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

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Transforming Healthcare in Missouri: Bridging the Gaps with Community Health Workers from Global to Local and Back

by Shria Bucha, BA Candidate; Khavya C Avula, MBBS, MPH; Megha Dabas, MSc, MPharm, BPharm; Venkatesh Satheeskumar, BS; and Abigail Barker, PhD | January 2024

In September 2023, the Center for Advancing Health Services, Policy & Economics Research convened a diverse stakeholder group, including significant representation from MO HealthNet, Missouri policymakers, university and community partners, and a large number of CHWs representing different settings. The group gathered to discuss possibilities for new reimbursement models for Community Health Worker (CHW) services. This white paper summarizes the discussions of our keynote speaker, panelists, and stakeholder breakout sessions while highlighting prominent policy themes and takeaways.

Implementing Medicaid Reimbursement for Home Visiting in Missouri

by Celeste Sanger and Abigail Barker, PhD | October 2023

Home visiting has the potential to make a positive impact on the landscape of infant and maternal health in Missouri. The variety of frameworks available make it possible to customize services to meet a family’s need and set them on a pathway to success in the future. Missouri has the opportunity to craft its own unique approach to reimbursing home visiting services through Medicaid, to make the intervention more accessible to more families across the state. Collaboration between MO HealthNet, home visiting agencies, and other home visiting and Medicaid stakeholders is necessary to address each consideration in this report and invest the time to craft the most effective approach with the greatest impact.

Initial View of the Medicaid Expansion and Public Health Emergency on Hospital Encounters in Missouri

by Timothy McBride, PhD and Eliot Jost, MBA,MPH | September 2023

An expansion of the Missouri Medicaid program was approved by voters in Missouri through the passage of a constitutional amendment in August 2020, later upheld by the Missouri Supreme Court in July 2021. This policy brief reviews changes in hospital encounters over time in Missouri, before and after the start of the Medicaid expansion, concentrating on emergency department encounters and inpatient encounters, and the “payer mix” of those visits, which is the source of payment the hospitals receive.

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.

View policy briefs published between 2016-2018.