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Publication Correcting Pessimistic Mortality Beliefs May Reduce Vaccine Hesitancy, Malawi Study Shows(2024-09-11) Purcell, Helene; Ciancio, Alberto; Mwera, James; Delavande, Adeline; Mwapasa, Victor; Kohler, Hans-PeterHelping people accurately understand their risk of dying or surviving may support public health campaigns years later. A new strategy for improving health behavior is supported by a randomized controlled trial from the longrunning Malawi Longitudinal Study of Families and Health (MLSFH) that showed that a 2017 intervention to correct misconceptions about mortality risk was linked to higher COVID-19 vaccination rates five years later. Vaccination was 7.8 percentage points higher in the intervention than the control group. Effects spread to families of intervention participants, whose siblings had higher vaccination rates than the control group.Publication Does Schooling Improve Cognitive Abilities at Older Ages(2023-02-02) Amin, Vikesh; Behrman, Jere R.; Fletcher, Jason M.; Flores, Carlos A.; Flores-Lagunes, Alfonso; Kohler, Hans-PeterAn estimated 11% of U.S. adults aged 65 or older have dementia, and as the population ages, dementia cases are predicted to nearly double from 5.2 million in 2019 to 10.2 million by 2050. Understanding how education levels may affect cognitive decline and presumably dementia is important for projecting future dementia in the population and potentially helping individuals understand and possibly reduce their risk. Prior research has suggested a link between more schooling and better later-life performance on cognitive tests. However, most of these studies provided suggestive associations rather than causal estimates. When prior studies did provide causal estimates, inferences were generally based on changes in educational levels after compulsory schooling laws were enacted. This limited estimated causal effects of schooling to the lower grade levels targeted by the laws and the individuals affected by them. In this study, the authors expanded the evidence about causal effects of schooling on older adults to higher levels of schooling, such as attending college, and to a broader population. The authors applied advanced methods to data from a national, longitudinal cohort study representative of U.S. individuals over age 50.Publication Community Health Centers and Value-Based Payment(Leonard Davis Institute of Health Ecoomics, 2024-04-01) Weiner, JanetCommunity health centers (CHCs) are a bedrock of the social safety net in the United States, providing care to vulnerable people in their communities, often for little or no cost to them. CHCs operate through funding streams and reimbursement mechanisms that pose challenges to participating in newer forms of value-based payment. This issue brief provides a snapshot of CHCs and the people they serve, how they currently are funded and reimbursed, how they fit into the landscape of value-based payment, and how alternative payment policies can align with their mission and mandate.Publication Expiration of the USDA Supplemental Nutrition Assistance Program (SNAP) Emergency Allotments(Leonard Davis Institute of Health Ecoomics, 2023-08-31) Richterman, Aaron; Roberto, Christina; Thirumurthy, HarshaThe U.S. Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) is the nation’s largest federal nutrition assistance program, providing monthly benefits for food to more than 42 million low-income people.1 SNAP has been proven to lift families from poverty and reduce food insecurity–inconsistent access to an adequate, nutritious diet.2 The COVID-19 pandemic brought U.S. food insecurity to its highest levels in recent history,3 prompting Congress to pass legislation allowing temporary issuance of additional SNAP benefits, called Emergency Allotments, to SNAP recipients. Emergency Allotments increased SNAP benefits substantially, adding an average of $126 to the monthly benefit in the first year and $166 in subsequent years.4 Emergency Allotments ended in March 2023, but 18 states ended them early, when their state public health emergency expired.Publication Medicare Payment Policy for Post-Acute Care in Nursing Homes(2023-09-14) Schotland, Samuel; Werner, Rachel M.; Janet WeinerThe costs and quality of post-acute care (PAC) have come under increasing scrutiny for the value they provide to the nearly 40% of patients receiving specialized nursing or rehabilitation after hospital discharge. Much of this scrutiny focuses on skilled nursing facilities (SNFs), which account for a disproportionate amount of spending. The stakes are high for Medicare, the primary payer of post-acute services, for the nursing home industry, which relies on these short-stay patients to subsidize long-term residents, and for patients and families themselves. This Issue Brief reviews Medicare coverage and payment policy around PAC, trends in utilization and costs in SNFs, and what we know about quality and outcomes. We recommend ways to improve the value of these services through payment policies that align incentives across payers and settings.