New Publications
Time for Change in WIC Foods?
 "WIC Food Packages: Time for a Change." Institute of Medicine, Food and Nutrition Board Committee to Review the WIC Food Packages of which Barbara Devaney is a member, April 2005. This new report proposes a number of changes to the WIC nutrition assistance program to encourage participants to consume more whole grains, fruits, and vegetables, as well as to promote breast-feeding, among other goals. If implemented, these revisions would be the most substantial changes to the mix of foods offered through WIC since the supplemental nutrition program for low-income women, infants, and children was launched in 1974. The recommendations also are the first effort to apply the new Dietary Guidelines for Americans to a national food program. Click here to view the summary or here for full report.
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School Lunches and Eligible Kids
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 "The National School Lunch Program: Ensuring that Free and Reduced-Price Meal Benefits Go to the Poor." Philip Gleason and John Burghardt, April 2005. This new four-page issue brief details two approaches to ensuring that free and reduced-price school meals go to eligible families. The brief finds that direct certification is useful in improving program access, although it could reach more eligible households. However, a pilot program that required free and reduced-price meal benefit applicants to provide income documentation with their applications did not deter ineligible households from applying and being approved for these benefits, and it did reduce access to these benefits among eligible households.
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Medicare Monitoring
 "Challenges in Improving Care for High-Risk Seniors in Medicare." Marsha Gold, Timothy Lake, William E. Black, and Mark Smith. Health Affairs Web Exclusive, April 26, 2005. Despite strong interest in improving care for high-risk elders, demonstration projects typically show negative results. This paper examines a large foundation-sponsored initiative to gain insight into why success can be so elusive. The findings indicate that flaws in concept, design, and implementation may make it more challenging for demonstrations, especially those involving cost and utilization reductions, to achieve their goals.
 "Early Effects of the Medicare Modernization Act: Benefits, Cost Sharing and Premiums of Medicare Advantage Plans, 2005." Lori Achman and Lindsay Harris, 2005. The authors find that the Medicare Advantage program is beginning to reverse its course from the premium increases and benefit reductions that marked the period from 2000 to 2003. Average monthly premiums declined from $25 to $22 between 2004 and 2005; however, premium levels in 2005 are still substantially higher than they were in 1999. As in previous years, premiums for HMOs are typically lower than those for PPO or PFFS plans. This, combined with a significant number of new plan entries into the program over the past two years, indicates that the 2004 and 2005 MA plan payment increases have accomplished the goal of providing much-needed stability to MA markets, at least in the short term. |
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Can Medicaid Attract More Physicians?
 "Physician Participation in Medicaid Managed Care: The California Experience." Jessica Mittler and Marsha Gold, Managed Care Quarterly, 2005. Many policymakers hope that Medicaid can improve patients' access to physician services by moving to a managed care model. The authors report that managed care plans surveyed in California generally did not have problems getting physicians to participate in Medi-Cal or Healthy Families, although problems arose for some specialties and areas, especially when supply was short. The findings highlight the importance of continued monitoring of access as well as collaborations among plans, providers, and government to strengthen participation and access.
Family Formation and Economics
 "The Economic Consequences of the Dissolution of Cohabitating Unions." Sarah Avellar and Pamela J. Smock, Journal of Marriage and Family, April 2005. Although the economic effects of divorce have been well studied, cohabitation has not been similarly explored. This analysis uses a sample from the National Longitudinal Survey of Youth to document changes in economic well-being at the end of a cohabiting relationship and compare the results to a sample of divorced respondents. After dissolution, formerly cohabiting men's economic standing declines moderately, whereas formerly cohabiting women's declines much more precipitously, leaving a substantial proportion in poverty. This effect is pronounced for African American and Hispanic women. Though the end of the relationship does reinforce gender stratification, it is also an "equalizer" between married and cohabiting women, leaving them in strikingly similar economic positions.
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