State-Level Health System and Coverage Reform Course Overview and Syllabus
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1 State-Level Health System and Coverage Reform Course Overview and Syllabus Description: Overview of the state initiatives in health care coverage, access, and costs, trends in the public and private sectors, and current issues and debates about reform nationally and in Wisconsin. Instructor: Donna Friedsam, MPH UW Population Health Institute 760 WARF Building, 610 Walnut St Phone Grading System: A-F Prerequisites: None Evaluation: Final paper: 50% Class participation 50% Format Guest lecture and facilitated discussion, with an expert from the practice arena on each topic of focus. Objectives: Students will be able to 1. identify three roles that states play in health care policy; 2. describe the Medicaid program, populations, and trends in coverage; 3. describe trends in private insurance coverage and the uninsured. 4. explain the relationship between federal law and state health insurance reform; 5. evaluate the potential for consumer-directed health care to reduce costs and increase coverage; 6. identify and describe at least two health care reform initiatives underway in Wisconsin. Topics/Lectures Role of States in Health Care Policy Medicaid, BadgerCare and the Uninsured Private Health Insurance, Trends, and Federal ERISA Quality, Price and Implications for Reform Current State-Level Trends and Health Reforms 1. Role of States in Health Care Policy Reading Materials/Resources Guest Faculty: Tom Oliver, PhD, Professor, Population Health Sciences Sweet, R. Wisconsin Legislator Briefing Book , Chapter J: Health Care and Health Insurance. Wisconsin Legislative Council, November Weil, A. KaiserEdu Tutorial on State Health Policy:
2 Elements of State Health Reform, Individual and Employer Requirements, Kaiser Family Foundation WebCast, April 17, Medicaid, BadgerCare, and the Uninsured Guest Faculty: Jason Helgerson, Director, Wisconsin Division of Health Care Access and Accountability Chapter 1 of Wisconsin Legislative Fiscal Bureau. Medical Assistance, BadgerCare, SeniorCare, and Related Programs. Informational Paper #44. January badgercare%20plus,%20seniorcare,%20and%20related%20programs.pdf BadgerCare Plus Fact Sheet: Online tutorials: Hoffman, C. Health Insurance and Access to Health Care: The Evidence. February Rowland, D. KaiserEdu Tutorial on Medicaid, The Basics: Rudowitz, R. KaiserEdu Tutorial on Children s Coverage/SCHIP: Rowland, D. KaiserEdu Tutorial on Expanding Health Coverage to the Uninsured: Bindman, A. America s Health Care Safety Net, December Private Health Insurance, Trends, and Federal ERISA Guest Faculty: Phil Dougherty, Senior Executive Officer, Wisconsin Association of Health Plans Enthoven, AC, Fuchs, VR. Employment-Based Health Insurance: Past, Present, and Future. Health Affairs 25, no. 6 (2006): Politz, K. KaiserEdu Tutorial on Private Health Insurance:
3 Butler, PA. Including Employer Financing in State Health Reform Initiatives: Implications of Recent Court Decisions, State Coverage Initiatives, January Quality, Price, and Implications for Reform Guest Faculty: Chris Queram, CEO, Wisconsin Collaborative for Healthcare Quality Steve Brenton, President and CEO, WI Hospital Association C. Clancy. Kaiser.Edu Tutorial on Measuring Health Care Quality, May Visit WisconsinHealthReports.Org: The Cost Conundrum: What a Texas town can teach us about health care by Atul Gawande, The New Yorker, June 1, Boulton, G. Hopes, fears mix as federal health plan forms. Milwaukee Journal Sentinel. June 24, Recommended Supplemental Reading: John Sheils, The Cost and Coverage Impacts of a Public Plan Testimony before the House Ways and Means Committee Hearing, Submitted by: John Sheils, Vice President, The Lewin Group, April 29, Holahan J, Blumberg LJ. Can a Public Insurance Plan Increase Competition and Lower the Costs of Health Reform? The Urban Institute. March 18, Blumberg LJ, Holahan J. The Individual Mandate An Affordable and Fair Approach to Achieving Universal Coverage. N Engl J Med 361;1 july 2, Haislmaier EF, Smith DF, Owcharenko N. Health Care Co-Operatives: Doing It the Right Way. The Heritage Foundation WebMemo #2493, June 18, Congressional Budget Office. Increasing Transparency in the Pricing of Health Care Services and Pharmaceuticals, June 5,
4 Claxton, G. KaiserEDu Tutorial on Consumer Directed Health Plans: "Health Savings Accounts: Participation Increased and Was More Common among Individuals with Higher Incomes" - General Accountability Office (GAO), Released online April 30, Current State-Level Trends and Health Reforms Guest Faculty: Laura Rose, JD, Deputy Director, Wisconsin Legislative Council The Commonwealth Fund. The Path to a High Performing US Health System. Executive Summary. February /Feb/The%20Path%20to%20a%20High%20Performance%20US%20Health %20System/1238_Commission_Path_Exec_Summ_21909.pdf A Guide to State Health Care Reform, The Heritage Foundation, Special Report #55, June 11, ook_web-2.pdf Wisconsin DHS Waiver Proposal to CMS. BadgerCare Plus Health Insurance for Childless Adults, September 8, BadgerCare%20Plus%20Items%20Under%20Review.pdf National Committee on Quality Assurance, Fact Sheet on Patient Centered Medical Homes: AAFP. States Take Lead in Adopting Medical Home Model: WI Legislative Council bill draft on Medical Homes: National Conference of State Legislatures. Retail Health Clinics: State Legislation and Laws.
5 Final Class Project: Due Friday, July 17 Choose a current reform initiative that was discussed during the week. Prepare a briefing document (brief!) for your boss, the Co-Chair of the Legislature s Joint Finance Committee, to support decision-making about this proposal. Include the following elements: 1. Summary of the proposal 2. What it is intended to achieve (objectives), in terms of cost, coverage, and quality. 3. Pro upside to the proposal 4. Con downside to the proposal 5. How the proposed reform fits with the state role and relates to the federal role, in health policy. 6. Anticipated support and critiques. 7. Your assessment and recommendation support or oppose and why. This should document should be no longer than 4 pages, single-space but with two spaces between paragraphs, in 12-point font. Use bullet lists and easy-to-read tables, anticipating that it will be read quickly or just skimmed.
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