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Brach, Cindy

Authors: Szilagyi PG, Shenkman E, Brach C, et al.
Date: 2003.
Title: Children with special health care needs enrolled in SCHIP: patient characteristics and health care needs.
Publication: Pediatrics 112(6 Pt. 2):508-20.
Abstract: Available on PubMed®.
Topics: Access, Children, Chronic Conditions, Medicaid/SCHIP, Mental Health, Public Policy
Availability: Reprints of this article can be ordered from the AHRQ Publications Clearinghouse (1-800-358-9295, AHRQ Publication No. 04-RO17).

Authors: Shone LP, Dick AW, Brach C, et al.
Date: 2003.
Title: The role of race and ethnicity in SCHIP in four states: are these baseline disparities, and what do they mean for SCHIP?
Publication: Pediatrics 112(6):521-32.
Abstract: Available on PubMed®.
Topics: Access, Children, Medicaid/SCHIP, Minorities, Public Policy
Availability: Reprints of this article can be ordered from the AHRQ Publications Clearinghouse (1-800-358-9295, AHRQ Publication No. 04-RO16).

Authors: Brach C, Lewit EM, VanLandeghem K, et al.
Date: 2003
Title: Who's enrolled in SCHIP? Findings from the Child Health Insurance Research Initiative (CHIRI™).
Publication: Pediatrics 112(6):499-507.
Abstract: Available on PubMed®
Topics: Access, Children, Chronic Conditions, Medicaid/SCHIP, Minorities, Public Policy
Availability: Reprints of this article can be ordered from the AHRQ Publications Clearinghouse (1-800-358-9295, AHRQ Publication No. 04-RO15).

Authors: Dick AW, Allison RA, Haber SG, Brach C, Shenkman B
Title: Consequences of States' Policies for SCHIP Disenrollment.
Publication: Health Care Financing Review 23(3):65-88.
Date: 2002
Abstract: Policymakers are concerned about disenrollment from the State Children's Health Insurance Program (SCHIP). We describe disenrollment in Florida, Kansas, New York, and Oregon and assess the links between disenrollment and states' SCHIP policies. We find that SCHIP is used on a long-term basis (at least 2 years) for a significant group of new enrollees and as temporary coverage (fewer than 12 months) for many others. Recertification generates large disenrollments (about half of children still enrolled at the time), but as many as 25 percent return within 2 months. The increased disenrollment rate at recertification is completely eliminated by a policy of passive re-enrollment.
Topics: Children, Insurance, Medicaid and SCHIP, Public Policy.
Availability: AHRQ Publication No. 02-R070 is available from the AHRQ Publications Clearinghouse.

Authors: Brach C, and Fraser I.
Title: Reducing Disparities through Cultural Competent Health Care: An Analysis of the Business Case.
Publication: Quality Management in Health Care 10(4):15-28.
Date: 2002
Abstract: The persistence of racial and ethnic disparities in health care access, quality, and outcomes has prompted considerable interest in increasing the cultural competence of health care, both as an end in its own right and as a potential means to reduce disparities. Health care organizations have financial incentives to become culturally competent, but limitations inherent in these incentives must be overcome if cultural competence is to become widespread.
Topics: Cost, Markets, Minorities, Organizational Research, Public Policy, Purchasing.
Availability: AHRQ Publication No. 02-R081 is available from the AHRQ Publications Clearinghouse.

Authors: Brach C, Fraser I.
Title: Can cultural competency reduce ethnic and racial health disparities? A review and conceptual model.
Publication: Med Care Res Rev 57(Suppl 1):181-217.
Date: 2000
Abstract: This article investigates cultural competency's potential to reduce racial and ethnic health disparities through a review of both the cultural competency and disparities literatures and development of a conceptual model. It identifies nine major cultural competency techniques described in the literature (interpreter services, recruitment and retention policies, training, coordinating with traditional healers, use of indigenous community workers, culturally competent health promotion, including family/community members, immersion into another culture, and administrative and organizational accommodations). The authors model how cultural competency techniques could improve the ability of health systems and their clinicians to deliver appropriate services to diverse populations that lead to good outcomes, thereby reducing disparities. The authors conclude that while there is substantial evidence to suggest that cultural competency should work, health systems have little evidence about which cultural competency techniques are in fact effective, and less evidence on when and how to implement them properly.
Topics: Minorities, Public Policy, Research Agenda.
Availability: AHRQ Publication No. 01-R007 is available from the AHRQ Publications Clearinghouse. Copies of this journal supplement can be ordered from the Kaiser Family Foundation (1-800-656-4533, publication #3072).

