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Medicaid Telehealth Policy in Marginalized Communities: Perspectives From Virginia Patients and Providers. 边缘化社区的医疗补助远程医疗政策：来自弗吉尼亚州患者和提供者的观点。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-05-28 DOI: 10.1177/10775587251331756
Kezia S Edmonson, Constance Elaine Owens-Jasey, Leah M Adams, Alison E Cuellar
{"title":"Medicaid Telehealth Policy in Marginalized Communities: Perspectives From Virginia Patients and Providers.","authors":"Kezia S Edmonson, Constance Elaine Owens-Jasey, Leah M Adams, Alison E Cuellar","doi":"10.1177/10775587251331756","DOIUrl":"https://doi.org/10.1177/10775587251331756","url":null,"abstract":"<p><p>We sought to understand stakeholder experience with telehealth services, through interviews with patients, providers, and health plans, to inform Medicaid policy after the COVID-19 public health emergency. Our primary aim was to examine whether and how such telehealth policies affect equitable care delivery and to uncover any remaining policy gaps. Applying the Framework for Digital Health Equity our study identified digital determinants that operate at the individual, interpersonal, community and societal levels. Across respondents, telehealth expansion was viewed as overwhelmingly positive and noted as a significant contributor to increased access among marginalized, minoritized, and rural Medicaid participants in this study. Despite these strengths, patients and health care providers identified several challenges and recommendations.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587251331756"},"PeriodicalIF":2.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 First Decade of ACO Model Evaluations in the Medicare Program: A Systematic Review. 医疗保险计划中ACO模型评估的第一个十年：系统回顾。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-05-08 DOI: 10.1177/10775587251325914
David J Nyweide
{"title":"The First Decade of ACO Model Evaluations in the Medicare Program: A Systematic Review.","authors":"David J Nyweide","doi":"10.1177/10775587251325914","DOIUrl":"https://doi.org/10.1177/10775587251325914","url":null,"abstract":"<p><p>Health care providers participating in five accountable care organization (ACO) models designed, implemented, and evaluated by the Innovation Center at the Centers for Medicare & Medicaid Services have cared for almost six million fee-for-service Medicare patients over the past decade. This systematic review summarizes the features and performance of these ACO models, capturing five major themes arising from their evaluation reports: spending performance by ACO organization type; the role of management companies in ACO structure and performance; financial risk and ACO participation; clinician incentives, waivers, and payment mechanisms; and patient engagement with ACOs. In difference-in-differences analyses, these 214 ACOs lowered spending by an estimated $2.8 billion, or $316.9 million after accounting for shared savings payouts derived from benchmarks, with no evident decrements in quality of care. ACOs' challenge in ongoing and future ACO models is to apply their accrued experience to reduce spending and improve quality within a fee-for-service payment system.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587251325914"},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Effects of Nursing Home Closures on Occupancy and Finances of Nearby Nursing Homes. 疗养院关闭对附近疗养院入住率和财务状况的影响。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2024-11-19 DOI: 10.1177/10775587241296182
Lili Xu, Hari Sharma, George L Wehby
{"title":"Effects of Nursing Home Closures on Occupancy and Finances of Nearby Nursing Homes.","authors":"Lili Xu, Hari Sharma, George L Wehby","doi":"10.1177/10775587241296182","DOIUrl":"10.1177/10775587241296182","url":null,"abstract":"<p><p>This study estimates the effect of nursing home closure on occupancy, net profit margin, and operating margin of nearby nursing homes. We use national nursing home data from 2009 to 2019 from Medicare cost reports, Medicare Provider of Services (POS), and LTCfocus.org data. Using the Callaway and Sant'Anna difference-in-differences model, we compare the changes in occupancy, net profit margin, and operating margin between incumbent nursing homes in markets with any closure and nursing homes in markets without a closure, overall, and across rurality. Our findings suggest that nursing home closure improves the occupancy rates of remaining nursing homes in the same market in rural areas but there is little evidence of effects in metropolitan and micropolitan areas. Nursing home regulators and local officials should consider the long-term care market heterogeneity when considering interventions targeted at nursing home closure.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"153-164"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Inpatient Care Experiences Differ for VA and Non-VA Hospitals, With Different Patterns by Health, Race, and Ethnicity. 退伍军人医院和非退伍军人医院的住院护理经验不同，健康、种族和民族的模式不同。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2024-12-05 DOI: 10.1177/10775587241300645
Marc N Elliott, Megan K Beckett, Christopher W Cohea, William G Lehrman, Elizabeth Goldstein, James H Schaefer, Laura A Giordano, Debra Saliba
