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Publications by Niall J. Brennan for Health Policy Center
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How are Safety Net Hospitals Responding to Health Care Financing Changes and The Health Care Safety Net (Article)
Niall J. Brennan, Stephen Zuckerman, Stuart Guterman
These reports are based on detailed case studies of safety net hospitals in Los Angeles, Houston, Boston, Detroit and Denver. Our analysis suggests that the future viability of hospitals to serve the uninsured is related to the availability of explicit or implicit financial support from local, state and federal sources and the magnitude of the uninsurance problem the facility is trying to solve. We did not find that the trend toward Medicaid managed care was an insurmountable problem for safety net hospitals. In fact, we found that the relative financial health of safety net hospitals in Denver and Boston was directly related to the aggressive approach they took toward establishing their own managed care plans. Nevertheless, despite the current financial status of individual facilities, there was widespread concern about the future. Published by the Kaiser Commission on the Medicaid and the Uninsured; 2001 April. Available at www.kff.org.
Confirming Insurance Coverage in a Telephone Survey (Article)
Shruti Rajan, Stephen Zuckerman, Niall J. Brennan
Until recently, most surveys of insurance coverage have classified people as uninsured if they have not been assigned some coverage in response to one of a series of questions about specific types of insurance. This “residual” approach to measuring uninsurance rates has not required respondents to either verify their insurance status or confirm that they are uninsured. Using the 1997 National Survey of America’s Families, this paper examines the impact of a question confirming whether or not individuals for whom no insurance coverage is reported are, in fact, uninsured. The results of our analysis suggest that a confirmation question as part of a telephone-based survey works to lower estimates of the uninsured. Staring in March 2000 and following the findings of this study, the Current Population Survey introduced a confirmation question in its health insurance sequence. (Inquiry 2000 Fall; 37(3):317-327)
Who are the Adult Uninsured? (Policy Briefs/NSAF)
John Holahan, Niall J. Brennan
This brief provides a snapshot of adults lacking health insurance coverage examining factors such as income level, family structure, race/ethnicity, employment, health status, and access to and utilization of health care. Findings show that younger, low-income adults, particularly blacks and Hispanics, have the highest uninsurance rates, but half of all low-income uninsured adults are white. The majority of uninsured low-income adults live in households with at least one full-time worker. Low-income uninsured adults are significantly worse off than the insured on measures of health access and health status. Uninsurance rates vary greatly among states. In general, states with low rates of employer-sponsored coverage have high uninsurance rates, although states with generous public programs can offset this effect somewhat.