Pamela Nadash - Academia.edu (original) (raw)
Papers by Pamela Nadash
Jonas and Kovner's Health …, 2008
International Journal of Social Welfare, 2013
Nadash P, Shih Y.-C. Introducing social insurance for longterm care in Taiwan: Key issues Taiwan ... more Nadash P, Shih Y.-C. Introducing social insurance for longterm care in Taiwan: Key issues Taiwan will shortly complete its comprehensive social safety net, which includes national health insurance, retirement security, and unemployment insurance, by introducing long-term care (LTC) insurance -putting it ahead of the many countries that rely on a patchwork of policies to address the need for LTC. The program, to be implemented in 3 to 5 years, will cover all citizens on a primarily social insurance basis. The range of LTC policy options considered is discussed, particularly how to structure the program, how to finance and regulate it, and how to develop its inadequate LTC infrastructure and workforce. Particularly thorny issues include the choice of social insurance, the feasibility of cash benefits, and how to address Taiwan's heavy reliance on foreign workers. Taiwan's increasingly democratic character, along with high levels of public support for the program, creates significant pressure on politicians to deliver on their promises to implement LTC reform.
Journal of Health & Social Policy, 2006
States play a principal role in designing and implementing publicly funded long term care program... more States play a principal role in designing and implementing publicly funded long term care programs. They are in a key position to determine what setting, from whom, and under what philosophy of care individuals can access long term care. State long term care systems have evolved over the past 25 years to support increased availability of community based care for older individuals. States have pursued three broad strategies to increase availability. One set of strategies aims to increase capacity through expanding the supply, public funding and eligibility for a wide array of home and community based services (HCBS). A second set of strategies seeks to constrain institutional growth in order to increase the dollars available for HCBS. Managed/capitated long term care is a third strategy that is a hybrid of the other two approaches. Empirically, increased capacity through use of Medicaid and Medicare resources and growth in the supply of community based care providers, combined with moderation of institutional bed supply, are associated with enhanced access and expenditures for community based long term care. The effectiveness of capitated or managed systems of care varies by model and in some cases is still under study. State fiscal resources are key to the ability to support community based care for the elderly. Targeted federal support may be critical to the continued expansion of community based care, given heterogeneity in state resources, coupled with an increasing demand for long term care.
... Over the years, however, various stakeholder groups have developed and expressed clear ... th... more ... Over the years, however, various stakeholder groups have developed and expressed clear ... that are attributable to (caused by) differences between the Professional Management Model and the ... Causal differences attributable to the models must be carefully distinguished from ...
Caring: National Association for Home Care magazine, 1998
Can the disability and the home care communities come together on the best way to provide client-... more Can the disability and the home care communities come together on the best way to provide client-centered home care with an appropriate balance between patient choice and provider liability? Should nurses be responsible and liable for all nursing tasks provided in home settings? Or are there some tasks--such as medication administration skin care, and even ventilator administration--that can safely be performed by non-nurses? And if tasks can legally be performed by non-nurses, what is necessary to ensure that tasks are done safely?
Health services …, 2012
To uncover lessons from abroad for Community Living Assistance Services and Supports (CLASS), a f... more To uncover lessons from abroad for Community Living Assistance Services and Supports (CLASS), a federally run voluntary public long-term care (LTC) insurance program created under the Accountable Care Act of 2010. Program administrators and policy researchers from Austria, England, France, Germany, and the Netherlands. Qualitative methods focused on key parameters of cash for care: how programs set benefit levels; project expenditures; control administrative costs; regulate the use of benefits; and protect workers. Structured discussions were conducted during an international conference of LTC experts, followed by personal meetings and individual correspondence. Germany's self-financing mandate and tight targeting of benefits have resulted in a solvent program with low premiums. Black markets for care are likely in the absence of regulation; France addresses this via a unique system ensuing legal payment of workers. Programs in the five countries studied have lessons, both positive and negative, relevant to CLASS design.
... The State of Health Care Delivery 3 in the United States Anthony R. Kovner and Steven Jonas 2... more ... The State of Health Care Delivery 3 in the United States Anthony R. Kovner and Steven Jonas 2 Measurement 10 Steven Jonas and Mary ... Michal D, Gursen 9 Mental Health Services 238 Steven S. Sharfstein, Anne M. Stoline, and Lorrin M. Koran 10 Drugs 263 Robin J. Strongin ...
Health Affairs, 2012
Although the Affordable Care Act requires states to establish health insurance exchanges, states ... more Although the Affordable Care Act requires states to establish health insurance exchanges, states have considerable discretion in the exchanges' design and in the range of products offered. We argue for a more activist approach, based on the Massachusetts experience, which found that consumers want the exchange to act as a trusted adviser and to offer a reasonable set of choices, but not too many. These findings are reflected in the Medicare prescription drug, Advantage, and Medigap markets and in the Dutch and Swiss experiences, which validate the evolving approach of Massachusetts of limiting the number of options, standardizing products, and providing consumer supports.
