New Medicare Developments

"Results from the 2003 Targeted Beneficiary Survey on Access to Physician Services Among Medicare Beneficiaries." Timothy Lake, Marsha Gold, Anne Ciemnecki, Michael Sinclair, Nuria Diaz-Tena, Colette Lamothe-Galette, and So Sasigant Limpa-Amara, June 2004. Reductions in the fees paid by Medicare to physicians have raised concerns that beneficiaries in some areas may have problems obtaining needed care in a timely manner. This report suggests that these reductions have not led to marked restrictions in access to care, even though the study examined geographic areas thought most likely to be experiencing difficulties. However, access problems are more common for certain subgroups that may be especially vulnerable to change, including those who had recently moved or changed insurance coverage.

Boosting Worker Skills

"Individual Training Accounts, Eligible Training Provider Lists, and Consumer Reporting Systems." Paul Decker and Irma Perez-Johnson, July 2004. In Job Training Policy in the United States, edited by Christopher J. O'Leary, Robert A. Straits, and Stephen A. Wandner. This book reviews the effectiveness of major federal job training programs, examines features of current programs, and speculates about directions for future programs. The contributors discuss the implementation of training programs under WIA, assess methods for delivering training, examine performance management of U.S. training programs, and compare public training programs to private programs and to programs offered in other industrialized nations.

Challenges for Vocational Education

“Factors That Influence Participation in Secondary Vocational Education.” Roberto Agodini, Stacey Uhl, and Timothy Novak, August 2004. Since the early 1990s, federal legislation has encouraged secondary vocational education to go beyond its traditional focus of developing narrowly defined workplace skills to a broader goal of providing career preparation. On the basis of a nationally representative sample of students who graduated from high school in 1992, this report examines factors that influence participation in vocational education—demographics; behaviors; and expectations of students, parents, and high schools. The findings show that students with low academic achievement, low educational aspirations, and low socioeconomic backgrounds are more likely to participate in vocational education, but race/ethnicity, disability status, and behavior problems have little, if any, influence on participation. A major challenge facing vocational education is how to meet the objectives of recent education reforms that aim to increase academic achievement and college enrollment for all students.

Housing for Low-Income Families

“The Benefits of Housing Subsidies for TANF Recipients: Evidence from New Jersey.” Robert G. Wood and Anu Rangarajan, November 2004. This four-page issue brief notes that government housing subsidies improve access to stable, affordable housing for low-income families. Current and former welfare families that receive these subsidies devote a smaller portion of their income to housing, face less housing instability, and live in housing that is less crowded than families that do not receive subsidies.

Welfare and Work

"The Challenge of Achieving High Work Participation Rates in Welfare Programs." LaDonna Pavetti, October 2004. Efforts to reform the welfare system over the past two decades have focused on reducing dependency by getting welfare recipients to work. By the time the TANF program was created by the welfare reform law of 1996, there was widespread agreement in the states that welfare recipients should be required to look for work and to do so shortly after—or even before—they began receiving cash assistance. Once TANF was implemented, work became a central focus of local welfare offices. However, as shown by recent debates on reauthorization, consensus on work requirements remains elusive and information on how to achieve high participation rates is limited. This brief looks at policy changes and service strategies that states and local welfare agencies might consider to help achieve higher work participation rates.