Authors: Brach C, Sanches L, Young D, et al.
Title: Wrestling with typology: Penetrating the "black box" of managed care by focusing on health care system characteristics.
Publication: Med Care Res Rev 57(Suppl 2):93-115.
Date: 2000.
Abstract: The health care system has undergone a fundamental transformation, undermining the usefulness of the typology of the HMO, IPA, PPO, etc. The authors present a new approach to studying the health care system. In matrix form, they have identified a set of organizational and delivery characteristics with the potential to influence outcomes of interest, such as access to services, quality, health status and functioning, and cost. The matrix groups the characteristics by domain (financial features, structure, care delivery and management policies, and products) and by key roles in the health care system (sponsor, plan, provider intermediary organization, and direct services provider). The matrix is a tool for researchers, administrators, clinicians, regulators and policy makers, and data collectors. It suggests a new set of players to be studied; emphasizes the relationships among the players; and provides a checklist of independent, control, and interactive variables to be included in analyses.
Topics: Managed Care, Markets, Methods, Public Policy, Research Agenda.
Availability: AHRQ Publication No. 01-R014 is available from the AHRQ Publications Clearinghouse.

Author: Brach C.
Title: Designing substance abuse and mental health capitation programs: A managed care guide for State and local officials.
Publication: Rockville (MD): Substance Abuse and Mental Health Services Administration.
Date: 1998
Abstract: This guide provides an overview of capitation and its goals for the substance abuse and mental health fields and defines 10 design decisions that must be analyzed when formulating a capitation program: identify goals, define populations eligible for enrollment, determine the scope of services, assign responsibilities for administration and delivery (integrated, mixed, or carved out), contracting, manage risk, set rates, market and enroll clients, ensure quality, and implementation.
Topics: Managed Care, Mental Health, Public Policy.
Availability: This guide can be ordered through the National Clearinghouse on Alcohol and Drug Information (NCADI) by calling 1-800-729-6686 or (301) 468-2600 or by E-mail info@health.org.

Authors: Brach C, Scallet L.
Title: Managed care challenges for children and family services.
Publication: In Humane Managed Care?, edited by Schamess G, and Lightburn A. Washington (DC): National Association of Social Workers Press.
Date: 1998
Abstract: This chapter highlights five challenges facing those dedicated to the welfare of children and their families who also want to make the most of the opportunity managed care presents: (1) The speed with which managed care is moving through the various systems that serve children and families. (2) The emphasis that has been placed on outcomes. (3) The participation of clients in the design and implementation of managed care policies and programs and the importance of ensuring client protection. (4) The need for the development of culturally competent systems of care. (5) The potpourri of legal considerations that accompany managed care initiatives.
Topics: Children, Managed Care, Minorities, Public Policy, Purchasing.

Authors: Fraser I, Chait E, Brach C.
Title: Promoting choice: Lessons from managed Medicaid programs.
Publication: Health Aff 17(5):165-73.
Date: 1998
Abstract: By examining the experiences of seven States with mandatory managed Medicaid programs, this article seeks to draw some lessons and raise research, policy, and operational questions about enrollee choice of health plans. The article explores the strategies States adopt to inform and facilitate choice, and what methods they use to assign individuals who do not make a choice in the time allotted. Differences are identified in the enrollment and education process that might account for some of the variation among States' rates of enrollees who choose a plan. Use of enrollment brokers and restrictions on marketing is also discussed.
Topics: Managed Care, Medicaid, Public Policy.
Availability: AHCPR Publication No. 98-R088 is available from the AHRQ Publications Clearinghouse.

Authors: Robinson G, Brach C.
Title: Developing integrated mental health service delivery systems.
Publication: In Living in the Community with Disability: A Cross-Group Perspective, edited by V. Mor and S. Allen. New York, NY: Springer Publications.
Date: 1998
Abstract: This chapter discusses three methods for integrating mental health services for persons with severe mental illness living in the community: case management, capitation, and central authorities.
Topics: Mental Health.

Author: Brach C, ed.
Title: AHCPR research about managed care.
Publication: Rockville (MD): AHCPR.
Date: 1997
Abstract: This Program Note describes recent research projects supported by AHCPR, some with other agencies in the Department of Health and Human Services, or conducted by AHCPR researchers on managed care. Most research on managed care has been conducted in HMOs, the prototypic managed care organization. These studies are designed to produce information that, ultimately, will improve consumer choice, improve the quality and value of health care services, and support and improve the marketplace. The Program Note organizes the studies into these categories: Changes in Health Care Markets; Organization and Delivery of Services; Impact on Clinical Decisionmaking, Access, and Quality; Interventions that Improve Outcomes; Informing Consumers; Impact on Cost; Rural Studies; Tools; and Fostering Research.
Topics: Cost, Managed Care, Markets, Medical Decisionmaking, Purchasing.
Availability: AHCPR Publication No. 97-0023 is available from the AHRQ Publications Clearinghouse. Select to access online version.