… Services, The National Council on the …, 1999
Neurobiology of Aging, 2000
Home healthcare nurse, 2003
Providing individualized education to home care patients with diabetes can significantly improve ... more Providing individualized education to home care patients with diabetes can significantly improve their foot care practices. A nurse researcher from the Intercollegiate College of Nursing at Washington State University conducted a study of 40 home healthcare patients with Type 2 diabetes and found that an individualized educational intervention led to improved foot care knowledge, self-care practices, and confidence performing foot related self-care.
Home Healthcare Nurse, 2003
The Gerontologist, 2004
Purpose: In this study an attempt is made to understand how a Medicaid-only managed long-termcare... more Purpose: In this study an attempt is made to understand how a Medicaid-only managed long-termcare (MMLTC) plan for elders differs from the Program of All-Inclusive Care for the Elderly (PACE), a fully integrated model, in terms of structure, operations, patient population, and service utilization. Design and Methods: With the use of information from the Outcome and Assessment Information Set and administrative data from a MMLTC plan in New York City, enrollees were compared at the start of care and their first-year service utilization with PACE, using the PACE national data set. Results: The plans differ in the range of services covered and in the larger number of members served by the MMLTC plan. The served populations differ in their sociodemographic profiles and have levels of functional need that are high, but they also differ in their relative severity of dependency in activities of daily living and instrumental activities of daily living. During the first year of enrollment, the utilization of traditional home-and community-based services was higher in PACE than in the MMLTC plan, although MMLTC plan members received much more care in the home. Total hospital utilization was lower in PACE, but nursing home utilization was higher. Implications: MMLTC is a feasible option for serving a population whose level of impairment is similar to that of PACE. Whereas PACE's reliance on adult day centers is seemingly associated with a stronger medical focus and lower hospital use, the MMLTC plan's emphasis on home-based personal care seems to be linked with lower nursing home use.
Home healthcare nurse, 2004
This research brief reports on a study that evaluated the effectiveness of a transitional care mo... more This research brief reports on a study that evaluated the effectiveness of a transitional care model for patients with congestive heart failure (CHF). The model focused on improving the transition from hospital to home care by upgrading traditional discharge practices and implementing an evidence-based educational program. It used usual care nurses, rather than specialist nurses, to carry out the intervention. The study found that health-related quality of life improved and the number of emergency room visits was reduced.
Jonas and Kovner's Health …, 2008
International Journal of Social Welfare, 2013
Nadash P, Shih Y.-C. Introducing social insurance for longterm care in Taiwan: Key issues Taiwan ... more Nadash P, Shih Y.-C. Introducing social insurance for longterm care in Taiwan: Key issues Taiwan will shortly complete its comprehensive social safety net, which includes national health insurance, retirement security, and unemployment insurance, by introducing long-term care (LTC) insurance -putting it ahead of the many countries that rely on a patchwork of policies to address the need for LTC. The program, to be implemented in 3 to 5 years, will cover all citizens on a primarily social insurance basis. The range of LTC policy options considered is discussed, particularly how to structure the program, how to finance and regulate it, and how to develop its inadequate LTC infrastructure and workforce. Particularly thorny issues include the choice of social insurance, the feasibility of cash benefits, and how to address Taiwan's heavy reliance on foreign workers. Taiwan's increasingly democratic character, along with high levels of public support for the program, creates significant pressure on politicians to deliver on their promises to implement LTC reform.
Journal of Health & Social Policy, 2006
States play a principal role in designing and implementing publicly funded long term care program... more States play a principal role in designing and implementing publicly funded long term care programs. They are in a key position to determine what setting, from whom, and under what philosophy of care individuals can access long term care. State long term care systems have evolved over the past 25 years to support increased availability of community based care for older individuals. States have pursued three broad strategies to increase availability. One set of strategies aims to increase capacity through expanding the supply, public funding and eligibility for a wide array of home and community based services (HCBS). A second set of strategies seeks to constrain institutional growth in order to increase the dollars available for HCBS. Managed/capitated long term care is a third strategy that is a hybrid of the other two approaches. Empirically, increased capacity through use of Medicaid and Medicare resources and growth in the supply of community based care providers, combined with moderation of institutional bed supply, are associated with enhanced access and expenditures for community based long term care. The effectiveness of capitated or managed systems of care varies by model and in some cases is still under study. State fiscal resources are key to the ability to support community based care for the elderly. Targeted federal support may be critical to the continued expansion of community based care, given heterogeneity in state resources, coupled with an increasing demand for long term care.
... Over the years, however, various stakeholder groups have developed and expressed clear ... th... more ... Over the years, however, various stakeholder groups have developed and expressed clear ... that are attributable to (caused by) differences between the Professional Management Model and the ... Causal differences attributable to the models must be carefully distinguished from ...
