Anupa Bir

Measuring Selection Incentives in Managed Care: Evidence From the Massachusetts State Employee Insurance Program

Capitation gives insurers incentive to manipulate their offerings to attract the healthy and deter the sick. We calculate the incentives for such service-specific quality distortions using managed care medical and pharmacy spending data for fiscal years 2001 and 2002 from the Massachusetts State Employee Insurance Program. Services most vulnerable to stinting are cardiac care, diabetes care, and mental health and substance abuse services. Empirically, the financial temptation to distort service quality increases nonlinearly with supply-side cost sharing. Our empirical results highlight how selection incentives work at cross-purposes with efforts to reward excellent chronic disease management. Initiatives coupling pay-for-performance with risk adjustment and mixed payment hold promise for aligning incentives with quality improvement.

Partnership after prison: Couple relationships during reentry

ABSTRACT In this article, we utilize quantitative and qualitative data from the Multi-Site Family Study on Incarceration, Parenting, and Partnering (MFS-IP) to examine couple relationships during men’s reentry. Couples were significantly less likely to report they were in an intimate relationship after release than during incarceration, and rated relationship happiness significantly lower postrelease. Qualitative data indicates that reentry presents new challenges, and obstacles to contact during incarceration reverberate in relationships postrelease. Policy and programming support could help justice-involved couples maintain contact during incarceration and assist in strengthening couples’ communication as they prepare for the male partner’s return to the community.

“Always having hope”: Father–child relationships after reentry from prison

ABSTRACT Despite a substantial base of literature on father–child relationships, little is known about how incarceration affects these relationships, or how fathers connect with and support their children during the reentry period. In the Multi-site Family Study on Incarceration, Parenting and Partnering (MFS-IP) sample, deterioration from preincarceration to reentry was evident in various aspects of father–child relationships, including reduced coresidence, financial support, and frequency of father–child activities. Multivariate modeling and qualitative analysis identified factors that shaped these aspects of father–child relationships at reentry, including father–child contact during incarceration, child age, and fathers’ relationships with their partners or coparents.

Measuring job satisfaction among healthcare staff in the United States: a confirmatory factor analysis of the Satisfaction of Employees in Health Care (SEHC) survey

Objective To validate the Satisfaction of Employees in Health Care (SEHC) survey with multidisciplinary, healthcare staff in the United States (U.S.). Design A cross-sectional psychometric study using confirmatory factor analysis. The original three-factor model was tested and modified using half-samples. Models were assessed using goodness-of-fit measures. Scale reliability and validity were tested with Cronbachs α coefficient and correlation of total SEHC score with two global satisfaction items, respectively. Setting We administered a web-based survey from January to May 2015 to healthcare staff participating in initiatives aimed at delivering better care and reducing costs. Participants The overall response rate was 38% (N = 1089), and respondents were from 86 healthcare projects. A total of 928 respondents completed the SEHC survey in full and were used in this study. Main Outcome Measures Model fit of 18 SEHC items and total SEHC score. Results The mean SEHC score was 77.6 (SD: 19.0). A one-factor model of job satisfaction had high loadings on all items, and demonstrated adequate model fit (second half-sample RMSEA: 0.069). The scale demonstrated high reliability (Cronbachs alpha = 0.942) and validity (r = 0.77 and 0.76, both P < 0.05). Conclusions The SEHC appears to measure a single general job satisfaction construct. The scale has adequate reliability and validity to recommend its use to assess satisfaction among multidisciplinary, U.S. healthcare staff. Our findings suggest that this survey is a good candidate for reduction to a short-form, and future research should validate this survey in other healthcare populations.

Intimate partner violence in couples navigating incarceration and reentry

Abstract Qualitative and preliminary quantitative research suggests that reentry from prison could be a time of heightened intimate partner violence (IPV) risk. Using data from 666 different-sex couples who participated in the dyadic, longitudinal Multi-site Family Study of Incarceration, Parenting and Partnering, we found that physical violence and controlling behavior were highly prevalent before and after incarceration. Women were more likely than their male partners to experience severe and frequent physical partner violence victimization. Participants with stronger healthy relationship beliefs, stronger conflict resolution skills, and longer relationship duration were less likely to report violence after the male partners release from prison.

Postprison relationship dissolution and intimate partner violence: Separation-instigated violence or violence-instigated separation?

Abstract Prior work suggests that partner violence may occur in the context of relationship dissolution among couples in which the male partner is reentering from prison. Using longitudinal data from 666 reentering men and their female partners, we found that couples who were no longer romantically involved were more likely to report violence in the relationship at reentry than those who were. Among those who broke up, 28% of women and 10% of men reported violence as a reason. Men who reported IPV in their relationships were less likely to report being in a romantic relationship with their study partner at the next survey wave than those who did not.

The Multisite Family Study on Incarceration, Partnering, and Parenting: Design and sample

ABSTRACT The Multisite Family Study on Incarceration, Partnering and Parenting documented the implementation and effectiveness of family-strengthening programming for incarcerated and reentering men and their intimate or coparenting partners. The findings presented in this issue use data collected for the impact study and qualitative substudy, which provide detailed information on the experiences of couples before, during, and after the male partner’s incarceration. This article describes the methodology and sample characteristics for the impact study, which included longitudinal interviews with nearly 2,000 couples in five states, and the qualitative substudy, which included in-depth interviews with 170 impact sample members in three states.

Whose punishment, whose crime? Understanding parenting and partnership in a time of mass incarceration

ABSTRACT Parenting and romantic partnership changes and challenges that occur in the context of incarceration are not yet fully understood, in part due to longstanding limitations in available data on the family lives of justice-involved individuals. This article reviews that prior work and introduces a set of new contributions in this volume of findings from the Multisite Family Study on Incarceration, Parenting, and Partnering (MFS-IP). The MFS-IP study brings new insight on parenting and partnership during incarceration and reentry, using longitudinal data collected from 2008–2015 with 1,482 committed romantic or coparenting couples in which the male partner was incarcerated at baseline.

Family life before and during incarceration

ABSTRACT It is widely recognized that a father’s incarceration strains a family, but too little is known about preincarceration family life, how families divided by incarceration navigate the imprisonment, and what they expect for postrelease family life. We analyze data from 1,482 incarcerated men and their partners to examine the assets and challenges that families brought with them into the incarceration experience; their considerable efforts to maintain family life during an incarceration in the face of physical separation and other obstacles; and the areas of convergence and divergence in their expectations for family life after the male partner’s release.

Child well-being when fathers return from prison

ABSTRACT A majority of men incarcerated are fathers, but little research has been conducted on the children’s well-being after their father’s release from incarceration. We measured changes in internalizing and externalizing problems (based on father’s and female partner’s report) across a 34-month period among children ages 6–17 (n = 431). Results suggested increased internalizing and externalizing problems in older children, increased internalizing problems when fathers had problem alcohol use, and a moderating role of father–child coresidence and father–child relationship. Programs to promote paternal well-being and father–child relationships before and after reentry may benefit children of incarcerated fathers.