Health Affairs最新文献_第9页

Primary Care Physicians In Medicare Advantage Were Less Costly, Provided Similar Quality Versus Regional Average. 与地区平均水平相比，"医疗保险优势 "计划中的初级保健医生费用较低，但提供的服务质量相似。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-03-01 DOI: 10.1377/hlthaff.2023.00803

Eran Politzer, Timothy S Anderson, John Z Ayanian, Vilsa Curto, John A Graves, Laura A Hatfield, Jeffrey Souza, Alan M Zaslavsky, Bruce E Landon

{"title":"Primary Care Physicians In Medicare Advantage Were Less Costly, Provided Similar Quality Versus Regional Average.","authors":"Eran Politzer, Timothy S Anderson, John Z Ayanian, Vilsa Curto, John A Graves, Laura A Hatfield, Jeffrey Souza, Alan M Zaslavsky, Bruce E Landon","doi":"10.1377/hlthaff.2023.00803","DOIUrl":"10.1377/hlthaff.2023.00803","url":null,"abstract":"The use of many services is lower in Medicare Advantage (MA) compared with traditional Medicare, generating cost savings for insurers, whereas the quality of ambulatory services is higher. This study examined the role of selective contracting with providers in achieving these outcomes, focusing on primary care physicians. Assessing primary care physician costliness based on the gap between observed and predicted costs for their traditional Medicare patients, we found that the average primary care physician in MA networks was $433 less costly per patient (2.9 percent of baseline) compared with the regional mean, with less costly primary care physicians included in more networks than more costly ones. Favorable selection of patients by MA primary care physicians contributed partially to this result. The quality measures of MA primary care physicians were similar to the regional mean. In contrast, primary care physicians excluded from all MA networks were $1,617 (13.8 percent) costlier than the regional mean, with lower quality. Primary care physicians in narrow networks were $212 (1.4 percent) less costly than those in wide networks, but their quality was slightly lower. These findings highlight the potential role of selective contracting in reducing costs in the MA program.","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11040031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neighborhoods And Health: Interventions At The Neighborhood Level Could Help Advance Health Equity. 街区与健康：邻里层面的干预措施有助于促进健康平等。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01037

Mariana C Arcaya, Ingrid Gould Ellen, Justin Steil

引用次数: 0

Addressing Housing-Related Social Needs Through Medicaid: Lessons From North Carolina's Healthy Opportunities Pilots Program. 通过医疗补助计划满足与住房相关的社会需求：北卡罗来纳州健康机会试点计划的经验教训。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01044

Katie Huber, Raman Nohria, Vibhav Nandagiri, Rebecca Whitaker, Yolande Pokam Tchuisseu, Nicholas Pylypiw, Meaghan Dennison, Brianna Van Stekelenburg, Amanda Van Vleet, Maria Ramirez Perez, Madlyn C Morreale, Andrea Thoumi, Michelle Lyn, Robert S Saunders, William K Bleser

{"title":"Addressing Housing-Related Social Needs Through Medicaid: Lessons From North Carolina's Healthy Opportunities Pilots Program.","authors":"Katie Huber, Raman Nohria, Vibhav Nandagiri, Rebecca Whitaker, Yolande Pokam Tchuisseu, Nicholas Pylypiw, Meaghan Dennison, Brianna Van Stekelenburg, Amanda Van Vleet, Maria Ramirez Perez, Madlyn C Morreale, Andrea Thoumi, Michelle Lyn, Robert S Saunders, William K Bleser","doi":"10.1377/hlthaff.2023.01044","DOIUrl":"10.1377/hlthaff.2023.01044","url":null,"abstract":"North Carolina Medicaid's Healthy Opportunities Pilots program is the country's first comprehensive program to evaluate the impact of paying community-based organizations to provide eligible Medicaid enrollees with an array of evidence-based services to address four domains of health-related social needs, one of which is housing. Using a mixed-methods approach, we mapped the distribution of severe housing problems and then examined the design and implementation of Healthy Opportunities Pilots housing services in the three program regions. Four cross-cutting implementation and policy themes emerged: accounting for variation in housing resources and needs to address housing insecurity, defining and pricing housing services in Medicaid, engaging diverse stakeholders across sectors to facilitate successful implementation, and developing sustainable financial models for delivery. The lessons learned and actionable insights can help inform the efforts of stakeholders elsewhere, particularly other state Medicaid programs, to design and implement cross-sectoral programs that address housing-related social needs by leveraging multiple policy-based resources. These lessons can also be useful for federal policy makers developing guidance on addressing housing-related needs in Medicaid.","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Experimental Evidence Shows That Housing Vouchers Provided Measurable Benefits, Including Parent Stress Reduction. 实验证据表明，住房券提供了可衡量的好处，包括减轻父母的压力。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01020

