Plan Choices of Retirees Under Managed Competition,” Health Services Research, 35(5), 2000. Buchmueller, T.C., 2000 “Price Sensitivity of Medicare Beneficiaries in a ‘Premium Support’ Setting,” in Competition With Constraints". Challenges Facing Medicare Reform, Washington, DC: Urban Institute Press. Strombom, B.A., Buchmueller, T.C. and Feldstein, P.J. “Switching Costs, Price Sensitivity and Health Plan Choice,” Journal of Health Economics, 21(1), 2002. Buchmueller, T.C. “Price and the Health Plan Choice of Retirees,” Journal of Health Economics, 25(1), 2006. Buchmueller, T.C. and Ohri, S. “Health Insurance Take-up by the Near-Elderly,” Health Services Research, publication forthcoming. 1 Buchmueller, Thomas C., “The Health Plan Choices of Employees and Retirees in a Managed Competition Setting: Evidence from the University of California,” Testimony, Senate Finance Committee, April 4, 2001.
Spotlight on Grantee Publication
Spotlight on Grantee Publication
J. William Thomas, Ph.D., a professor at the Institute for Health Policy at the Edward J. Muskie School of Public Service, University of Southern Maine, is the author of an article that appeared in the April 2006 issue of HSR, titled “Should Episode-Based Economic Profiles Be Risk Adjusted to Account for Differences in Patients' Health Risks?”. The article details HCFO sponsored research examining the effect of risk-adjustment on cost efficiency rankings of physicians.
Current HCFO grantee publications and recent grant findings will be regularly featured in the results section of our Web site.
New HCFO Findings Brief
A new project from the University of Minnesota and The University of Pennsylvania offers fresh insights into the relationship between hospital consolidation, the managed care environment, and consumer welfare. Robert Town; Ph.D., Douglas Wholey Ph.D., and Roger Feldman Ph.D., in collaboration with Lawson R. Burns Ph.D., conducted two related analyses, the first examining the relationship between managed care and hospital consolidation, and the second examining the impact of hospital consolidation on consumers. Their research reveals that hospital consolidation has a distinct impact on consumer interests, increasing both HMO premiums in the most competitive markets and the number of uninsured. These findings are the result of the first systematic examination of the consequences of hospital consolidation for consumers.
New Data Available for Researchers
National Data on Hospitalizations
The National Center for Health Statistics (NCHS) is pleased to announce the availability of 2004 data from the National Hospital Discharge Survey (NHDS). Data from the NHDS are used to profile hospital use, conditions resulting in hospitalization, disparities in use, diffusion of new technologies, and trends over time.
In addition to announcing the availability of public use data files, a new NCHS report released this month provides key estimates for 2004 and highlights trends affecting patients age 65 and over. Findings show that while hospitalization rates declined for all other age groups, rates increased 24 percent for the elderly during the period from 1970 through 2004 (despite a temporary decrease in the 1980s). Though persons age 65 and over comprised 12 percent of the US population in 2004, they accounted for 38 percent of all hospital discharges and used 44 percent of all inpatient days of care.
The NHDS, which has been conducted continuously since 1965, provides the country’s most current, and only nationally representative, data on hospitalizations and the characteristics of patients discharged from non-Federal, short-stay hospitals. Public use data files and information about the surveys may be found at http://www.cdc.gov/nchs/about/major/hdasd/nhds.htm Users are encouraged to subscribe to the NHDS listserv, which provides information about data from the NHDS and its companion survey, the National Survey of Ambulatory Surgery (NSAS).
The NHDS and NSAS are two in a family of provider and establishment-based surveys known collectively as the National Health Care Survey. These surveys collect data from health care providers about practice and organizational characteristics, patient characteristics, and details about patients’ clinical management. Other component surveys include the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (NAMCS and NHAMCS, respectively, which cover care delivered in physicians’ offices, hospital outpatient and emergency departments), and the National Nursing Home Survey, National Nursing Assistant Survey, and National Home and Hospice Care Survey (NNHS, NNAS and NHHCS, respectively, which cover long term care): http://www.cdc.gov/nchs/nhcs.htm.
AcademyHealth 2006 Annual Research Meeting
AcademyHealth 2006 Annual Research Meeting
June 25-27 Washington State Convention & Trade Center in Seattle
Join more than 2,000 health services researchers, policymakers, and practitioners in Seattle to hear the latest health services research, discuss timely health policy issues, develop new research methodologies, and network with friends and colleagues. The ARM provides access to more than 130 breakout sessions and 700 poster presentations covering 17 health care theme areas such as coverage and access, public health systems research, health workforce, disparities, health information technology, long-term care, health care quality, and patient safety.
Jobs at AcademyHealth
Jobs at AcademyHealth
AcademyHealth is currently seeking candidates for a Senior Associate to work on public health services research activities, a Program Coordinator for the State Coverage Initiatives program, and a Marketing Manager.
Click here for more information about these positions and working at AcademyHealth.