Population Health Management最新文献_第2页

Profiling Social Needs Activities in Publicly Traded Medicare Advantage Organizations. 剖析公开交易的医疗保险优势组织的社会需求活动。

IF 1.8 4区医学

Population Health Management Pub Date : 2025-04-01 Epub Date: 2024-08-27 DOI: 10.1089/pop.2024.0045

Khyathi Gadag, Fred Ullrich, Keith J Mueller

{"title":"Profiling Social Needs Activities in Publicly Traded Medicare Advantage Organizations.","authors":"Khyathi Gadag, Fred Ullrich, Keith J Mueller","doi":"10.1089/pop.2024.0045","DOIUrl":"10.1089/pop.2024.0045","url":null,"abstract":"The objective was to examine Medical Advantage (MA) organizations' commitment toward addressing social determinants of health (SDOH) through their health-related social benefit offerings, and the perceived impact of providing supplemental benefits associated with SDOH in their plans. Public reporting documents were reviewed from six of the largest MA firms: Humana, UnitedHealthcare, Cigna, Elevance Health, CVS Health, and Centene. Public reports were obtained from each company's website (eg, from the \"Investor Relations\" page). Quarterly reports for Q1 2023, annual reports for 2022, and proxy statements for 2023 for all companies were examined. Content analysis of the public reports was conducted under three constructs: (1) Growth of MA in the company, (2) SDOH-related activities in the company, and (3) SDOH-related activities in the MA plans of the company. Each of the three constructs was further analyzed for recurring themes and elements. The findings from content analysis suggests that plans are providing tailored benefits that may address the social needs of vulnerable and underserved populations. Companies that offered supplemental benefits and value-based arrangements that addressed social needs reported beneficiary clinical outcomes resulting in cost savings and increased revenue. Health insurance companies identify MA as a significant growth opportunity and a strategically important market for overall membership and revenue growth. Moreover, companies providing innovative social benefits through their MA plans reported witnessing increased value propositions by underserved and vulnerable populations, leading to increased revenue and cost containment.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"81-87"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relationship Between Socioeconomic Deprivation and Healthy Days Among Commercially Insured Adults Using a Digital Health Application: An Observational Study. 使用数字健康应用程序的商业保险成年人的社会经济剥夺与健康天数的关系：一项观察性研究。

IF 1.8 4区医学

Population Health Management Pub Date : 2025-04-01 Epub Date: 2025-01-31 DOI: 10.1089/pop.2024.0202

Jaclyn Marshall, Oliver-John M Bright, Nicholas Leiby, Todd Thames, Alexandra Yurkovic

{"title":"Relationship Between Socioeconomic Deprivation and Healthy Days Among Commercially Insured Adults Using a Digital Health Application: An Observational Study.","authors":"Jaclyn Marshall, Oliver-John M Bright, Nicholas Leiby, Todd Thames, Alexandra Yurkovic","doi":"10.1089/pop.2024.0202","DOIUrl":"10.1089/pop.2024.0202","url":null,"abstract":"Population health research has long demonstrated that where someone lives is highly correlated with health outcomes and quality of life. This study explored if this relationship remained between zip code socioeconomic deprivation index (SDI) and member-reported healthy days among commercially insured adults interacting with virtual care and navigation services between May 1, 2023 and May 31, 2024, offered by Included Health. Members received an SMS-based survey that included the 4 Centers for Disease Control and Prevention Healthy Days questions after interacting with the digital health application. The proportion of members who reported frequent (14 or more) physically unhealthy, mentally unhealthy, and total unhealthy days during the past 30 days was calculated. The adjusted odds ratio for reporting frequent total unhealthy days was estimated by members' zip code SDI quartile, accounting for member demographic characteristics. Of the 6692 survey respondents, 13.7% reported frequent physically unhealthy days, 20.8% reported frequent mentally unhealthy days, and 29.2% reported frequent total unhealthy days. After adjusting for covariates, members in the highest SDI quartile were 1.2 times more likely to report frequent unhealthy days (P = 0.047) than those in the lowest SDI quartile. The results demonstrate the importance of geographic indices, in the absence of other data, to assist employers in identifying members with potentially higher need of digital health services. It also highlights the feasibility of collecting quality of life measures to identify members who could benefit from timely intervention.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"71-80"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bridging the Digital Divide: A Practical Roadmap for Deploying Medical Artificial Intelligence Technologies in Low-Resource Settings. 弥合数字鸿沟：在低资源环境中部署医疗人工智能技术的实用路线图。

