New Medicare Developments

The resources needed to sustain the Medicare program are growing as baby boomers begin to retire and the elderly and disabled population expands. We are at the forefront of studying how Medicare is changing and meeting the needs of elders. A new page on our internet site details our recent Medicare work.

Trends in Health Care Quality

“Children with Special Health Care Needs: Building a Quality-of-Care Initiative.” Rebecca Nyman and Henry Ireys, November 2004. Nearly two-thirds of children with special health care needs (CSHCN) are insured through employer-based health insurance. This four-page issue brief summarizes recent studies investigating utilization and cost patterns for a large sample of CSHCN enrolled in two commercial managed care plans. CSHCN incur almost half the total costs of care for children in these plans, even though they are only 12 percent of enrolled children, and there are opportunities to improve care for this high-cost, high-risk group. Key to implementing quality improvement efforts is finding an effective, broad-based strategy for identifying this population. In addition, an effective quality improvement project needs a team of health plan staff with experience in pediatrics, quality assessment, and data management.

A Look at Food Stamp Households

"Characteristics of Food Stamp Households: Fiscal Year 2003." Karen Cunnygham and Beth Brown, November 2004. Summarizes the demographic and economic circumstances of food stamp households. On average, about 21.3 million people received food stamps each month in 2003. A little more than half of all food stamp households contained children, and most of these households were headed by a single parent. About 18 percent of food stamp households contained an elderly person. Although benefit amounts varied quite a bit, the average monthly benefit was $195 per household. Compared with 2002, the number of program participants increased by 12 percent.

Making Prescriptions Affordable

"The PHS 340B Drug Pricing Program: Results of a Survey of Eligible Entities." Robert Schmitz, So Limpa-Amara, Julita Milliner-Waddell, and Frank Potter, August 2004. Escalating drug prices have affected safety net providers in serious ways. This report studies providers eligible to purchase prescription drugs at a discount under the 340B program, which requires manufacturers that receive reimbursement from Medicaid to provide reduced prices to more than 10,000 qualified health care clinics, centers, and hospitals in the U.S. These providers in turn serve more than 10 million people in all 50 states. The findings suggest that the program has led to significant savings and a high level of satisfaction for providers enrolled in it. In its absence, providers would probably serve fewer patients, charge higher prices for prescription drugs, and incur greater losses.

Into the Working World

“Unemployment Insurance as a Potential Safety Net for TANF Leavers: Evidence from Five States.” Anu Rangarajan and Carol Razafindrakoto, September 2004. Does the unemployment insurance (UI) system, the primary safety net for working individuals who lose jobs, adequately address the needs of former welfare recipients who have left welfare and found work? This report, using data from the National Evaluation of the Welfare-to-Work (WtW) Grants Program, examines the extent to which former welfare recipients in five states had monetary eligibility for UI, as well as the amount of benefits for which they likely were eligible. The authors note that 90 percent of TANF recipients who left welfare and found employment would potentially attain UI monetary eligibility at some point during the two-year period after TANF exit, but they would have also lost this eligibility over time. In addition, potential UI benefit amounts were higher than what they would have received as TANF payments.