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Publication Community Health Centers and Value-Based Payment(Leonard Davis Institute of Health Ecoomics, 2024-04-01) Weiner, JanetCommunity health centers (CHCs) are a bedrock of the social safety net in the United States, providing care to vulnerable people in their communities, often for little or no cost to them. CHCs operate through funding streams and reimbursement mechanisms that pose challenges to participating in newer forms of value-based payment. This issue brief provides a snapshot of CHCs and the people they serve, how they currently are funded and reimbursed, how they fit into the landscape of value-based payment, and how alternative payment policies can align with their mission and mandate.Publication Expiration of the USDA Supplemental Nutrition Assistance Program (SNAP) Emergency Allotments(Leonard Davis Institute of Health Ecoomics, 2023-08-31) Richterman, Aaron; Roberto, Christina; Thirumurthy, HarshaThe U.S. Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) is the nation’s largest federal nutrition assistance program, providing monthly benefits for food to more than 42 million low-income people.1 SNAP has been proven to lift families from poverty and reduce food insecurity–inconsistent access to an adequate, nutritious diet.2 The COVID-19 pandemic brought U.S. food insecurity to its highest levels in recent history,3 prompting Congress to pass legislation allowing temporary issuance of additional SNAP benefits, called Emergency Allotments, to SNAP recipients. Emergency Allotments increased SNAP benefits substantially, adding an average of $126 to the monthly benefit in the first year and $166 in subsequent years.4 Emergency Allotments ended in March 2023, but 18 states ended them early, when their state public health emergency expired.Publication Medicare Payment Policy for Post-Acute Care in Nursing Homes(2023-09-14) Schotland, Samuel; Werner, Rachel M.; Janet WeinerThe costs and quality of post-acute care (PAC) have come under increasing scrutiny for the value they provide to the nearly 40% of patients receiving specialized nursing or rehabilitation after hospital discharge. Much of this scrutiny focuses on skilled nursing facilities (SNFs), which account for a disproportionate amount of spending. The stakes are high for Medicare, the primary payer of post-acute services, for the nursing home industry, which relies on these short-stay patients to subsidize long-term residents, and for patients and families themselves. This Issue Brief reviews Medicare coverage and payment policy around PAC, trends in utilization and costs in SNFs, and what we know about quality and outcomes. We recommend ways to improve the value of these services through payment policies that align incentives across payers and settings.Publication Using Financial Incentives to Treat Stimulant Use Disorders(2024-01-18) Beatty, Benicio; Komaragir, Ameya; Weiner, JanetStimulants are playing a prominent role in the current U.S. overdose crisis. As stimulant use continues to mount, the need for evidence-based treatment grows more urgent. This brief highlights contingency management, the most effective treatment for stimulant use disorder, and reviews the current barriers to its widespread use along with practice and policy strategies for increasing implementation.Publication Does Schooling Improve Cognitive Abilities at Older Ages?(Leonard Davis Institute of Health Ecoomics, 2023-02-02) Tachibana, ChrisIn older U.S. adults, higher levels of education resulted in better performance on tests that assess cognitive function in a study using innovative methods that provided average causal effects of schooling on a broad population. Higher cognitive scores were most prominent among college-educated individuals compared to high school graduates: A college education led to the equivalent of a 1.4- to 5.4-point increase on a 100-point cognitive test.Publication To Protect and Serve(Leonard Davis Institute of Health Ecoomics, 2023-07-14) Weiss, Madison; Weiner, JanetLocal police officers and other external law enforcement officers are ubiquitous in emergency departments (EDs) across the country. But the job of law enforcement to protect public safety can sometimes conflict with clinicians’ dedication to patient care while putting patient privacy, autonomy, and trust at risk. This brief reviews published work examining ambiguities around the role of law enforcement in EDs.Publication Penn Library's Ms. Codex 1666 - Ars logicae : in Aristotelis Logicam Quaestiones (Video Orientation)Porter, DotVideo Orientation to the University of Pennsylvania Library's Ms. Codex 1666, commentaries on Aristotelian logic divided into six sections. Written in Italy in the 18th century. Record on Franklin (link to digitized copy): https://franklin.library.upenn.edu/catalog/FRANKLIN_9962934853503681Publication Penn Library's Ms. Codex 1665 - [Alchemical compilation]. (Video Orientation)Porter, DotVideo Orientation to the University of Pennsylvania Library's Ms. Codex 1665, a collection of treatises on Hermetic works, the philosopher's stone, with instructions for the transmutation of metals, creating artificial diamonds, and alchemical recipes for powders, elixirs, and occasional medicinal remedies. Includes a table of contents (p. iii-x). Written in France(?), between 1750 and 1799. Record on Franklin (link to digitized copy): https://franklin.library.upenn.edu/catalog/FRANKLIN_9962934963503681Publication Is the Growing Burden of Non-Communicable Diseases in India Preventable?(2024-06-19) Gaiha, Raghav; Kulkarni, Vani S.; Unnikrishnan, VidhyaNon-Communicable Disease (NCD) morbidity and mortality as shares of total morbidity and mortality have risen steadily in India and projected to surge rapidly. In 1990, NCDs accounted for 40% of all Indian mortality and are now projected to account for three quarters of all deaths by 2030. Currently, cardiovascular diseases, cancer, respiratory illness, and diabetes are the leading causes of death in India, accounting for almost 50% of all deaths. Underlying these rising shares are growing risks that are common to several NCDs. NCDs are chronic in nature and take a long time to develop. They are linked to aging and affluence and have replaced infectious diseases and malnutrition as the dominant causes of ill health and death in much of the world including India. Some NCDs cause others and create clusters of co-morbid conditions (e.g., diabetes can lead to kidney failure and blindness). Old-age morbidity is a rapidly worsening curse in India. The swift descent of the elderly in India (60 years +) into non-communicable diseases (e.g., cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes) could have disastrous consequences in terms of impoverishment of families, excess mortality, lowering of investment and deceleration of economic growth. Indeed, the government must deal simultaneously with the rising fiscal burden of NCDs and substantial burden of infectious diseases. The present study seeks to answer three questions: Why has the prevalence of two NCDs, diabetes and heart diseases risen in recent years? Given the surge in these diseases, whether social protection policies and restructuring of medical services can mitigate such surges in the near future? A related but equally important concern is whether lifestyle and dietary changes could be induced to further prevent the rising burden of these NCDs. Our analysis is based on the only all-India panel survey-India Human Development survey that covers 2005 and 2012. This survey was conducted jointly by University of Maryland and National Council of Applied Economic Research, New Delhi. A robust econometric methodology-specifically, 2SLS- is used to address the endogeneity of key explanatory variables. The results here stress the need to make sure that pension and healthcare reforms are accompanied by greater awareness, expansion of old age pensions and public hospitals, and effective regulation of both public and private hospitals. Key words: NCDs, Diabetes, Heart diseases, Old age and other pensions, Hospitals, IndiaPublication Penn Library's Ms. Codex 1669 - [Works on spirits and their sigils]. (Video Orientation)Porter, DotVideo Orientation to the University of Pennsylvania Library's Ms. Codex 1669, a collection of works primarily focused on spirits and their sigils that includes numerous tables, drawings, and diagrams of magical symbols and their properties. Also includes additional sections on making rings of invisibility (f. 40r) and for uncovering thefts (f. 44r). Written in France[?] in the second half of the 18th century.