Caring: National Association for Home Care magazine, 1998
Can the disability and the home care communities come together on the best way to provide client-... more Can the disability and the home care communities come together on the best way to provide client-centered home care with an appropriate balance between patient choice and provider liability? Should nurses be responsible and liable for all nursing tasks provided in home settings? Or are there some tasks--such as medication administration skin care, and even ventilator administration--that can safely be performed by non-nurses? And if tasks can legally be performed by non-nurses, what is necessary to ensure that tasks are done safely?
Health services …, 2012
To uncover lessons from abroad for Community Living Assistance Services and Supports (CLASS), a f... more To uncover lessons from abroad for Community Living Assistance Services and Supports (CLASS), a federally run voluntary public long-term care (LTC) insurance program created under the Accountable Care Act of 2010. Program administrators and policy researchers from Austria, England, France, Germany, and the Netherlands. Qualitative methods focused on key parameters of cash for care: how programs set benefit levels; project expenditures; control administrative costs; regulate the use of benefits; and protect workers. Structured discussions were conducted during an international conference of LTC experts, followed by personal meetings and individual correspondence. Germany's self-financing mandate and tight targeting of benefits have resulted in a solvent program with low premiums. Black markets for care are likely in the absence of regulation; France addresses this via a unique system ensuing legal payment of workers. Programs in the five countries studied have lessons, both positive and negative, relevant to CLASS design.
... The State of Health Care Delivery 3 in the United States Anthony R. Kovner and Steven Jonas 2... more ... The State of Health Care Delivery 3 in the United States Anthony R. Kovner and Steven Jonas 2 Measurement 10 Steven Jonas and Mary ... Michal D, Gursen 9 Mental Health Services 238 Steven S. Sharfstein, Anne M. Stoline, and Lorrin M. Koran 10 Drugs 263 Robin J. Strongin ...
Health Affairs, 2012
Although the Affordable Care Act requires states to establish health insurance exchanges, states ... more Although the Affordable Care Act requires states to establish health insurance exchanges, states have considerable discretion in the exchanges' design and in the range of products offered. We argue for a more activist approach, based on the Massachusetts experience, which found that consumers want the exchange to act as a trusted adviser and to offer a reasonable set of choices, but not too many. These findings are reflected in the Medicare prescription drug, Advantage, and Medigap markets and in the Dutch and Swiss experiences, which validate the evolving approach of Massachusetts of limiting the number of options, standardizing products, and providing consumer supports.
… Services, The National Council on the …, 1999
Neurobiology of Aging, 2000
Home healthcare nurse, 2003
Providing individualized education to home care patients with diabetes can significantly improve ... more Providing individualized education to home care patients with diabetes can significantly improve their foot care practices. A nurse researcher from the Intercollegiate College of Nursing at Washington State University conducted a study of 40 home healthcare patients with Type 2 diabetes and found that an individualized educational intervention led to improved foot care knowledge, self-care practices, and confidence performing foot related self-care.
Home Healthcare Nurse, 2003
The Gerontologist, 2004
Purpose: In this study an attempt is made to understand how a Medicaid-only managed long-termcare... more Purpose: In this study an attempt is made to understand how a Medicaid-only managed long-termcare (MMLTC) plan for elders differs from the Program of All-Inclusive Care for the Elderly (PACE), a fully integrated model, in terms of structure, operations, patient population, and service utilization. Design and Methods: With the use of information from the Outcome and Assessment Information Set and administrative data from a MMLTC plan in New York City, enrollees were compared at the start of care and their first-year service utilization with PACE, using the PACE national data set. Results: The plans differ in the range of services covered and in the larger number of members served by the MMLTC plan. The served populations differ in their sociodemographic profiles and have levels of functional need that are high, but they also differ in their relative severity of dependency in activities of daily living and instrumental activities of daily living. During the first year of enrollment, the utilization of traditional home-and community-based services was higher in PACE than in the MMLTC plan, although MMLTC plan members received much more care in the home. Total hospital utilization was lower in PACE, but nursing home utilization was higher. Implications: MMLTC is a feasible option for serving a population whose level of impairment is similar to that of PACE. Whereas PACE's reliance on adult day centers is seemingly associated with a stronger medical focus and lower hospital use, the MMLTC plan's emphasis on home-based personal care seems to be linked with lower nursing home use.
Home healthcare nurse, 2004
This research brief reports on a study that evaluated the effectiveness of a transitional care mo... more This research brief reports on a study that evaluated the effectiveness of a transitional care model for patients with congestive heart failure (CHF). The model focused on improving the transition from hospital to home care by upgrading traditional discharge practices and implementing an evidence-based educational program. It used usual care nurses, rather than specialist nurses, to carry out the intervention. The study found that health-related quality of life improved and the number of emergency room visits was reduced.