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1.
J Health Econ ; 44: 309-19, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26596789

ABSTRACT

In February 2009 the U.S. Congress unexpectedly passed the Health Information Technology for Economic and Clinical Health Act (HITECH). HITECH provides up to $27 billion to promote adoption and appropriate use of Electronic Medical Records (EMR) by hospitals. We measure the extent to which HITECH incentive payments spurred EMR adoption by independent hospitals. Adoption rates for all independent hospitals grew from 48 percent in 2008 to 77 percent by 2011. Absent HITECH incentives, we estimate that the adoption rate would have instead been 67 percent in 2011. When we consider that HITECH funds were available for all hospitals and not just marginal adopters, we estimate that the cost of generating an additional adoption was $48 million. We also estimate that in the absence of HITECH incentives, the 77 percent adoption rate would have been realized by 2013, just 2 years after the date achieved due to HITECH.


Subject(s)
American Recovery and Reinvestment Act/economics , Economics, Hospital , Electronic Health Records/economics , Medicaid/economics , Medicare/economics , Reimbursement, Incentive/economics , American Recovery and Reinvestment Act/statistics & numerical data , Cost-Benefit Analysis , Economics, Hospital/legislation & jurisprudence , Economics, Hospital/statistics & numerical data , Electronic Health Records/legislation & jurisprudence , Electronic Health Records/statistics & numerical data , Humans , Investments/economics , Investments/legislation & jurisprudence , Medicaid/legislation & jurisprudence , Medicare/legislation & jurisprudence , Reimbursement, Incentive/legislation & jurisprudence , Taxes/economics , Taxes/legislation & jurisprudence , United States
2.
Econ Hum Biol ; 19: 170-83, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26414481

ABSTRACT

This paper examines the relationship between increased Supplemental Nutritional Assistance Program (SNAP) benefits following the 2009 American Recovery and Reinvestment Act (ARRA) and the diet quality of individuals from SNAP-eligible compared to ineligible (those with somewhat higher income) households using data from the 2007-2010 National Health and Nutrition Examination Survey. The ARRA increased SNAP monthly benefits by 13.6% of the maximum allotment for a given household size, equivalent to an increase of $24 to $144 for one-to-eight person households respectively. In the full sample, we find that these increases in SNAP benefits are not associated with changes in nutrient intake and diet quality. However, among those with no more than a high school education, higher SNAP benefits are associated with a 46% increase in the mean caloric share from sugar-sweetened beverages (SSBs) and a decrease in overall diet quality especially for those at the lower end of the diet quality distribution, amounting to a 9% decline at the 25th percentile.


Subject(s)
American Recovery and Reinvestment Act/statistics & numerical data , Diet/economics , Food Assistance/statistics & numerical data , Poverty/statistics & numerical data , Adult , Aged , Beverages/statistics & numerical data , Energy Intake , Feeding Behavior , Female , Humans , Male , Middle Aged , Nutrition Surveys , Nutritional Status , Socioeconomic Factors , Sweetening Agents , United States , Young Adult
3.
Arch Intern Med ; 172(9): 731-6, 2012 May 14.
Article in English | MEDLINE | ID: mdl-22782203

ABSTRACT

Over 30,000 clinicians have already qualified to receive initial incentive payments for the meaningful use of electronic health records (EHRs) through the Centers for Medicare & Medicaid Services (CMS) EHR Incentive Programs. However, 2012 is the final year to receive maximum incentive payments, and many physicians still have questions regarding meaningful use objectives and how to register for, report, and attest to meaningful use. We provide herein an overview of the Medicare and Medicaid EHR Incentive Programs and guide physicians in the process of how to demonstrate meaningful use of health information technology.


Subject(s)
Electronic Health Records/statistics & numerical data , Medical Informatics , American Recovery and Reinvestment Act/statistics & numerical data , Medicaid/statistics & numerical data , Medicare/statistics & numerical data , Physicians/statistics & numerical data , Reimbursement, Incentive/statistics & numerical data , United States
4.
Health Serv Res ; 47(5): 1980-98, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22515835

ABSTRACT

OBJECTIVE: To help preserve continuity of health insurance coverage during the recent recession, the American Recovery and Reinvestment Act provided a 65 percent Consolidated Omnibus Budget Reconciliation Act (COBRA) premium subsidy for workers laid off in 2008-2010. We examined COBRA enrollment levels with the subsidy and the health, access, and financial consequences of enrollment decisions. STUDY DESIGN/DATA COLLECTION: Telephone interviews linked with health system databases for 561 respondents who were laid off in 2009 and eligible for the COBRA subsidy (80 percent response rate). PRINCIPAL FINDINGS: Overall, 38 percent reported enrolling in COBRA and 54 percent reported having some gaps in insurance coverage since being laid off. After adjustments, we found that those who had higher cost-sharing, who had higher incomes, were older, or were sicker were more likely to enroll in COBRA. COBRA enrollees less frequently reported access problems or that their health suffered because of poor access, but they reported greater financial stress due to health care spending. CONCLUSION: Despite the substantial subsidy, a majority of eligible individuals did not enroll in COBRA, and many reported insurance coverage gaps. Nonenrollees reported more access problems and that their health worsened. Without a mandate, subsidies may need to be widely publicized and larger to encourage health insurance enrollment among individuals who suffer a negative income shock.


Subject(s)
American Recovery and Reinvestment Act , Insurance, Health/legislation & jurisprudence , Adolescent , Adult , American Recovery and Reinvestment Act/economics , American Recovery and Reinvestment Act/statistics & numerical data , Economic Recession/legislation & jurisprudence , Economic Recession/statistics & numerical data , Educational Status , Female , Financing, Government/economics , Financing, Government/legislation & jurisprudence , Financing, Government/statistics & numerical data , Health Benefit Plans, Employee/economics , Health Benefit Plans, Employee/legislation & jurisprudence , Health Benefit Plans, Employee/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Health Status , Humans , Income/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/legislation & jurisprudence , Insurance, Health/economics , Logistic Models , Male , Middle Aged , Unemployment , United States , Young Adult
7.
Article in English | MEDLINE | ID: mdl-19963534

ABSTRACT

Title XIII of Division A and Title IV of Division B of the American Recovery and Reinvestment Act (ARRA) of 2009 [1] include a provision commonly referred to as the "Health Information Technology for Economic and Clinical Health Act" or "HITECH Act" that is intended to promote the electronic exchange of health information to improve the quality of health care. Subtitle D of the HITECH Act includes key amendments to strengthen the privacy and security regulations issued under the Health Insurance Portability and Accountability Act (HIPAA). The HITECH act also states that "the National Coordinator" must consult with the National Institute of Standards and Technology (NIST) in determining what standards are to be applied and enforced for compliance with HIPAA. This has led to speculation that NIST will recommend that the government impose the Federal Information Security Management Act (FISMA) [2], which was created by NIST for application within the federal government, as requirements to the public Electronic Health Records (EHR) community in the USA. In this paper we will describe potential impacts of FISMA on medical image sharing strategies such as teleradiology and outline how a strict application of FISMA or FISMA-based regulations could have significant negative impacts on information sharing between care providers.


Subject(s)
American Recovery and Reinvestment Act/statistics & numerical data , Computer Security/legislation & jurisprudence , Diagnostic Imaging/standards , Academies and Institutes/legislation & jurisprudence , Computer Security/standards , Electronic Data Processing/methods , Electronic Data Processing/standards , Health Insurance Portability and Accountability Act/standards , Humans , Security Measures , Teleradiology/instrumentation , Teleradiology/methods , Teleradiology/standards , United States
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