{"title":"Inpatient Care Experiences Differ for VA and Non-VA Hospitals, With Different Patterns by Health, Race, and Ethnicity.","authors":"Marc N Elliott, Megan K Beckett, Christopher W Cohea, William G Lehrman, Elizabeth Goldstein, James H Schaefer, Laura A Giordano, Debra Saliba","doi":"10.1177/10775587241300645","DOIUrl":"10.1177/10775587241300645","url":null,"abstract":"<p><p>This article estimates differences and difference-in-differences in patient experiences for Veterans Health Administration (VA) compared to non-VA patients in 2017, when there was concern about the health quality of VA hospitals, and in 2021, the second year of the COVID-19 pandemic, both overall, and for specific patient groups. We used data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. In 2017, HCAHPS performance was somewhat better for non-VA than for VA hospitals, with Care Transition being the only measure for which VA hospitals performed better on average. By 2021, HCAHPS performance was better for VA than for non-VA hospitals for all but two measures (Quietness and Discharge Information), for which there were no differences from non-VA hospitals. In 2017, the VA provided worse experiences than non-VA hospitals for Black and poor-health patients; in 2021, VA hospitals outperformed non-VA hospitals for these, and all patient subgroups examined.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"195-200"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Effect of Extending the Window to Disenroll From Medicare Advantage Among Post-Acute Users. 延长窗口退出医疗保险优势在急性后用户中的影响。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2025-01-23 DOI: 10.1177/10775587241313092
Emma M Achola, Amal N Trivedi, Daeho Kim, David J Meyers, Hiren Varma, Laura M Keohane
{"title":"The Effect of Extending the Window to Disenroll From Medicare Advantage Among Post-Acute Users.","authors":"Emma M Achola, Amal N Trivedi, Daeho Kim, David J Meyers, Hiren Varma, Laura M Keohane","doi":"10.1177/10775587241313092","DOIUrl":"10.1177/10775587241313092","url":null,"abstract":"<p><p>Post-acute care users in Medicare Advantage (MA) plans may seek coverage changes if facing issues with plan benefits. In 2019, the Centers for Medicare and Medicaid Services extended the deadline to disenroll from an MA plan from February 14 to March 31 and, for the first time, permitted beneficiaries to switch to a different MA plan instead of traditional Medicare. Using 2016-2019 Medicare administrative data, we implemented a difference-in-differences approach to evaluate the impact of this policy on disenrollment from a plan within 1 month of initiating skilled nursing facility or home health services. When MA disenrollment rules became more flexible, overall rates of exiting MA plans did not change. Switching to a different MA plan increased after the policy change, but this outcome was so rare that this increase did not affect overall rates of exiting MA plans.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"165-172"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
COVID-19 Provider Relief Funds Distribution by Hospital Characteristics. COVID-19提供者救济资金按医院特点分配。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2025-01-19 DOI: 10.1177/10775587241308934
Michael D Rosko, Kate J Li, Mona Al-Amin
{"title":"COVID-19 Provider Relief Funds Distribution by Hospital Characteristics.","authors":"Michael D Rosko, Kate J Li, Mona Al-Amin","doi":"10.1177/10775587241308934","DOIUrl":"10.1177/10775587241308934","url":null,"abstract":"<p><p>This study assessed the distribution of Covid Provider Relief Funds (PRFs) to 3,886 private and public general acute care hospitals during 2020-2022. Marginal effects from two-part regression were analyzed. More than 13% of study hospitals did not receive PRFs. Some targeted groups of hospitals, that is, safety-net hospitals and high-impact hospitals (those with high COVID-19 admissions), were the most likely to receive PRFs. Hospitals providing the most uncompensated care, and facilities serving counties with high concentrations of Black or Hispanic populations, were less likely to receive PRFs. Among facilities receiving subsidies, rural, high-impact, safety-net, and financially vulnerable hospitals received more PRFs in relation to their total revenues. Those serving impoverished communities received a larger proportion of PRFs relative to their total revenues, while those in areas with a high concentration of Hispanics received a smaller proportionate subsidy.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"173-183"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Urban and Rural Disparities in COVID-19 Outcomes in the United States: A Systematic Review. 美国城乡COVID-19结果差异：系统评价
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2024-12-10 DOI: 10.1177/10775587241298566
Jung A Kang, Denise D Quigley, Ashley M Chastain, Hsin S Ma, Jingjing Shang, Patricia W Stone
{"title":"Urban and Rural Disparities in COVID-19 Outcomes in the United States: A Systematic Review.","authors":"Jung A Kang, Denise D Quigley, Ashley M Chastain, Hsin S Ma, Jingjing Shang, Patricia W Stone","doi":"10.1177/10775587241298566","DOIUrl":"10.1177/10775587241298566","url":null,"abstract":"<p><p>This systematic review investigates disparities in COVID-19 outcomes (infections, hospitalizations, and deaths) between urban and rural populations in the United States. Of the 3,091 articles screened, 55 were selected. Most studies (<i>n</i> = 43) conducted national analyses, using 2020 data, with some extending into 2021. Findings show urban areas had higher COVID-19 cases and hospitalizations in 2020, while rural areas saw increased cases in 2021 and mixed hospitalization results. Urban areas also had higher mortality rates in 2020, with rural rates rising in 2021 and 2022. Most studies did not explore reasons for urban/rural differences. The few that did found that vulnerable groups, including racially and ethnically minoritized populations, older adults, and those with comorbidities and lower socioeconomic status and vaccination rates, experienced exacerbated disparities in rural regions. COVID-19 outcomes varied over time and by area due to population density, healthcare infrastructure, and socioeconomic factors. Tailored interventions are essential for health equity and effective policies.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"119-136"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Changes in Caregivers' Use of the Online Medical Record Pre- and Post-COVID: Analysis of the Health Information National Trends Survey, 2018-2022. covid前后护理人员使用在线病历的变化：2018-2022年卫生信息全国趋势调查分析
