Publications by authors named "Michael Doonan"

Objective: This study aimed to examine whether changes in mental health services use under the Patient Protection and Affordable Care Act (ACA) differed in Mental Health Professional Shortage Areas (MHPSAs) versus non-MHPSAs.

Methods: Multiple waves of data from the California Health Interview Survey (2011-2018) were analyzed. The sample (N=10,497) was restricted to adults (ages 18-64) who reported experiencing serious psychological distress (SPD) during the past 12 months.

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Background: The Affordable Care Act (ACA) aimed to expand mental health service use in the US, by expanding access to health insurance. However, the gap in mental health utilization by race and ethnicity is pronounced: members of racial and ethnic minoritized groups remain less likely to use mental health services than non-Hispanic White individuals even after the ACA.

Aims Of The Study: This study assessed the effect of the Affordable Care Act (ACA) on mental health services use in one large state (California), and whether that effect differed among racial and ethnic groups.

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Acquired brain injury (ABI) is a major global public health problem and source of disability. A major contributor to disability after severe ABI is limited access to multidisciplinary rehabilitation, despite evidence of sustained functional gains, improved quality of life, increased return-to-work, and reduced need for long-term care. A societal model of value in rehabilitation matches patient and family expectations of outcomes and system expectations of value for money.

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Importance: Insurance status has been linked to important differences in cancer treatment and outcomes in the US. With more than 15 million individuals gaining health insurance through Medicaid expansion, there is an increasing need to understand the implications of this policy within the US cancer population. This review provides an overview of the fundamental principles and nuances of Medicaid expansion, as well as the implications for cancer care.

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Massachusetts is in the midst of a demographic shift that will leave the state with unprecedented ethnic, racial and cultural diversity. In light of this change, health care services in the Commonwealth need to respond to and serve an increasingly multicultural population. The time is now for bold initiatives to reduce behavioral health and health service disparities by building collaborations between policymakers, insurers/payers, provider organizations, training institutions, and community groups.

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On November 30, 2010, the Massachusetts Health Policy Forum will convene a forum to examine models of accountable health care delivery. The forum will showcase organizations from Massachusetts and other states that have taken significant steps toward improving the efficiency and quality of health care delivery through vertically and virtually integrated systems. Local stakeholders representing government, payers, providers and consumers will discuss challenges and opportunities for the Commonwealth in promoting accountable care.

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Context: Much can be learned from Massachusetts's experience implementing health insurance coverage expansions and an individual health insurance mandate. While achieving political consensus on reform is difficult, implementation can be equally or even more challenging.

Methods: The data in this article are based on a case study of Massachusetts, including interviews with key stakeholders, state government, and Commonwealth Health Insurance Connector Authority officials during the first three years of the program and a detailed analysis of primary and secondary documents.

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This issue brief outlines five strategies for improving the quality of treatment in Massachusetts: (1) Engaging detoxification clients in a broader continuum of treatment, (2) Improving retention in treatment, (3) Providing client/family-centered services, (4) Increasing the use of evidence-based treatment approaches, and (5) Supporting recovery to address the chronic nature of substance use disorders. These strategies are essential to maximizing the impact of our substance abuse dollars. We need to do it right and then expand access to treatment more broadly and fill the treatment gap.

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Hospital use and spending greatly increased in 2001 and 2002, reversing a long-term trend. In this paper we contend that the forces driving current hospital expenditures are more likely to continue than they are to abate. If current trends continue, real hospital spending per capita will increase 75 percent between 2002 and 2012, and the demand for hospital beds will increase considerably.

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