January 2010
Lewin Contact: John Sheils
December 2009
Affordable Healthcare for America Act (H.R. 3962) as passed by the U.S. House of Representatives, and the Patient Protection and Affordable Care Act (H.R. 3590, being considered in the U.S. Senate)
Lewin Contact: John Sheils
The Lewin Group does not advocate for or against any legislation, and maintains editorial independence with respect to all work products. This document provides further clarifications about the recent study.
December 2009
Long Term Costs for Governments, Employers, Families and Providers
Lewin Contact: John Sheils
The appendices for the main report.
Expertise Area: Health Reform
December 2009
Long Term Costs for Governments, Employers, Families and Providers
Lewin Contact: John Sheils
Prepared for: The Peter G. Peterson Foundation
The purpose of this analysis was to compare the effects of two major proposals to reform the U.S. health care system. These include the Senate Leadership “Patient Protection and Affordable Care Act” and the “Affordable Health Care for America Act” passed by the House of Representatives.
In this study we provide estimates of the program’s impact on coverage and spending for the federal government, state and local governments, private employers, consumers and providers. We estimated the impact of both bills on federal spending over a 20 year period from 2010 through 2029. The Congress uses 10-year forecasts for budgeting purposes, which is currently 2010 through 2019. To better understand the long-term budget implications of the bill, we present spending estimates for both the 2010 through 2019 budget window and the 2020 through 2029 period.
Expertise Area: Health Reform
November 2009
New York State Department of Health AIDS Institute
Lewin contact: Joel Menges
The Lewin Group, in collaboration with the New York State Department of Health AIDS Institute, conducted an evaluation of New York State’s Medicaid HIV Special Needs Plan program. The study focused on the following impact areas: inpatient hospital costs and utilization, prescription drug costs and utilization, trends in overall medical costs, and the program’s effect on cost and HIV SNP enrollees’ service utilization compared to Medicaid spending had the HIV SNP initiative not been implemented.
Client Area: State and Local Governments
Expertise Area: Medicaid and CHIP
November 2009
Lewin Group Analysis of Long Term Costs of The America’s Healthy Future Act of 2009
Lewin Contact: John Sheils
October 2009
Prepared for The Peter G. Peterson Foundation
Lewin Contact: John Sheils
The Lewin Group released a study of the impact on the federal budget and deficit of the Senate Finance bill, America's Healthy Future Act of 2009 ("the Act"). The report was commission by the Peter G. Peterson Foundation, which also released its analysis and commentary on the Act, drawing upon the Lewin report.
Expertise Area: Health Reform
October 2009
Lewin Contact: Cliff Goodman
The Lewin Group Center for Comparative Effectiveness Research released a report prepared for the Personalized Medicine Coalition describing how comparative effectiveness research (CER) can be designed, conducted, and reported to better align with personalized medicine, achieving a synergy toward improved patient outcomes. While CER has been oriented largely toward evaluating treatment effects across study populations, personalized medicine focuses on using individuals’ genomic information and other personal traits to inform decisions about their health care. It is essential that these emerging initiatives evolve to complement, not contradict, each other.
Expertise Area: Comparative Effectiveness Research
October 2009
Searching for Low-Hanging Fruit in the Garden of Health System Reform
Lewin Contact: Carol Simon
In this paper, we examine the recent literature documenting the major drivers of health care costs in
the U.S. and identify where new policies and initiatives could reduce costs without adversely affecting quality or access to medically necessary care.
Expertise Area: Health Reform
October 2009
American Affordable Health Choices Act of 2009
Lewin Contact: John Sheils
Updated October 22, 2009
Expertise Area: Health Reform
September 2009
American Clinical Laboratory Association; Advanced Medical Technology Association (AdvaMed)
Lewin contact: Clifford Goodman
The contributions of clinical laboratory screening and diagnostic tests to health care quality and outcomes are substantial. These contributions were described in an earlier report from The Lewin Group, The Value of Diagnostics Innovation, Adoption, and Diffusion in Health Care (2005). This report updates key elements of that study, providing a current overview of the important role of laboratory screening and diagnostic tests in our health care system, today’s means of assessing value, and four case studies documenting value of specific tests to patient care.