IF 1.8 4区医学

Population Health Management Pub Date : 2025-04-01 Epub Date: 2025-02-03 DOI: 10.1089/pop.2024.0222

Evelyn Wong, Alvaro Bermudez-Cañete, Matthew J Campbell, David C Rhew

{"title":"Bridging the Digital Divide: A Practical Roadmap for Deploying Medical Artificial Intelligence Technologies in Low-Resource Settings.","authors":"Evelyn Wong, Alvaro Bermudez-Cañete, Matthew J Campbell, David C Rhew","doi":"10.1089/pop.2024.0222","DOIUrl":"10.1089/pop.2024.0222","url":null,"abstract":"In recent decades, the integration of artificial intelligence (AI) into health care has revolutionized diagnostics, treatment customization, and delivery. In low-resource settings, AI offers significant potential to address health care disparities exacerbated by shortages of medical professionals and other resources. However, implementing AI effectively and responsibly in these settings requires careful consideration of context-specific needs and barriers to equitable care. This article explores the practical deployment of AI in low-resource environments through a review of existing literature and interviews with experts, ranging from health care providers and administrators to AI tool developers and government consultants. The authors highlight 4 critical areas for effective AI deployment: infrastructure requirements, deployment and data management, education and training, and responsible AI practices. By addressing these aspects, the proposed framework aims to guide sustainable AI integration, minimizing risk, and enhancing health care access in underserved regions.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"105-114"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ringside Seat. 比赛场的座位。

IF 1.8 4区医学

Population Health Management Pub Date : 2025-03-28 DOI: 10.1089/pop.2025.0049

David B Nash

引用次数: 0

Additive Impact of Virtual Urgent and Emergency Department at Home Care on Value-Based Primary Care for Medicaid and Dual-Eligible Members. 家庭护理中的虚拟急诊科和急诊部对医疗补助和双重资格成员基于价值的初级保健的附加影响。

IF 1.8 4区医学

Population Health Management Pub Date : 2025-03-28 DOI: 10.1089/pop.2024.0232

Inam Sakinah, Lena Bertozzi, Sney Patel, David Gurley, Eric Hilton, Deeksha Kola, Pooja K Mehta

{"title":"Additive Impact of Virtual Urgent and Emergency Department at Home Care on Value-Based Primary Care for Medicaid and Dual-Eligible Members.","authors":"Inam Sakinah, Lena Bertozzi, Sney Patel, David Gurley, Eric Hilton, Deeksha Kola, Pooja K Mehta","doi":"10.1089/pop.2024.0232","DOIUrl":"10.1089/pop.2024.0232","url":null,"abstract":"Virtual urgent care (VUC) and emergency department at home (ED at home) are two emerging interventions that may help address avoidable health care costs driven by inadequate access to primary care. This study evaluates the integration of VUC and ED at home as a combined mobile integrated care program, into a value-based primary care model that serves Medicaid and dual-eligible populations. Use of embedded VUC and ED at home among individuals with claim-identified physical health needs was associated with a statistically significant 27% reduction in inpatient admissions (P = 0.05), a 61% reduction in readmission (P = 0.04), and a 240% increase in engagement with primary care and care coordination (P < 0.001). Use of these services was also associated with a total cost of care decrease of $550 per member per month (P = 0.07). Findings suggest that virtual and home-based acute care services may be a promising lever for value-based payment models to enhance engagement and realize goals of improved cost and outcomes among populations with complex medical and social needs.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Short-Term Gains, Enduring Potential: An Integrated SDOH-Focused Care Model Delivers Cost Savings and Patient-Reported Benefits. 短期收益，持久潜力：以sdoh为重点的综合护理模式可节省成本和患者报告的利益。

