The Center for Advancing Health Services, Policy & Economics Research is committed to providing policy briefs and white papers which offer analysis of health-related issues framed for a policy-focused audience.
Missouri Policy Publications
Transforming Healthcare in Missouri: Implementing Accountable Care within Medicaid
by Abigail Barker, PhD, and Venkatesh Satheeskumar, BS | March 2023
In September 2022, the Center for Health Economics and Policy convened stakeholders from a variety of organizations as part of our Transforming Healthcare in Missouri series. In addition to summarizing the event, this white paper summarizes the models presented and describes related policies in Missouri and the programs that have been successfully implemented.
Understanding the Impact of Work Requirements on Medicaid-Eligible Adults in Post-Expansion Missouri
by Isha Yardi; Eliot Jost, MBA, MPH; Timothy McBride, PhD | January 2023
The purpose of this brief is to understand the potential effects of enacting work and community engagement requirements for Medicaid eligibility in Missouri post-Affordable Care Act Medicaid expansion. This brief includes a discussion of whether work requirements are well-aligned with the objectives of the Medicaid program to promote health and wellness among beneficiaries.
The Role of Culturally Congruent Community-based Doula Services in Improving Key Birth Outcomes in Kansas City
by Ria Hegde, BA; H. Ellis McCormick, BA; Hakima Payne, MSN, RN; Abigail R. Barker, PhD | November 2022
This brief reports on data from Uzazi Village, a Kansas City organization providing culturally congruent, community-based doula services since 2012. Improvements in three key health outcomes (gestational age, birthweight, and APGAR scores) were associated with doula services provided by Uzazi Village, in comparison to Kansas City birth outcome data for the same ZIP codes. This evidence can help inform the policy discussion regarding the addition of Medicaid coverage for doula services in Missouri.
National Policy Publications
Impact of State Laws Governing Physical Education on Attendance among U.S. High School Students, 2003-2017
by Ruopeng An, PhD; Mengmeng Ji, MS; Caitlin Clarke, PhD; Chenghua Guan, PhD | January 2020
Schools play a critical role in promoting physical activity among children through physical education (PE), which helps students gain necessary knowledge, skills, and confidence to practice sports and adopt an active lifestyle. Government policies and regulations profoundly influence local schools’ decisions and practices in delivering PE and promoting physical activity among students. This policy brief assessed the influence of state laws governing PE on weekly PE class attendance among U.S. high school students.
Social Risk and Dialysis Facility Penalties Under the End-Stage Renal Disease Quality Incentive Program
by Andrew C. Qi BS, Anne M. Butler PhD, Kristine Huang BA, and Karen E. Joynt Maddox MD, MPH | September 2019
Introduced in 2012, Medicare’s End-Stage Renal Disease Quality Incentive Program (ESRD QIP) is a mandatory pay-for-performance program for U.S. dialysis facilities that penalizes facilities up to 2% of their Medicare payments based on their performance on a set of quality measures. This program has had an impact on dialysis facilities in low-income areas and those with high proportions of Black or dually Medicare and Medicaid enrolled patients. The analysis showed that facilities serving these vulnerable populations have lower quality scores and higher financial penalties. Consequently, the ESRD QIP could cause facilities to avoid caring for high-risk patients, or could worsen facility quality by taking away valuable resources. However, the penalties could also spur facilities to improve quality, which could reduce disparities. The impact of the program needs to continue to be monitored to ensure the program is as equitable as possible.
Medicaid Work Requirements: The Relationship between Work and Health
by Linda Li, MPH, Abigail Barker, PhD, Leah Kemper, MPH, Timothy McBride, PhD | February 2019
Whether work requirements in Medicaid promote health and align with the aims of the program has become a central question in the current policy debate. In this third of three briefs, we assess the relationship between work and health by using longitudinal data to analyze the effects of employment and health status over time. We evaluate the effect of health on work and then examine whether work improves health. Policy implications of current Medicaid work requirements and recommendations follow based on our findings.