Client Area: Associations
Expertise Area: Evidence-Based Medicine / HTA
September 2009
Peter G. Peterson Foundation Report
Lewin Contact: John Sheils
In this study for the Peter G. Peterson Foundation, we estimate the impact of The American Affordable Health Choices Act of 2009 (H.R. 3200) (Act) as amended by the Energy and Commerce (E&C) Committee in August of 2009. We provide estimates of the program’s impact on coverage and spending for the federal government, state and local governments, private employers and consumers. To demonstrate the long-term impact of the Act, we provide estimates for a 20-year period from 2010 through 2029.
Expertise Area: Health Reform
September 2009
DHHS, Office of the Assistant Secretary for Planning and Evaluation (ASPE)
Lewin contact: Clifford Goodman
Unlike most conventional drugs, biological products are usually large, complex molecules that are produced by living organisms. These commercially engineered biologics currently account for billions of dollars in health care spending. Starting early last century, Congress has regulated most biologics separately from small molecules under the Biologics Control Act, which was later incorporated into the Public Health Service (PHS) Act. Although some biologics are regulated under the Federal Food, Drug, and Cosmetic Act (FDCA) for historical reasons, and are, therefore, candidates for generic production through section 505(j), an Abbreviated New Drug Application (ANDA), or through 505(b)(2), using data from previously approved innovator biologics to make claims of safety and effectiveness, there is no abbreviated path for replica or closely similar follow-on products for biologics under the PHS Act. While this group of products is known by various names, this report uses the term “follow-on protein products” (FoPPs).
Due to the potential cost savings that FoPPs could provide in the US market, members of Congress have made various proposals for establishing a regulatory pathway for FoPPs. The purpose of this report is to provide an unbiased estimate of potential cost savings from the introduction of FoPPs under multiple scenarios for abbreviated regulatory pathways. Findings from this analysis may be useful in the context of ongoing policy deliberations. A better understanding of the potential impact of legislative provisions for the regulatory pathway on cost savings may inform policymakers as such a pathway is considered.
Client Area: Federal Government
July 2009
Colorado Department of Human Services
Lewin contact: Sam Elkin
This report explores why former welfare recipients in Colorado left the Colorado Works program and how they fare after exiting. It is part of a multi-year, in-depth study The Lewin Group conducted for the Colorado Department of Human Services (CDHS). The analysis in this report relies primarily on data from a survey of 494 individuals who had been on single-parent Colorado Works cases and left the program during the first three months of 2007. Survey Research Management conducted the survey for Lewin. The survey occurred in August through November of 2008, which was between 17 and 23 months after the individuals surveyed had left Colorado Works. The paper covers characteristics of this sample of welfare leavers; their reasons for leaving the program; the extent to which they have returned to TANF in Colorado or elsewhere; employment outcomes of the group; characteristics of the jobs held by those who are working; sources of income, including earnings of spouses, partners, or other household members, and benefits from other government programs; and indicators of well being, such as food security, mental health, and health insurance coverage. The paper gives particular attention to the outcomes of Colorado Works leavers who were neither working nor receiving TANF benefits at the time of the survey.
Client Area: State and Local Governments
Expertise Area: Income Security
July 2009
Minnesota Department of Human Services
Lewin contact: Kathy Kuhmerker.
The Minnesota Department of Human Services (DHS), Disability Services Division contracted with The Lewin Group to conduct a study of the infrastructure of the State’s Medical Assistance State Plan Personal Care Assistance (PCA) program. Lewin partnered with the University of Minnesota’s Institute on Community Integration on this study.
