Health affairs (Project Hope)最新文献_第10页

Physician Turnover Increased In Private Equity-Acquired Physician Practices. 在私募股权收购的医师实践中，医师流动率增加。

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2024.00974

Yashaswini Singh, Geronimo Bejarano Cardenas, Hamid Torabzadeh, Durga Borkar, Christopher M Whaley

{"title":"Physician Turnover Increased In Private Equity-Acquired Physician Practices.","authors":"Yashaswini Singh, Geronimo Bejarano Cardenas, Hamid Torabzadeh, Durga Borkar, Christopher M Whaley","doi":"10.1377/hlthaff.2024.00974","DOIUrl":"10.1377/hlthaff.2024.00974","url":null,"abstract":"Consolidation of physician practices by private equity (PE) firms has accelerated, raising concerns that PE's emphasis on short-term profitability may exacerbate physician turnover, with implications for care continuity. Despite their significance, evidence on how PE acquisitions affect physician turnover is limited. Using clinician-level data linked to practice acquisition data from the period 2014-21, we used a difference-in-differences design to examine changes to physician employment and turnover after PE acquisition of 200 ophthalmology practices with 1,980 clinicians. Relative to matched controls, PE-acquired practices increased the total number of clinicians by 46.8 percent through three years after acquisition. This growth was driven by increases in the numbers of both ophthalmologists and optometrists (30.7 percent and 36.2 percent, respectively). PE acquisitions also increased physician turnover, with the share of physicians leaving PE-acquired practices from one year to another increasing by 13 percentage points, or 265 percent, after acquisition, relative to non-PE-acquired practices. Findings highlight how PE acquisitions of physician practices are reshaping physician employment and workforce stability. As PE expands its footprint, policy makers should monitor the long-term implications of PE ownership on physician employment and turnover to mitigate potential undesirable effects on patient health.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 3","pages":"280-287"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuous Eligibility Policies And CHIP Structure Affected Children's Coverage Loss During Medicaid Unwinding. 连续资格政策和芯片结构影响儿童在医疗补助解除期间的覆盖面损失。

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2024.01099

Erica Eliason, Daniel Nelson, Aditi Vasan

{"title":"Continuous Eligibility Policies And CHIP Structure Affected Children's Coverage Loss During Medicaid Unwinding.","authors":"Erica Eliason, Daniel Nelson, Aditi Vasan","doi":"10.1377/hlthaff.2024.01099","DOIUrl":"10.1377/hlthaff.2024.01099","url":null,"abstract":"In April 2023, with the \"unwinding\" of the Families First Coronavirus Response Act (FFCRA) continuous enrollment provisions in Medicaid, states were permitted to commence redetermination and disenrollment procedures for Medicaid beneficiaries. Using Centers for Medicare and Medicaid Services monthly state enrollment data for forty-nine states and Washington, D.C., from the period January 2021-December 2023, we examined changes in children's Medicaid and Children's Health Insurance Program (CHIP) coverage during the Medicaid unwinding, both overall and by whether states had previous twelve-month continuous eligibility policies for children and by the structure of states' programs for CHIP. We found substantially lower Medicaid and CHIP enrollment among children during the unwinding than during the FFCRA period, with lower levels of coverage declines among children in states that had previous twelve-month continuous eligibility policies and states with a program structure of separate CHIP or Medicaid expansion CHIP, rather than combination CHIP. These findings highlight the consequences of the FFCRA unwinding for children's Medicaid and CHIP enrollment, as well as potential state health policies that can promote coverage continuity and prevent further coverage loss for children moving forward.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 3","pages":"288-295"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association Between Telehealth Initiation Of Stimulant Therapy And New Substance Use Disorder Diagnoses. 远程医疗启动兴奋剂治疗与新物质使用障碍诊断的关系。

Health affairs (Project Hope) Pub Date : 2025-03-01 DOI: 10.1377/hlthaff.2024.01026

Joanne Constantin, Sean Esteban McCabe, Emily Pasman, Timothy Wilens, Kao-Ping Chua

