The impact of cost-sharing on appropriate utilization and health status: a review of the literature on seniors.

This article provides a review of research that has addressed the impact of patient cost sharing on the use of services and resulting health status impacts, among the population age 65 and older. Nearly all of the 22 relevant studies examined that have been published since 1990-16 focusing on cost-sharing for prescription drugs and 6 on cost-sharing for medical services--conclude that increased cost-sharing reduces either or both the utilization and health status of seniors. Most of the studies, however, rely on cross-sectional and self-reported data. Further research, employing stronger study designs as well as clinical and administrative data, is necessary before drawing more definitive conclusions.

Workforce development in Maryland to promote clinical-community connections that advance payment and delivery reform.

Promoting clinical-community linkages is at the heart of Maryland's efforts systematically to transform health care delivery, with community health workers (CHW) playing a central role. This article describes how Maryland is using the evidence-base on CHW effectiveness and training to develop a workforce capable of most effectively connecting communities with care.

Working with communities to achieve health equity in Maryland's five Health Enterprise Zones.

This report introduces Maryland's Health Enterprise Zones (HEZ) Initiative, describes the efforts to establish the first HEZs, describes the principles fundamental to the HEZ intervention, provides an overview of their intervention strategies, and summarizes efforts to assess the impact of the program.