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2024-12-09 DOI: 10.1177/10775587241298029
Minakshi Raj, TsungYen Chen, Bradley Iott, Denise Anthony
{"title":"Changes in Caregivers' Use of the Online Medical Record Pre- and Post-COVID: Analysis of the Health Information National Trends Survey, 2018-2022.","authors":"Minakshi Raj, TsungYen Chen, Bradley Iott, Denise Anthony","doi":"10.1177/10775587241298029","DOIUrl":"10.1177/10775587241298029","url":null,"abstract":"<p><p>Little is known about online medical record (OMR) use among caregivers, including changes in OMR use through the COVID-19 pandemic. This study compares OMR use among caregivers and non-caregivers before and during the COVID-19 pandemic, identifies reasons for non-use, and examines the association between caregiving status and characteristics with OMR use. Secondary data analysis of the nationally representative Health Information National Trends Survey data from 2018 to 2022 (<i>n</i> = 14,034). Caregivers were more likely to use the OMR post-COVID (51.8%) compared with pre-COVID (44.7%). Caregiving was significantly associated with increased likelihood of OMR use post-COVID (odds ratio = 1.67), but not pre-COVID. The increased use of OMR among caregivers during COVID-19 highlights the potential of OMRs as a support tool for caregivers' health and well-being. Interventions and policies to improve OMR engagement must address persisting disparities across demographic groups and encourage caregivers' OMR use to support their role and enhance their personal health management.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"184-194"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Assessing Narrative Patterns in Health Access, Outcomes, and Behaviors Across Three Data Sets From England, the United States, and California for Sexual Minority Adults. 评估英格兰、美国和加利福尼亚三个数据集中性少数群体成年人的健康获取、结果和行为的叙述模式。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2024-10-14 DOI: 10.1177/10775587241285135
Sarah MacCarthy, Peyton Miller, Ninez A Ponce, Marc N Elliott
{"title":"Assessing Narrative Patterns in Health Access, Outcomes, and Behaviors Across Three Data Sets From England, the United States, and California for Sexual Minority Adults.","authors":"Sarah MacCarthy, Peyton Miller, Ninez A Ponce, Marc N Elliott","doi":"10.1177/10775587241285135","DOIUrl":"10.1177/10775587241285135","url":null,"abstract":"<p><p>We examined peer-reviewed publications analyzing data from the English GP Patient Survey (GPPS), U.S. National Health Interview Survey (NHIS), and California Health Interview Survey (CHIS) to explore how the health of sexual minority populations varies across settings and subgroups. We searched for English language articles published 2011-2022, screening abstracts (<i>n</i> = 112), reviewing full text (<i>n</i> = 97), and extracting data (<i>n</i> = 85). We conducted a content analysis to identify patterns across settings for sexual minority people compared with heterosexual counterparts and each other. Across all settings, sexual minority adults had poorer health care access, worse health outcomes and patient experiences, more detrimental health behaviors, and greater health care services utilization (reflecting risk awareness and need). When subgroup data were reported, differences were greater among women, except for HIV and related cancers, which were most prevalent among sexual minority men. Sexual minority people generally reported significantly worse health access, outcomes, and behaviors in all three settings.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"137-152"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Effective Roles of Primary Care Clinics in Lowering Total Cost of Care Among Commercially Insured Populations: A Systematic Review. 初级保健诊所在降低商业参保人群医疗总成本中的有效作用：一项系统回顾。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-03-18 DOI: 10.1177/10775587251323636
Arindam Debbarma, Roshani Dahal, Bryan E Dowd
{"title":"Effective Roles of Primary Care Clinics in Lowering Total Cost of Care Among Commercially Insured Populations: A Systematic Review.","authors":"Arindam Debbarma, Roshani Dahal, Bryan E Dowd","doi":"10.1177/10775587251323636","DOIUrl":"https://doi.org/10.1177/10775587251323636","url":null,"abstract":"<p><p>Proposals to reduce the cost of health care services and improve the quality of care often involve ambitious expectations for the role of primary care clinics (PCCs). We systematically reviewed the literature to identify interventions PCCs could undertake to reduce avoidable emergency department visits and ambulatory care-sensitive admissions. Database searches resulted in only seven studies that met the inclusion criteria for this review. Very few studies identified interventions that primary care physicians could undertake to reduce total cost of care, possibly because relatively few PCCs are held responsible for total cost of care. Evidence-based interventions to reduce ACS admissions and ED use included case-management models, clinical decision-support tools, & care plans integrated into patients' electronic medical records. The interventions highlighted a heightened role for PCCs in care coordination and access to care that could lead to patients actively engaging in care management and consulting PCCs before seeking urgent care.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587251323636"},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
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