This final report analyzes the drivers of Medical Assistance expenditures in the State’s PCA program and provides recommendations to strengthen the program. While the study focuses primarily on PCA State Plan services, important considerations include how other Medical Assistance Programs (e.g., home and community-based waiver programs) provide PCA services, and the interaction between those program requirements and the PCA State Plan program.
Three interim reports were also developed for this project and are posted on this website as well:
- Interim Report #1 (dated March 31, 2009) provided a national scan of PCA programs, analyses of Minnesota PCA program enrollment and expenditure data, findings from interviews with State officials in Minnesota and other states with PCA programs, findings from stakeholder interviews, and preliminary recommendations for the State.
- Interim Report #2 (dated June 24, 2009) included findings from a series of 14 focus groups, conducted by the
University of Minnesota’s Institute on Community Integration, with recipients of PCA services and PCA workers in a variety of Minnesota Medical Assistance programs offering PCA services. The purpose of conducting these focus groups was to hear from workers about their experiences providing PCA services and from service recipients about their experiences receiving PCA services. - Interim Report #3 (dated June 25, 2009) presented provider agency perspectives and related recommendations to strengthen and improve provider-related components of the program based on a survey of PCA provider agencies. This report also included analyses of the types of living arrangements .
Client Area: State and Local Governments
Expertise Area: Aging and Disability, Medicaid and CHIP
July 2009
Lewin contact: John Sheils
Note: This analysis covers the bill as it appeared on July 15, 2009. The bill has been amended since then, and a final bill was released on July 31.
Expertise Area: Health Reform
July 2009
Lewin Contact: John Sheils
This document addresses several technical questions regarding the estimates in the recent Lewin Group report, “Analysis of the July 15 draft of The American Affordable Health Choices Act of 2009” prepared for The Heritage Foundation.
Expertise Area: Health Reform
July 2009
Lewin Contact: John Sheils
In this memorandum for The Heritage Foundation, originally published July 17, 2009 and revised July 23, 2009 , we present estimates of the impact of the Act on sources of insurance coverage and provider incomes. We present our results in the following sections:
- Insurance exchanges and the public plan;
- Medicare payment reforms;
- Coverage effects;
- Detailed physician impacts analysis; and
- Detailed hospital impacts analysis.
Client Area: Foundations
Expertise Area: Health Reform
July 2009
Medicaid Health Plans of America (MHPA); Association for Community Affiliated Plans (ACAP)
For MHPA and ACAP, The Lewin Group assessed the financial impact and administrative burden that out-of-network claims pose in Medicaid managed care. The report examined Medicaid non-emergency out-of-network payment policies in Arizona, California, Florida, Georgia, Maryland, Nebraska, New Jersey, New York, Pennsylvania, Tennessee, Texas and Wisconsin.
Client Area: Associations
Expertise Area: Medicaid and CHIP
July 2009
Colorado Department of Human Services
Colorado counties have used the TANF block grant in a number of ways to reach a population beyond those served by basic cash assistance This issue brief outlines ways in which counties may use their TANF funds to assist needy families in their communities and highlights promising practices and strategies from across the state.
The brief is a part of a five-year evaluation of Colorado Works, the state's TANF program, that The Lewin Group and its partners, University of Colorado's Health Sciences Center, The Johns Hopkins University's Institute for Policy Studies, and Capital Research Corporation, are conducting for the Colorado Department of Human Services.
Client Area: State and Local Governments
Expertise Area: Income Security
June 2009
Lewin contact: Paul Hogan
Expertise Area: Medicaid and CHIP
June 2009
Pharmaceutical Research and Manufacturers of America (PhRMA)
PhRMA commissioned an evaluation of the degree to which changes in rebates for Medicare/Medicaid dual eligibles would create "spillover" impacts on the Part D premiums charged to other Medicare beneficiaries. Ingenix Consulting staff conducted modeling of various scenarios and Lewin staff prepared the written report. Our analyses estimate that if dual eligibles' prescriptions are paid for at Medicaid prices, additional costs will be imposed on Part D participants who are not dual eligibles. These increased monthly costs per beneficiary are estimated to range from $8 - $16, which constitutes an increase of 25% - 50% in the Part D premiums paid by non-dual eligibles.