{"title":"Association Between Telehealth Initiation Of Stimulant Therapy And New Substance Use Disorder Diagnoses.","authors":"Joanne Constantin, Sean Esteban McCabe, Emily Pasman, Timothy Wilens, Kao-Ping Chua","doi":"10.1377/hlthaff.2024.01026","DOIUrl":"10.1377/hlthaff.2024.01026","url":null,"abstract":"Policy makers have temporarily extended COVID-19 pandemic-related flexibilities allowing controlled substance prescribing via telehealth without in-person visits. To inform debates regarding whether these flexibilities should be permanent, we used commercial and Medicaid claims to evaluate the risk for newly diagnosed substance use disorders (SUDs) associated with telehealth versus in-person initiation of stimulant therapy. Analyses included 77,153 patients ages 12-64 without prior SUD diagnoses who initiated stimulant therapy during 2021. The outcome was a new diagnosis for SUD within 365 days of initiation. The prevalence of new SUDs was higher in the telehealth versus in-person group (3.7 percent versus 3.2 percent), as was the prevalence of psychiatric comorbidities, which are known SUD risk factors. In adjusted analyses, telehealth initiation was not an independent risk factor for new SUDs, as the higher risk for this diagnosis disappeared when we controlled for psychiatric comorbidities. The same was true when we stratified the analyses by age, except among people ages 26-34. These findings suggest that extending telehealth flexibilities for stimulant prescribing might not increase the risk for newly diagnosed SUDs in most patients. When stimulants are being prescribed via telehealth, measures to prevent misuse may be particularly important among people ages 26-34.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 3","pages":"361-369"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Errata. 勘误表。

Health affairs (Project Hope) Pub Date : 2025-02-01 DOI: 10.1377/hlthaff.2025.00043

引用次数: 0

Critical Steps To Address Climate, Health, And Equity. 解决气候、健康和平等问题的关键步骤。

Health affairs (Project Hope) Pub Date : 2025-02-01 Epub Date: 2025-01-22 DOI: 10.1377/hlthaff.2024.01008

William H Frist, Sonia Y Angell, Kristie L Ebi, Mary Hayden, Katharine Hayhoe, Paul Locke, Kari Nadeau, Lisa Patel, Jonathan A Patz, Jonathan B Perlin, Linda Rudolph, Walt B Vernon

引用次数: 0

The Number Of Family Caregivers Helping Older US Adults Increased From 18 Million To 24 Million, 2011-22. 2011-22年，帮助美国老年人的家庭看护人数从1800万增加到2400万。

Health affairs (Project Hope) Pub Date : 2025-02-01 DOI: 10.1377/hlthaff.2024.00978

Jennifer L Wolff, Jennifer C Cornman, Vicki A Freedman

{"title":"The Number Of Family Caregivers Helping Older US Adults Increased From 18 Million To 24 Million, 2011-22.","authors":"Jennifer L Wolff, Jennifer C Cornman, Vicki A Freedman","doi":"10.1377/hlthaff.2024.00978","DOIUrl":"10.1377/hlthaff.2024.00978","url":null,"abstract":"The evolving composition and experiences of the family caregiver workforce have profound ramifications for public policy but are not well understood. Drawing on the linked National Health and Aging Trends Study and National Study of Caregiving, we found that the numbers of family caregivers providing help to older adults increased by nearly six million between 2011 and 2022, rising from 18.2 million to 24.1 million. Among older adults receiving care, network size was stable, at about two caregivers per older adult at both points in time. However, in 2022, family caregivers were assisting older adults who were younger, more likely to be male and better educated, and less likely to have dementia. We found few changes in competing work and child care responsibilities, weekly care hours, and caregiving-related difficulty. A smaller number of family caregivers were assisting fewer older adults with dementia, but in this group, co-residence increased by 25 percent, average care hours increased by 50 percent, and employment decreased. For family caregivers as a whole, challenges persist, and for those assisting people with dementia, tailored surveillance and effective support programs are needed.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 2","pages":"187-195"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New Directions For Women's Health: Expanding Understanding, Improving Research, Addressing Workforce Limitations. 妇女健康的新方向：扩大理解，改进研究，解决劳动力限制。