IF 1.8 4区医学

Population Health Management Pub Date : 2025-03-28 DOI: 10.1089/pop.2024.0245

Sasha Ruben Sioni, Lesley Manson, Nicholas Arledge

{"title":"Short-Term Gains, Enduring Potential: An Integrated SDOH-Focused Care Model Delivers Cost Savings and Patient-Reported Benefits.","authors":"Sasha Ruben Sioni, Lesley Manson, Nicholas Arledge","doi":"10.1089/pop.2024.0245","DOIUrl":"https://doi.org/10.1089/pop.2024.0245","url":null,"abstract":"High-need, high-cost (HNHC) adults require comprehensive strategies that address both clinical and social determinants of health (SDOH). This retrospective, propensity score-matched study (n = 526) evaluated a care model integrating monthly SDOH screenings, medication oversight, and real-time admission-discharge-transfer alerts in four urban primary care clinics. Compared to usual care, the intervention significantly reduced acute utilization within 60 days: emergency department (ED) visits decreased by 0.17 (P < 0.001) and hospital admissions declined by 0.12 (P < 0.001). Gross per-participant costs fell from $6,019 to $2,422 (a $3,597 reduction); after accounting for intervention expenses, net savings reached $3,222 (P < 0.001), yielding an estimated 6.9:1 return on investment. Patient-reported outcomes also demonstrated significant gains: EQ-5D-5L scores increased by 0.082 (P < 0.001) in the intervention cohort, exceeding the threshold for clinically meaningful change, while Net Promoter Scores rose by 8.8 points (P < 0.001). Subgroup analyses revealed slightly smaller quality-of-life gains among non-White cohorts, highlighting the need for culturally tailored approaches to advance equity. These findings align with prior Population Health Management research showing that integrated care models can reduce costs and enhance patient satisfaction. Overall, this multifaceted model effectively curbs avoidable ED visits and admissions, generates short-term cost savings, and boosts patient satisfaction-key outcomes under value-based care contracts. Future research should investigate longer-term outcomes and refine equity-focused strategies to ensure sustained and inclusive benefits.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Evolution of Population Health Management: Time to Accredit the Curriculum? 人口健康管理的演变：该认证课程了吗？

IF 1.8 4区医学

Population Health Management Pub Date : 2025-03-17 DOI: 10.1089/pop.2025.0028

Anthony C Stanowski, David Nash

引用次数: 0

The Long-Term Trend of the Affordable Care Act on Health Insurance Marketplace Enrollment. 平价医疗法案对健康保险市场注册的长期趋势。

IF 1.8 4区医学

Population Health Management Pub Date : 2025-03-03 DOI: 10.1089/pop.2024.0238

Julianna Vecchio, Hao Wang, Bo Zhou, Usha Sambamoorthi

{"title":"The Long-Term Trend of the Affordable Care Act on Health Insurance Marketplace Enrollment.","authors":"Julianna Vecchio, Hao Wang, Bo Zhou, Usha Sambamoorthi","doi":"10.1089/pop.2024.0238","DOIUrl":"https://doi.org/10.1089/pop.2024.0238","url":null,"abstract":"The Affordable Care Act (ACA) expanded health care access in the United States. This study examines the long-term impact of the ACA on private health insurance enrollment using National Health Interview Survey (NHIS) data. A repeated cross-sectional study using NHIS data from 2015 to 2022 was analyzed. Given the repeal of the ACA's individual mandate in 2019, stratified analyses compared Marketplace enrollment before (2015, 2018) and after (2019, 2022) the repeal. The study included US adults aged 26-64 years. Unadjusted enrollment rates were compared across age, sex, race/ethnicity, social determinants of health (SDOH), chronic conditions, body mass index, and smoking. Multivariable logistic regression assessed enrollment trends and associated factors. Marketplace enrollment increased by 1.4 percentage points post-mandate (P < 0.001), with no significant change pre-mandate (0.5-point decline, P = 0.235). Some subgroups (ages 26-39, Midwest, West) saw declines pre-mandate, while many experienced increased enrollments post-mandate. After adjustment, individuals in 2022 had 27% higher odds of enrollment than in 2019 (adjusted odds ratio [aOR] = 1.27, 95% confidence interval [CI] = 1.13-1.43, P < 0.001), whereas no significant change occurred between 2015 and 2018 (aOR = 1.02, 95% CI = 0.89-1.16, P = 0.818). Age, racial minority status, and unfavorable SDOH were associated with higher post-mandate enrollment odds. Marketplace enrollment grew post-mandate, particularly among vulnerable populations. While the repeal of the individual mandate may have contributed, other policy changes-expanded enrollment windows, increased subsidies, enhanced outreach, and streamlined applications-likely played a role, particularly in response to COVID-19.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Health Resources and Services Administration-Funded Health Centers Reduce Health Care Expenditures of California Medicaid Managed Care Beneficiaries with Complex Needs. 卫生资源和服务管理局资助的医疗中心减少了加州医疗补助管理医疗受益人复杂需求的医疗保健支出。