Client Area: Associations
Expertise Area: Medicaid and CHIP, Medicare
June 2009
Minnesota Department of Human Services
Lewin contact: Kathy Kuhmerker
The Minnesota Department of Human Services (DHS), Disability Services Division contracted with The Lewin Group to conduct a study of the infrastructure of the State’s Medicaid State Plan Personal Care Assistance (PCA) program. This study analyzes the drivers of Medical Assistance expenditures in the State’s PCA program and provides recommendations to inform legislation to strengthen the PCA program.
This report is the last of several interim reports that Lewin submitted to DHS, in addition to a comprehensive final report. This report focuses on provider agency perspectives and related recommendations to strengthen and improve provider-related components of the program, and analyses of the types of living arrangements in which individuals receive PCA services and related recommendations.
Client Area: State and Local Governments
Expertise Area: Aging and Disability, Medicaid and CHIP
June 2009
Lewin Contact: John Sheils
Submitted by: John Sheils, Vice President, The Lewin Group
Date: June 25, 2009
The House bill includes a public plan as part of a broad health reform proposal that would expand health insurance coverage. The program expands increases Medicaid eligibility to 133 percent of the federal poverty level (FPL) and provides individual subsidies for the purchase of insurance for people between 133 percent and 400 percent of the FPL. Tax credits are available to small employers who purchase coverage, while larger employers are also required to contribute to the cost of coverage for workers. Individuals who do not have coverage would be fined 2.0 percent of their income up to the national average premium amount.
The bill would permit individuals and employers to purchase health insurance from a newly created “public plan” modeled on Medicare. The public plan would compete for enrollment with private insurers in a newly formed network of “exchanges” that present a selection of competing health plans to consumers. The public plan would be required to follow the same rules concerning pre-existing conditions and premium rating practices that apply to private plans.
We estimate that the public plan under the House bill would have premiums that are 20 percent to 25 percent less than for comparable private coverage.
Expertise Area: Health Reform
June 2009
Minnesota Department of Human Services
Lewin contact: Kathy Kuhmerker
The Minnesota Department of Human Services (DHS), Disability Services Division contracted with The Lewin Group to conduct a study of the infrastructure of the State’s Medicaid State Plan Personal Care Assistance (PCA) program. This study analyzes the drivers of Medical Assistance expenditures in the State’s PCA program and provides recommendations to inform legislation to strengthen the PCA program.
This report is the second of several interim reports that Lewin submitted to DHS, in addition to a comprehensive final report. This second report includes findings from a series of 14 focus groups, conducted by the University of Minnesota’s Institute on Community Integration, with recipients of PCA services and PCA workers in a variety of Minnesota Medical Assistance programs offering PCA services. The purpose of conducting these focus groups was to hear from workers about their experiences providing PCA services, and from service recipients about their experiences receiving PCA services. This report provides: a description of the methodology used to obtain this data (through the focus groups); findings from several topical areas such as services delivered/received, quality of services, wages/benefits, education/training, and family members as PCA workers; a summary of focus group participants’ recommended key changes to improve the Minnesota PCA program; and interim recommendations to improve and strengthen Minnesota’s PCA program.
Client Area: State and Local Governments
Expertise Area: Aging and Disability, Medicaid and CHIP
June 2009
Presentation to Capitol Hill Briefing with NCOA 19 June 2009
Lewin Contact: Lisa Alecxih
Consumers in Control: Cost-Effective Chronic Care Strategies for Health Reform
Friday, June 19, 2009
9:30-11:00 am
Lisa
Alecxih, Vice President of the Lewin Group, spoke today at a briefing
on Capitol Hill sponsored by the not-for-profit National Council on
Aging (NCOA), along with other leading health care experts. The
briefing discussed the results of NCOA's national survey of adults with
multiple chronic health conditions. The Capitol Hill briefing
highlighted the day-to-day challenges Americans face in managing their
chronic conditions in a fragmented health system, and showcased models
that are helping consumers regain control of their health.
