Productivity of highly skilled immigrants: economists in the postwar period

Prior work finds declining immigrant quality in the postwar period that is linked to source-country and skill-composition changes associated with the 1965 Immigration Act. This paper uses a unique panel of foreign- and native-born American Economic Association members to show that the highly skilled experienced a similar shift away from European migrants toward those from Asia. However, the findings do not indicate that this change in source-country composition has been accompanied by a decline in quality; rather, the most recent cohorts of foreign-born economists appear to be more productive than their native counterparts.     

Providing information to help Medicare beneficiaries choose a health plan

Many Medicare beneficiaries have limited knowledge of the Medicare program and related health insurance options. This is due in part to the complexity of the Medicare program and supplemental health insurance market. A recent congressional mandate through the Balanced Budget Act of 1997 called for broad dissemination of information to educate beneficiaries about their health plan options and to encourage informed health plan decision-making. In response, the Health Care Financing Administration (HCFA) launched the National Medicare Education Program (NMEP) to support the educational objectives of the BBA. This paper provides an overview of the components of the NMEP information campaign. We also review lessons learned from our experience in designing and testing a prototype consumer handbook that explains the different health plan options to Medicare beneficiaries. Through our discussion of the handbook, we highlight several ways to communicate information effectively about a complex publicly funded program to an older adult population.     

The role of consumer satisfaction in ensuring quality long-term care: opportunities and challenges

Consumer-satisfaction information can play a valuable role as one component among a broader set of publicly- and privately led activities to improve the quality of long-term care (LTC). However, measuring and using consumer-satisfaction information in LTC is not without its challenges. We start by defining the ways in which we use the term "consumer satisfaction" in this article. We discuss current and planned uses of consumer-satisfaction information in assuring LTC quality. We end by describing some of the key opportunities for broader use of consumer-satisfaction information and accompanying challenges to be addressed to make more effective use of this information in the effort to improve LTC quality.     

Activity Engagement in Residential Care Settings: Findings from the National Survey of Residential Care Facilities

Assisted living and similar residential care is an important source of care for elders, including those with dementia. Meaningful activities may help residents maintain function, improve self-esteem, and enhance quality of life. Using data from the 2010 National Survey of Residential Care Facilities, this study identifies the extent of resident engagement in different types of activities; examines the extent to which cognitive status, other resident characteristics, and residential care community characteristics relate to activity engagement; and, among cognitively impaired residents, assesses whether being in dementia-specific settings is associated with activity engagement. Compared with persons without cognitive impairment, those with severe cognitive impairment are less likely to go on outings (79% versus 36%) and talk with family and friends (85% versus 72%). Residents with mild to severe cognitive impairment have higher participation in leisure activities than other residents if they live in dementia-specific settings (73% higher) than those who do not.