IF 1.8 4区医学

Population Health Management Pub Date : 2025-02-27 DOI: 10.1089/pop.2024.0241

Nadereh Pourat, Weihao Zhao, Leigh Ann Haley, Jamie Ryan, Alek Sripipatana

{"title":"Health Resources and Services Administration-Funded Health Centers Reduce Health Care Expenditures of California Medicaid Managed Care Beneficiaries with Complex Needs.","authors":"Nadereh Pourat, Weihao Zhao, Leigh Ann Haley, Jamie Ryan, Alek Sripipatana","doi":"10.1089/pop.2024.0241","DOIUrl":"https://doi.org/10.1089/pop.2024.0241","url":null,"abstract":"The authors aimed to investigate potential differences between health care use and related payments for patients with complex needs and high costs in Health Resources and Services Administration-funded health centers (HCs) and with other safety net primary care providers. The authors used data from the California Health Homes Program that was designed to improve health outcomes and reduce expenditures of such Medicaid managed care beneficiaries. The authors used 2018 data prior to program implementation and conducted propensity score-matched regressions. The authors then estimated predicted rates of use across seven service categories and payment values for each category and for overall payments. The authors found that 29% of the sample were HC patients and had lower estimated average total payment values ($21,220) than group provider patients ($23,180). HC patients also had lower values for hospitalizations and long-term facility stays and higher values for primary and mental health services than all other providers. Payment differences were generally consistent with differences in predicted rates of use. These findings suggest that HC approaches to managing patient care access and integrated mental health services may explain these differences in use and payment patterns.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating Clinical Outcomes of Telehealth as Adjunct to In-Person Care for Older Adults with Diabetes: A Systematic Review of Research Studies. 评估远程医疗作为老年人糖尿病患者亲自护理辅助的临床结果：研究的系统回顾。

IF 1.8 4区医学

Population Health Management Pub Date : 2025-02-20 DOI: 10.1089/pop.2024.0135

Jorge Isaac Peña Garcia, Sahebi Saiyed, Monica Gavaller, Elena Cabb, Katharina V Echt, Erin E Reardon, Mary Rhee, Quratulain Syed

{"title":"Evaluating Clinical Outcomes of Telehealth as Adjunct to In-Person Care for Older Adults with Diabetes: A Systematic Review of Research Studies.","authors":"Jorge Isaac Peña Garcia, Sahebi Saiyed, Monica Gavaller, Elena Cabb, Katharina V Echt, Erin E Reardon, Mary Rhee, Quratulain Syed","doi":"10.1089/pop.2024.0135","DOIUrl":"https://doi.org/10.1089/pop.2024.0135","url":null,"abstract":"The aim was to compare clinical outcomes for older adults with diabetes who received telehealth (TH) as an adjunct to in-person care (F2F) compared with those who received in-person only care (F2F). Systematic literature search was performed using the following databases: Ovid MEDLINE, Embase, Scopus, Web of Science, Cochrane, CINAHL, and ClinicalTrials.gov to include studies involving TH care for older adults with diabetes. Two authors independently reviewed the full text of shortlisted articles. A total of four studies that met the eligibility criteria were included. One study showed slight worsening in glycemic control in the TH group, but the remaining three showed improvement or no difference between the two groups. This review shows that TH modality, when utilized as an adjunct to F2F care, has comparability to F2F alone, with similar or better glycemic control for older adults with type II diabetes, especially those residing in rural communities, those older than age 75, and those with multiple comorbidities who had multiple clinical encounters.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0