Expertise Area: Chronic Disease / Cost of Illness, Health Reform
June 2009
Lewin contact: John Sheils
Expertise Area: Health Reform
May 2009
Lewin contact: John Sheils
Statement for the Senate Committee on Finance
Submitted by: John Sheils, Vice President, The Lewin Group
May 12, 2009
Health reform can be funded with new revenues and savings to existing federal programs. In this analysis we examine two tax-based options that would both raise revenues and reduce health spending. These include placing limits on the tax exclusion for employer health benefits and a large increase in the tax on tobacco products. We also discuss potential savings to existing federal safety-net programs under expansions in coverage that could be redirected to help pay for health reform.
We estimate that these three proposals would raise about $1.25 trillion in revenues and savings to federal programs over the 2010 through 2019 period. This is roughly equal the amount of funding required to pay for the health reform program proposed by President Obama in the 2008 campaign ($1.17 trillion). These provisions would also reduce national health spending by about $461.0 billion over this period.
Expertise Area: Health Reform
April 2009
Lewin contact: John Sheils
The Cost and Coverage Impacts of a Public Plan
Testimony before the House Ways and Means Committee Hearing on Health Reform in the 21st Century: Employer Sponsored Insurance
Submitted by: John Sheils, Vice President, The Lewin Group
April 29, 2009
President Obama and Senator Baucus have proposed to create an “exchange” offering individuals and employers a selection of health plans. They also propose to create a new “public plan” that would compete for enrollment with private insurance plans in the exchange.
Premiums under the public plan would be up to 30 percent less than private insurance plans if Medicare payment levels are used. Due to this substantial cost advantage, we estimate that up to 119.1 million of the 171.6 million people who now have private employer or non-group coverage would move to the public plan (70 percent).
Expertise Area: Health Reform
April 2009
Lewin Contact: John Sheils
Combined Baucus And Wyden Plan Meets President's Health Reform Goals, Controls Costs And Expands Coverage To All Without Increasing Federal Deficit
This report identifies similarities and differences of the coverage provisions of the Healthy Americans Act (HAA, led by Senators Wyden and Bennett, with 14 bipartisan co-sponsors) and the proposal offered by Senator Baucus, and presents ideas on how these differences could be resolved. Lewin Group researchers identify the specific elements of both proposals taken together that would meet President Obama’s eight health reform goals stated in the budget proposal to Congress, forming a bill that achieves universal coverage and controls cost in the public and private sectors, without increasing the federal deficit. Finally, due to the complexity of reform, the paper discusses how the coverage provisions could be phased-in over a period of four years as suggested in the Baucus report.
Expertise Area: Health Reform
April 2009
Novo Nordisk
Lewin contact: Tim Dall
For Novo Nordisk, The Lewin Group estimated the economic costs of diagnosed type 1 (T1DM) and type 2 (T2DM) diabetes mellitus in the United States in 2007. Lewin analyzed medical claims to estimate the proportion of diagnosed diabetes cases and excess medical costs by diabetes type. Indirect costs associated with T1DM and T2DM were estimated by using findings from the literature on diagnosed diabetes, as well as differences in health per case of T1DM and T2DM. This study builds on the Cost of Diabetes Model developed by Lewin for the American Diabetes Association to estimate the economic burden of diagnosed diabetes. The study is published in the journal Population Health Management.
Client Area: Pharma / Bio / Device
Expertise Area: Chronic Disease / Cost of Illness
April 2009
Novo Nordisk
Lewin contact: Tim Dall
For Novo Nordisk, The Lewin Group conducted a study to estimate the national economic costs associated with undiagnosed diabetes mellitus (UDM). This study builds on previous work on the national costs associated with diagnosed diabetes mellitus. Lewin used a Cost of Diabetes Model that combines data from multiple sources to estimate the national prevalence of UDM in 2007; to quantify differences in health care use patterns for a proxy for the population with UDM compared to a population with no history of diabetes; to estimate the proportion of national health care use and expenditures associated with UDM; and to estimate the loss in national productivity. The study is published in the journal Population Health Management.
