Publications

Strategic Planning for Safety-Net Services: Final Report

February 2006

In July of 2005, The Lewin Group was engaged to develop a strategic plan and unified approach to the coordination and delivery of health care services to the medically indigent population of Tulsa County and the surrounding metropolitan area. The final strategic planning for safety-net services report presented a “road-map” that would in the long-term lead to measurable improvements in health care outcomes for Tulsa residents.

Client Area: Foundations
Expertise Area: Community Health Needs Assessment

Electronic Applications Present Opportunities to Improve Enrollment into New York's Public Health Insurance Programs

November 2004

As part of an effort to identify ways to expand and strengthen public health insurance coverage, the United Hospital Fund, with the support of the Altman Foundation, commissioned The Lewin Group to study the process for applying for public health insurance programs in New York City and determine how automation might improve that process. Results of the analysis show that an automated application process could speed up the current application processing time by over one week and help applicants access medical care sooner by decreasing the transition time between agencies, reducing errors, and limiting duplication of effort. Automation would also save enrollment organizations and their staff one hour or more every day by improving process efficiencies.

Client Area: Foundations
Expertise Area: Medicaid and CHIP

How Policy Changes Impact Enrollment: A Look at Three Counties

May 2004

In the current economic climate, California’s counties struggle with the need to provide health coverage to low-income individuals and families in the face of sharp budget cuts. How can a county ensure that its most vulnerable residents gain access to the appropriate public health insurance program? Three California counties – Alameda, San Mateo, and Santa Clara – have gone beyond state requirements, not only in expanding eligibility for coverage, but also in creating a more seamless process for enrollment in county programs, Medi-Cal, and Healthy Families. The report, prepared by The Lewin Group, explores the policy, operational, and other considerations of implementing partnerships among county agencies, health plans, and other community stakeholders to change and improve the process for enrolling families into public health care programs.

Client Area: Foundations
Expertise Area: Medicaid and CHIP

Assessment of Health Care Safety Net Needs and Services in Central Louisiana

May 2004

In 2003, The Rapides Foundation contracted with The Lewin Group to conduct an intensive assessment of the programmatic and financial environment of primary and hospital services for the medically indigent and describe options for an affordable and more effective system of delivery.

Client Area: Foundations
Expertise Area: Health Reform

Covering America: Cost and Coverage Analysis of Ten Proposals to Expand Health Insurance Coverage

October 2003

The Covering America project, made possible by a grant from the Robert Wood Johnson Foundation and directed by the Economic & Social Research Institute (ESRI), promotes serious thinking and debate about comprehensive policies to extend health care coverage to uninsured Americans. In June 2001 the project published a set of 10 comprehensive health coverage proposals. The Robert Wood Johnson Foundation commissioned The Lewin Group to analyze the 10 proposals and prepare estimates of the number of people who would be covered by public and private health insurance and the costs of extending coverage. Appendices to the summary report provide a detailed explanation of the methodology used for the study, and detailed cost and coverage estimates for each proposal. Additional publications prepared for the Covering America project are posted on the ESRI website. Appendix A: The Health Benefits Simulation Model (HBSM): Uniform Methodology and Assumptions Appendix B: Reforming the Tax Treatment of Health Care to Achieve Universal Coverage, by Stuart M. Butler Appendix C: Assessing the Combination of Public Programs and Tax Credits, by Judith Feder, Larry Levitt, Ellen O'Brien, and Diane Rowland Appendix D: A Private/Public Partnership for National Health Insurance, by Jonathan Gruber Appendix E: Medicare Plus: Increasing Health Coverage by Expanding Medicare, by Jacob S. Hacker Appendix F: Expanding Health Insurance Coverage: A New Federal/State Approach, by John F. Holahan, Len M. Nichols, and Linda J. Blumberg Appendix G: A State-Based Proposal for Achieving Universal Coverage, by Richard Kronick and Thomas Rice Appendix H: An Adaptive Credit Plan for Covering the Uninsured, by Mark V. Pauly Appendix I: Near-Universal Coverage Through Health Plan Competition: An Insurance Exchange Approach, by Sara J. Singer, Alan M. Garber, and Alain C. Enthoven Appendix J: The Medical Security System: A Proposal to Ensure Health Insurance for all Americans, by Alan R. Weil Appendix K: A Plan for Achieving Universal Health Coverage: Combining the New with the Best of the Past, by Elliot K. Wicks, Jack A. Meyer, and Sharon Silow-Carroll

