A Postcard from California: Cal Wellness Foundation President on the ACA and the Foundation’s New Grants Program

October 29th, 2014

A few short months after I took the helm as The California Wellness Foundation’s president and CEO, the results of our eighth annual Cal Wellness/Field Health Policy Survey were released. I dug into the results to get a view of what Californians are thinking and feeling about the Affordable Care Act’s (ACA’s) implementation in our state.

Here’s my key take-away—Californians are happy with the ACA. And the percentage of bipartisan support for the ACA has risen steadily in California over the years.

I think it’s likely that the satisfaction will continue to increase as folks who have experienced tangible health benefits through the ACA share those success stories.

While other states—including my childhood home of Virginia—have opted not to expand Medicaid through the ACA, in California nearly two of three voters said that the state’s Medicaid program (Medi-Cal) is important and that it’s been successful in meeting its objectives.

This positive outlook is attributable to more than just California sunshine.

For one thing, California has a history of working across political divides on health care reform. Years before the ACA, California tried to create statewide health system reform. While reform didn’t happen then, it laid the ground work for policy makers to prioritize health care access. California health foundations have been working together since then, too.

Also, and perhaps most significantly, a robust cadre of health advocates has been central to bringing grassroots voices to the attention of policy makers. This is why Cal Wellness has a strong grant-making commitment to support public policy advocacy organizations. Read the rest of this entry »

Family Members Caring for People With Cognitive and Behavioral Health Conditions: Nationwide Survey Results

October 23rd, 2014

In 2012, 9.6 million adults in the United States had lived with a serious mental illness in the past year. Also, 20 percent of adults over age fifty have depression, and about 11 percent suffer from anxiety disorders. And what about the people who care for an aging population? What challenges do family caregivers face when supporting and providing for adults with chronic physical and mental illness?

The report, “Family Caregivers Providing Complex Chronic Care to People with Cognitive and Behavioral Health Conditions,” published in August by the AARP Public Policy Institute and the United Hospital Fund (UHF), with support from the John A. Hartford Foundation and the AARP Foundation, sheds some light on the stresses and challenges that family caregivers of people with these conditions face.

The report is the third in the “Insight on the Issues” series, based on analyses from a December 2011 national survey of 1,677 family caregivers. Earlier findings were published in the AARP/UHF report Home Alone: Family Caregivers Providing Complex Chronic Care and earlier publications in the series.

The Stresses of Family Caregiving

According to the survey results, nearly half of family caregivers performed medical/nursing tasks (such as medication management and wound care) in addition to assisting with both activities of daily living (such as bathing and dressing) and instrumental activities of daily living (such as transportation and shopping). And about half of this group provided care for a family member with at least one behavioral or cognitive health condition.

Authors Susan C. Reinhard of AARP and Sarah Samis and Carol Levine of UHF define cognitive impairments as memory problems, dementia, or Alzheimer’s disease, and behavioral conditions as depression, anxiety, or other mental illness.

In addition, care recipients with behavioral and/or cognitive conditions were more likely to have chronic physical diagnoses such as stroke/hypertension, musculoskeletal problems, cardiac disease, and diabetes than care recipients who did not have behavioral or cognitive conditions. Care recipients with both behavioral health and cognitive conditions were most likely to have undergone ambulatory surgery or to have gone to a hospital emergency department. Read the rest of this entry »

The RWJF Seeks Proposals for a New National Program: Policy-Relevant Insurance Studies

October 22nd, 2014

In its coverage work, in recent years, the Robert Wood Johnson Foundation has prioritized grant making related to the implementation of health reform. Research we have funded in this area has focused largely on monitoring the impact of health reform on important outcomes such as coverage, access, and utilization.

Many of these activities can be seen on our landing page Reform By the Numbers, where we feature results from unique data sources such as the Urban Institute’s Health Reform Monitoring Survey, Breakaway Policy’s Health Insurance Exchange (HIX) Compare (comprehensive data on silver plans, under the Affordable Care Act), athenahealth’s ACAView, and the University of Pennsylvania’s Health Insurance Exchanges Research Group’s Health Insurance Exchanges (HIX) 2.0.

We are also funding a number of analytical briefs that provide more detailed looks at particular issues and places, such as the Leonard Davis Institute of Health Economics at the University of Pennsylvania’s Deciphering the Data series and the Urban Institute’s Monitoring and Tracking series.

In keeping with our focus on health reform, we have a strong interest in funding investigator-initiated research that is highly policy relevant. On October 15, we announced the awarding of nine grants for State Health Access Reform Evaluation (SHARE), an investigator-initiated research effort focused on state health reform issues. Newly funded SHARE projects focus on topics ranging from Medicaid expansion to a study of health care provider networks.

That same day we also announced a call for proposals (CFPs) for a new funding opportunity, Policy-Relevant Insurance Studies (PRIS). While funding research that informs policy is not new, the PRIS announcement differs somewhat from prior CFPs in both focus and approach. One way in which PRIS is unique is in its exclusive emphasis on highly policy-relevant questions related to health insurance markets. Additionally, we would prefer to fund projects that use modeling and have relatively short timeframes. Read the rest of this entry »

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