Understanding Medicaid pharmaceutical utilization in Kentucky is important: over $6.6 billion was expended in the state from 2000 to 2010 on outpatient medication; it has the potential to fundamentally transform the health and well‐being individuals, and by extension wider communities; and there is a continuing trend in the nonmedical use (and abuse) of prescription drugs, exacting a heavy toll on individuals, their families, and the wider community. The Kentucky Medicaid Pharmaceutical Utilization Guide, 2000‐2010 provides information on the 50 most utilized pharmaceuticals in Kentucky with respect to prescriptions, costs, and total grams—and presents this information for children (age 18 and younger) and adults (19 and older). These data are organized at the state, regional, and county levels—which should enable leaders and citizens to compare pharmaceutical utilization between different communities. These comparisons should provoke important public policy and public health questions, such as what accounts for the vastly different pharmaceutical utilization patterns across the state over‐ all, between genders, and among races with respect to, for example, pain medication, ADHD drugs, or antipsychotic medication. Moreover, this report can facilitate the strategic allocation of resources dedicated to improving health literacy—among patients, health care providers, and the community at large.
This work is a collaborative effort between the Foundation for a Healthy Kentucky, the University of Kentucky College of Communication and Information, the Center for Business and Economic Research (CBER) in the Gatton College of Business and Economics, and the College of Pharmacy’s Institute for Pharmaceutical Outcomes and Policy (IPOP).PDF: Kentucky Medicaid Pharmaceutical Utilization Guide 2000-2010.pdf
The Bluegrass Economic Advancement Movement region encompasses the Louisville and Lexington MSAs and the corridor between them. It is an area with much of the manufacturing, medical and transportation & warehousing industries of Kentucky contained within. Over 36% of the population and 38% of the Kentucky labor force live and work in this region. This report analyzes the labor market structure within the region. We also examine the labor market structure in five Workforce Investment Act Regions: Bluegrass, Lake Cumberland, Lincoln Trail, Kentuckiana Works, and Indiana Region 10. We examine employment at the industry and occupation level and project employment growth for the regions. We examine important inter-industry linkages, and how these linkages may be important for attracting and maintaining the manufacturing base, in spite of a 30 year decline in manufacturing employment. We also examine the educational attainment of the regions and consider whether the workforce has the mix of education best suited to growth. Finally, we examine the age structure of occupations important to the regions. As is well known, the baby boomer generation is approaching retirement age. While the impact of the aging population will be felt across all occupations, we examine general characteristics which point to certain types of occupations as having a preponderance of workers in these age categories.
Our main findings:
- Manufacturing employment will continue to grow at a slower rate than employment in other sectors. The predicted growth in the level of manufacturing employment is a change from the last decade, but consistent with the overall trend in manufacturing as a decreasing proportion of employment.
- Two key inputs to manufacturing in the BEAM region, and particularly Auto Manufacturing, are the Transportation & Warehousing and the Wholesale Trade industry. 2 The BEAM region has an important cluster in these industries, and this strength could be used to attract additional manufacturing to the region.
- The Health Care industry, already a primary employer in the region, is projected to grow quite rapidly during the next decade. While health care is not generally an input into manufacturing or other industries, access to high quality health care can be used to attract firms in other industries to the region.
- In many of the manufacturing industries, the BEAM region has a relatively high concentration of production workers and a low concentration of management. This raises concerns that these industries are not attached to the region. Attracting management requires a highly educated labor force. Without this, attracting large firms will be difficult.
- Employment of production workers is likely to grow slowly over the next decade. In contrast, while starting from a small base, transportation and materials handling employment is likely to grow quite rapidly.
- Two types of medium skill occupations are likely to have high growth. All medical technology and technologist occupations and nursing are projected to experience rapid growth. We focus on these two as they require less education (typically an associate’s degree) than many of the other high growth occupations (physicians for example). Similarly, skilled workers in transportation and manufacturing, including truck drivers, welders, computer control programmers and similar occupations are predicted to grow (although at a slower rate). Again, these are occupations with medium skill and education levels.
- We find that higher paying medium skill occupations (again, truck drivers are an excellent example) are highly skewed toward baby boomers, and thus likely to experience even higher demand.
- Kentucky continues to lag behind competitor states in its production of highly educated workers. Much of the employment growth will be concentrated in occupations requiring a minimum of a bachelors degree. As noted above, attaching large firms to the region requires an educated work force. Kentucky is failing to produce a large enough pool of these workers to sustain the growth predicted.
This report examines the economic consequences of the current access rate system for intrastate long-distance calls, governed by the Kentucky Public Service Commission. At the time Kentucky created an access rate system for telephone service in 1984, the main goal of telecommunication policy was universal wireline access. Since then the telecommunications landscape has changed dramatically, as well as current policy goals. New forms of communication and policy have emerged such as cellular phones and cable telephony, as well as the introduction of the National Broadband Plan and the strong desire both nationally and in Kentucky for ubiquitous broadband availability. Economic theory, along with expert testimony, suggests that the current access system is not socially optimal.PDF: Intrastate Switched Telephone Access Charges in Kentucky.pdf
There is growing concern over the emissions of greenhouse gases in the United States. Policymakers at both the state and national levels have discussed, and in some cases enacted, policies with the goals of reducing energy demand and encouraging the use of more efficient energy technologies. Because these policies will have an effect on the cost of energy, a quantitative examination of the energy demand is warranted.
In this project, we estimate the likely effects of increased electricity prices on the demand for electricity, production as measured by Gross State Product (GSP), and employment.PDF: The Relationship between Electricity Prices....pdf