Sandra Newman, Tama Leventhal, C Scott Holupka, Fei Tan

引用次数: 0

Exposing Pittsburgh Landlords To Asset-Framing Narratives: An Experiment To Increase Housing Voucher Participation. 让匹兹堡房东了解资产框架叙事：提高住房券参与率的实验。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01051

Selena E Ortiz, Andrew Fenelon, Yousef Chavehpour

引用次数: 0

Erratum. 勘误。

IF 9.7 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01630

引用次数: 0

For Some Patients, Better Health Starts With Finding A Home. 对于一些患者来说，改善健康状况首先要找到一个家。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01612

Michele Cohen Marill

引用次数: 0

Gentrification Yields Racial And Ethnic Disparities In Exposure To Contextual Determinants Of Health. 在接触决定健康的环境因素方面，城市化造成了种族和民族差异。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01034

Arthur Acolin, Kyle Crowder, Ari Decter-Frain, Anjum Hajat, Matthew Hall, Lydia Homandberg, Philip M Hurvitz, Lauren Woyczynski

{"title":"Gentrification Yields Racial And Ethnic Disparities In Exposure To Contextual Determinants Of Health.","authors":"Arthur Acolin, Kyle Crowder, Ari Decter-Frain, Anjum Hajat, Matthew Hall, Lydia Homandberg, Philip M Hurvitz, Lauren Woyczynski","doi":"10.1377/hlthaff.2023.01034","DOIUrl":"10.1377/hlthaff.2023.01034","url":null,"abstract":"This article examines racial and ethnic disparities in the relationship between gentrification and exposure to contextual determinants of health. In our study, we focused on changes in selected contextual determinants of health (health care access, social deprivation, air pollution, and walkability) and life expectancy during the period 2006-21 among residents of gentrifying census tracts in six large US cities that have experienced different gentrification patterns and have different levels of segregation: Chicago, Illinois; Los Angeles, California; New York, New York; Philadelphia, Pennsylvania; San Francisco, California; and Seattle, Washington. We found that gentrification was associated with overall improvements in the likelihood of living in Medically Underserved Areas across racial and ethnic groups, but it was also associated with increased social deprivation and reduced life expectancy among Black people, Hispanic people, and people of another or undetermined race or ethnicity. In contrast, we found that gentrification was related to better (or unchanged) contextual determinants of health for Asian people and White people. Our findings can inform policies that target communities identified to be particularly at risk for worsening contextual determinants of health as a result of gentrification.","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Housing And Health. 住房与健康

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2024.00097

Alan R Weil

引用次数: 0

Energy Insecurity Indicators Associated With Increased Odds Of Respiratory, Mental Health, And Cardiovascular Conditions. 能源不安全指标与呼吸系统、心理健康和心血管疾病发生几率增加有关。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01052

Eva Laura Siegel, Kathryn Lane, Ariel Yuan, Lauren A Smalls-Mantey, Jennifer Laird, Carolyn Olson, Diana Hernández

{"title":"Energy Insecurity Indicators Associated With Increased Odds Of Respiratory, Mental Health, And Cardiovascular Conditions.","authors":"Eva Laura Siegel, Kathryn Lane, Ariel Yuan, Lauren A Smalls-Mantey, Jennifer Laird, Carolyn Olson, Diana Hernández","doi":"10.1377/hlthaff.2023.01052","DOIUrl":"10.1377/hlthaff.2023.01052","url":null,"abstract":"Energy insecurity, defined as the inability to meet household energy needs, has multiple economic, physical, and coping dimensions that affect health. We conducted the first citywide representative survey of energy insecurity and health in a sample of 1,950 New York City residents in 2022. We compiled ten indicators that characterize energy insecurity as experienced in New York City housing settings and then examined associations between number and types of indicators and health conditions. Nearly 30 percent of residents experienced three or more indicators, with significantly higher levels among Black non-Latino/a and Latino/a residents compared with White non-Latino/a residents, renters compared with owners, recent immigrants compared with those living in the United States for longer, and those in households with children compared with those with no children. Residents with three or more indicators of energy insecurity had higher odds of respiratory, mental health, and cardiovascular conditions and electric medical device dependence than residents with no indicators. Our study demonstrates that broadening the understanding of energy insecurity with context-specific metrics can help guide interventions and policies that address disparities relevant to health and energy equity.","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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