Client Area: Foundations
Expertise Area: Health Reform

Simplifying Medi-Cal Enrollment

June 2003

The Medi-Cal Policy Institute commissioned The Lewin Group to study various ways in which the process for families applying for Medi-Cal, California's Medicaid program, could be simplified. To apply for Medi-Cal, many applicants must provide documentation of their assets and income, which can serve as a barrier to successful completion of the application process. Through interviews with county eligibility workers, advocates, state staff and others, Lewin developed several alternatives for simplifying both the assets and income tests. For five of these options, Lewin developed estimates of medical costs and administrative savings associated with the implementation of these initiatives. The results of the analyses are summarized in an issue brief, as well as in two detailed reports addressing each of the assets and income options. A technical report on the cost modeling is also included.

Client Area: Foundations
Expertise Area: Medicaid and CHIP

The California Working Disabled Program : Lessons Learned, Looking Ahead

April 2003

The California Working Disabled Medi-Cal Buy-In Program was implemented in April 2000 to enable disabled individuals to participate in the workforce without the threat of losing their Medi-Cal coverage. Although a relatively new program, policymakers and advocates have already begun considering programmatic and policy changes that would build on the existing program, expand eligibility, and broaden access to certain services. This study was initiated to better understand the factors affecting enrollment in CWD and to estimate the enrollment and cost impacts of select programmatic changes. This report shares findings from an enrollee survey, interviews with county eligibility workers, and modeling of data from the Census Bureau and the California Department of Health Services.

Client Area: Foundations
Expertise Area: Medicaid and CHIP

Patient Advocate Foundation Survey: Patient and Consumer Views of Brown Bagging and Mandatory Vendor Imposition

January 2003

For the Patient Advocate Foundation (PAF), The Lewin Group tabulated and reported the results of a PAF survey of patient and consumer attitudes regarding two practices being used by some health plans to manage chemotherapy costs, commonly known as "brown bagging" and "mandatory vendor imposition."

Client Area: Foundations

Financial Impact of the 2020 Vision Proposal

October 2002

The Lewin Group developed an analysis of the cost and coverage impacts of a proposal to expand insurance coverage developed by the Commonwealth Fund. Results from the analysis were featured in a recent article in Health Affairs by Karen Davis and Cathy Schoen of the Commonwealth Fund. The proposal includes an expansion of employer sponsored coverage through a "pay-or-play" program in which employers must either provide coverage to their workers or pay a tax covering their workers under a new public program. The proposal also expands upon the existing Medicaid/SCHIP programs, provides premium subsidies to middle-income people for the purchase of insurance, creates a Medicare buy-in for people over age 60 and permits people to obtain coverage from health plans offered through the Federal Employees Health Benefits Program (FEHBP).

Client Area: Foundations
Expertise Area: Health Reform

Financial Performance of Academic Health Center Hospitals, 1994 - 2000

September 2002

This report examines how competitive market dynamics between 1994 and 2000 have affected the financial stability of academic health center (AHC) hospitals and their ability to support their academic and social missions. It looks at the financial challenges facing AHC hospitals and demonstrates that fewer financial resources are currently available to subsidize mission-related activities than at any other time since 1994. Although the analysis focuses on AHC hospitals, the report considers other teaching hospitals as well as other types of hospitals.

Client Area: Foundations