Client Area: Pharma / Bio / Device
Expertise Area: Chronic Disease / Cost of Illness
April 2009
Colorado Department of Human Services
This issue brief provides analysis of employment and earnings outcomes of individuals who received welfare in Colorado since 2005, based on wage records from Colorado’s Unemployment Insurance Program. The brief is a part of a five-year evaluation of Colorado Works, the state's TANF program, that The Lewin Group and its partners, University of Colorado's Health Sciences Center, The Johns Hopkins University's Institute for Policy Studies, and Capital Research Corporation, are conducting for the Colorado Department of Human Services. The brief shows that between 2005 and 2008, about a third of Colorado Works participants worked while on welfare, and had relatively low earnings during that period. Those who left welfare worked at higher rates, but the consistency of their employment varied. Earnings increased overall in the two years following exit, though remained low. About 10 percent earned $20,000 or more in the first and second years after leaving Colorado Works. Among certain subgroups, including those with fewer months of welfare and those with older children, larger shares of individuals earned $20,000 or more.
Client Area: State and Local Governments
Expertise Area: Income Security
April 2009
Lewin contact: John Sheils
The Lewin Group released a report today titled “The Cost and Coverage Impacts of a Public Plan: Alternative Design Options.” This report examines potential impacts that a “public health plan” might have in competing for enrollment with the private insurance industry. A public plan is currently being considered in a number of health reform proposals being considered by President Obama and the U.S. Congress. This analysis enhances prior work done by The Lewin Group of the major party presidential candidate health reform proposals during the 2008 campaign, as well as more recent analyses of Congressional plans being considered. The report estimates the impact on cost and coverage based on different levels of eligibility and reimbursement rates.
Expertise Area: Health Reform
March 2009
Minnesota Department of Human Services
Lewin contact: Kathy Kuhmerker
The Minnesota Department of Human Services (DHS), Disability Services Division contracted with The Lewin Group to conduct a study of the infrastructure of the State’s Medicaid State Plan Personal Care Assistance (PCA) program. This study analyzes the drivers of Medical Assistance expenditures in the State’s PCA program and provides recommendations to inform legislation to strengthen the PCA program.
This report is the first of several interim reports that Lewin submitted to DHS, in addition to a comprehensive final report. This first report includes findings from a national scan of PCA programs, analysis of Minnesota PCA program enrollment and expenditure data, interviews with state officials in Minnesota and other states with PCA programs, stakeholder interviews, and initial recommendations for the State.
Client Area: State and Local Governments
Expertise Area: Aging and Disability, Medicaid and CHIP
March 2009
Lewin contact: John Sheils
The purpose of this document is to describe the data and methods used to develop the Lewin Group Health Benefits Simulation Model (HBSM).
The Health Benefits Simulation Model is a micro-simulation model of the U.S. health care system. HBSM is a fully integrated platform for simulating policies ranging from narrowly defined Medicaid coverage expansions to broad-based reforms such as changes in the tax treatment of health benefits. The model is also designed to simulate the impact of numerous universal coverage proposals such as single-payer plans and employer mandates. The use of a single modeling system for these analyses helps assure that simulations of alternative proposals are executed with uniform and internally consistent methodologies.
Expertise Area: Health Reform
March 2009
America's Health Insurance Plans (AHIP)
Lewin contact: Joel Menges
In 2004, America’s Health Insurance Plans engaged The Lewin Group to synthesize existing research on the savings achieved when states have implemented Medicaid managed care programs. This report is an update of the 2004 report, and includes both studies from the previous report and studies that have been released since 2004. In all, The Lewin Group reviewed 24 studies. The studies reviewed were identified and selected by America’s Health Insurance Plans and Lewin and include federally required independent assessments, studies commissioned by the federal and state governments, private foundations, and researchers, and one health plan-funded study. Studies are grouped into three categories: state studies, which examine states’ cost savings in their overall Medicaid managed care programs; targeted Medicaid managed care studies, which assess savings in Medicaid managed care programs targeted to specific populations; and specific service studies, which analyze Medicaid managed care program savings for specific services.
