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April 8, 2019

Engineering outcomes: Managed care and value-based design in Ohio Medicaid

Introduction The Ohio Medicaid program is privatized. In 1978, roughly a decade after Medicaid was first created by Congress, Ohio contracted private corporations to assist it in managing Medicaid benefits for Ohioans. Today, these relationships represent some of the most significant sources of public expenditures, representing billions in taxpayer money both in Ohio and nationally....

February 11, 2019

Implementing a trauma-informed approach in public assistance programs

Trauma-informed care has become more widely adopted throughout the human services field, but public assistance programs like TANF and SNAP have largely not adopted a trauma-informed approach. For some individuals, the experience of living in poverty is a form of chronic trauma, resulting in negative health outcomes and creating additional barriers to self-sufficiency. Could states...

January 14, 2019

Ohio community groups face challenges helping needy Ohioans navigate new benefits system

Introduction Community-based organizations play a critical role in connecting low-income families to public benefits, such as food, medical and cash assistance, that help make ends meet. Accessing these benefits often requires navigating complex rules and paperwork at County Job and Family Services (CJFS) offices, leading many vulnerable families to turn to trusted intermediaries for help....

January 7, 2019

Trauma, Toxic Stress and the Impact: Defining Adverse Childhood Experiences

Introduction In the mid-1990s the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente joined to conduct a study that focused on the history of exposure to trauma in 17,000 adults. Data from physical examinations was combined with a percent question survey that focused instances of abuse or neglect that occurred when each participant...

December 3, 2018

The $44,000 Question: Examining Disengaged Youth in Cuyahoga County

Most people establish a stable attachment to the workforce during their late teens and early twenties that sets them on the path for their career. They finish their studies, obtain employment and begin to live independently. Unfortunately, some youth do not make the transition from student to employee. These young adults are disconnected from both...

October 22, 2018

From Point A to Point B: Transportation as a Social Determinant in Medicaid

INTRODUCTION Time is money. This cliché is a cliché because the lens of time as an economic analytical tool is not new or unexplored territory. Time has a value, intrinsically and in very real financial terms, and is a key measurement in analyzing the effectiveness of decisions around resources. In most healthcare reimbursement schemes, including...