Authors: Brach C, Robinson G.
Title: Mental health.
Publication: In Health Care Choices for Today's Consumer: Families USA Guide to Quality and Cost, edited by M. Miller. New York, NY: Springer Publications.
Date: 1997
Abstract: This chapter in a popularly-sold consumer's guide provides advice on how to choose a provider and how to find appropriate care, and reviews the types of mental health services that are available and how to pay for them. The rights of mental patients are also delineated.
Topics: Mental Health, Purchasing.

Authors: Fraser I, Brach C.
Title: Meeting Medicaid's cost and quality challenges: The role of AHRQ research.
Publication: Rockville (MD): AHCPR.
Date: 1997
Abstract: This Program Note describes AHCPR's role in providing research and technical assistance to the Medicaid program in six areas: care for elderly and disabled populations, maternal and child health, HIV and AIDS, drug policy, informing consumers, and system financing and management.
Topics: Cost, Medicaid.
Availability: AHCPR Publication No. 97-R0044 is available from the AHRQ Publications Clearinghouse. Select to access online version.

Author: Brach C.
Title: Cultural competency and managed care.
Publication: Washington (DC): Mental Health Policy Resource Center.
Date: 1996
Abstract: This brief publication discusses why and how managed care organizations are likely to become culturally competent, identifies the five components of culturally competent care, and lists selected resources.
Topics: Managed Care, Minorities.

Author: Brach C.
Title: Privatizing local mental health authorities and mental health services: Raising questions and considering options.
Publication: Boston (MA): Technical Assistance Collaborative, Inc.
Date: 1996
Abstract: This monograph, distributed to state and county mental health agencies, weighs the advantages and disadvantages of privatizing local mental health authorities and the relative merits to different organizational forms (quasi-public v. private non-profit corporation). The monograph also reviews considerations for privatizing the delivery of mental health services, and gives guidance on implementing either type of privatization strategy.
Topics: Cost, Mental Health, Public Policy, Purchasing.
Availability: Select to access information on how to order this monograph on the Web site of the Technical Assistance Collaborative.

Authors: Brach C, Mauch D.
Title: Public sector responsibilities in managed care.
Publication: In Managed care: Challenges for children and family services, edited by L. Scallet, C. Brach and E. Steel. Baltimore, (MD): Annie E. Casey Foundation.
Date: 1996
Abstract: This report poses the question: "What responsibilities must remain with the public sector?" The response comes in three parts. First, the public sector's objectives in caring for vulnerable children and families are defined. Second, core functions of government that cannot be delegated are articulated. Third, strategies are offered for executing core functions and securing the public sector's objectives. Public sector officials who think through these issues and plan accordingly can remain in control while using the private sector effectively to accomplish public objectives.
Topics: Children, Managed Care, Public Policy, Purchasing.

Authors: Brach C, Scallet L.
Title: Trends.
Publication: In Managed care: Challenges for children and family services, edited by Scallet L, Brach C, Steel E. Baltimore (MD): Annie E. Casey Foundation.
Date: 1996
Abstract: This report was designed to educate the systems that serve children and families (e.g., child welfare, special education, juvenile justice) about managed care. Drawing upon knowledge from the sectors where managed care is relatively more advanced, such as the health and mental health sectors, the authors discuss the implications of the advancement of managed care techniques into child- and family-serving systems.
Topics: Children, Managed Care, Mental Health, Public Policy, Purchasing.

Author: Drissel A.
Title: Managed care and children and family services: A guide for State and local officials.
Publication: Baltimore (MD): Annie E. Casey Foundation. Edited by Brach C.
Date: 1996
Abstract: This guide is the final product of a project for the Annie E. Casey Foundation, Managed care: Implications for children and family services. A major goal of the project was to provide a bridge from the sectors where managed care is relatively more advanced, such as the health and mental health care systems, to those where managed care is beginning to make inroads.
Topics: Children, Managed Care, Public Policy, Purchasing.

Authors: Robinson G, Brach C.
Title: Managed mental health care and women: Implications of a changing delivery system.
Publication: Paper read at Changes in Mental Health Care: What Might They Mean for Women?
Date: October 2, 1996
Abstract: This article was written to serve as the basis of discussion for the Commonwealth Fund Commission on Women's Health's symposium, Changes in Mental Health Care: What Might They Mean for Women? The public mental health system is now undergoing a radical transformation with the advent of managed care. Over the past two decades Medicaid has grown into a dominant funding source for public mental health services. States, facing budgetary pressures, are increasingly shifting Medicaid programs into managed care.
Topics: Managed Care, Medicaid, Mental Health, Public Policy, Women.

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