Expertise Area: Medicaid and CHIP
March 2009
Lewin contact: John Sheils
This report provides estimates of the cost and coverage impacts of the Healthy Americans Act as introduced on February 5, 2009 (S. 391). It provides estimates of cost effects for the federal government, state and local governments, private employers and families, assuming the program is fully implemented in 2011. It also provides estimates of the average cost impacts of the Act for families by income, age and current coverage status.
Client Area: Federal Government
Expertise Area: Health Reform
March 2009
Colorado's TANF program's caseload has fallen sharply since federal welfare reform legislation was enacted in 1996 that gave states considerable authority in setting welfare policy. While employment gains among low-income families contributed to the decline, many families in Colorado are leaving TANF without employment. This issue brief is a part of a five-year evaluation of Colorado Works, the state's TANF program, that The Lewin Group and its partners, University of Colorado's Health Sciences Center, The Johns Hopkins University's Institute for Policy Studies, and Capital Research Corporation, are conducting for the Colorado Department of Human Services. The brief defines a sample of welfare recipients in Colorado who left welfare but were not working in 2008 as "disconnected" and provides an in-depth analysis using survey and Unemployment Insurance data. It examines the characteristics and outcomes of the disconnected adults, including why they left TANF, how they differ from other TANF leavers, their sources of income, their employment history, and their overall well-being.
Expertise Area: Income Security
March 2009
AARP
Lewin contact: Lisa Alecxih
AARP commissioned The Lewin Group to conduct research to help inform policy discussions about quality of care and litigation in Tennessee nursing homes. Specifically, the study addresses the following overarching policy questions: What are the factors driving litigation in Tennessee? What are the nursing home litigation trends in the state? What positive or negative outcomes does litigation have for nursing home residents? What steps have nursing facility operators in Tennessee taken to reduce the frequency and cost of litigation, and what are the implications for nursing home quality? What are the potential impacts of tort restrictions, based on the experiences of other states?
Based on the findings, the report discusses considerations and potential strategies for ensuring delivery of quality services in Tennessee nursing homes.
Client Area: Associations
Expertise Area: Aging and Disability
February 2009
Partnership for America's Economic Success
This study, for the Partnership for America's Economic Success, explores the impacts of a range of parenting education programs and their short- and long-term gains for families and society.
Client Area: Foundations
Expertise Area: Children, Youth, and Family Policy
February 2009
The Commonwealth Fund
Lewin contact: John Sheils
This document presents the approach used by The Lewin Group to estimate the impact of the Commonwealth Fund’s health reform proposal entitled “Path to a High-Performance Health Care System.” The report describe the provisions of the plan and explains how Lewin simulated the plan’s impact on coverage and costs for households, employers, the federal government and state and local governments. It also presents the methodology used to estimate the cost impacts of a series of system savings initiatives included in the proposal.
The primary analytic tool used in the analysis is The Lewin Group Health Benefits Simulation Model (HBSM). The model is designed to show the impact of major health reform plans on major stakeholder groups. It provides estimates of enrollment and costs under alternative health reform plans that reflect the impact of financial incentives created under the plan. Lewin supplemented the model with separate analysis of the various system savings proposals. For each initiative, the report provides a description of the proposal, a review of the available research and evidence on the options and Lewin's estimates of the program’s impact over five-, ten- and fifteen-year periods.
Client Area: Foundations
Expertise Area: Health Reform
February 2009
Lewin contact: John Sheils
Presentation by John Sheils to Senate Republicans and Staff February 11, 2009.
Client Area: Federal Government
Expertise Area: Health Reform
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