Health affairs (Project Hope) Pub Date : 2025-02-01 Epub Date: 2025-01-22 DOI: 10.1377/hlthaff.2024.01004

Paula A Johnson, Claire D Brindis, Karen Donelan, Michele Goodwin, Lisa Harris, Katy Backes Kozhimannil, Sara Rosenbaum, Tracy A Weitz

引用次数: 0

Increases In Physician Professional Fees In Private Equity-Owned Gastroenterology Practices. 私人股本拥有的胃肠病学实践中医师专业费用的增加。

Health affairs (Project Hope) Pub Date : 2025-02-01 DOI: 10.1377/hlthaff.2024.00190

Yashaswini Singh, Zirui Song, Daniel Polsky, Jane M Zhu

{"title":"Increases In Physician Professional Fees In Private Equity-Owned Gastroenterology Practices.","authors":"Yashaswini Singh, Zirui Song, Daniel Polsky, Jane M Zhu","doi":"10.1377/hlthaff.2024.00190","DOIUrl":"10.1377/hlthaff.2024.00190","url":null,"abstract":"Consolidation of physician practices, largely driven by health systems, has motivated policy efforts to move care toward lower-price, non-health system settings. At the same time, however, private equity (PE) firms are increasingly acquiring those non-health system practices, potentially negating the prior price advantages of those practices. We used novel ownership data on gastroenterology practices linked to commercial claims for the period 2015-20 to study how PE acquisitions affect the prices and volume of care relative to both health system-affiliated practices and independent practices. We examined both professional fees and facility fees. After PE acquisition, prices increased by $92 per claim, or 28.4 percent, driven by a 78.1 percent increase in professional fees. Facility fees did not exhibit a statistically significant change. Meanwhile, utilization also increased. These findings suggest that PE firms have multiple avenues for raising prices-in this case, primarily via professional fees. For policy makers, although moving care out of higher-price health system settings remains a key strategy to lower spending, unchecked growth in professional fees in PE-acquired outpatient settings may nullify some of the intended effects.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 2","pages":"215-223"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updating US Public Health For Healthier Communities. 为更健康的社区更新美国公共卫生。

Health affairs (Project Hope) Pub Date : 2025-02-01 Epub Date: 2025-01-22 DOI: 10.1377/hlthaff.2024.01010

Mark McClellan, Karen B DeSalvo, Georges C Benjamin, Frederick P Cerise, Bechara Choucair, Carlos Del Rio, Marc Harrison, Rhonda Medows, Megan L Ranney, Anne Zink

{"title":"Updating US Public Health For Healthier Communities.","authors":"Mark McClellan, Karen B DeSalvo, Georges C Benjamin, Frederick P Cerise, Bechara Choucair, Carlos Del Rio, Marc Harrison, Rhonda Medows, Megan L Ranney, Anne Zink","doi":"10.1377/hlthaff.2024.01010","DOIUrl":"10.1377/hlthaff.2024.01010","url":null,"abstract":"The United States faces urgent public health challenges, including high preventable death rates, pervasive health disparities, and emerging health risks, despite unprecedented medical progress. This article, part of the National Academy of Medicine's Vital Directions for Health and Health Care: Priorities for 2025 initiative, presents a vision for modernizing the US public health system to address these twenty-first-century challenges through federally supported partnerships with health care, social services, and community organizations. We identify actions to address persistent public health challenges that stem from insufficient and fragmented funding models, inadequate data infrastructure, workforce vulnerabilities, and limited public trust. Our proposals focus on four areas: enabling cross-sector collaboration, aligning financing mechanisms with accountability for population health outcomes, improving data systems, and building a ready workforce. These changes would enable significant improvements in population health outcomes and reductions in health disparities and provide a stronger foundation for a \"team-based\" future public health enterprise.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"148-155"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vital Directions For Health And Health Care: Priorities For 2025. 健康和保健的重要方向：2025年的优先事项。

Health affairs (Project Hope) Pub Date : 2025-02-01 Epub Date: 2025-01-22 DOI: 10.1377/hlthaff.2024.01200

Victor J Dzau, J Michael McGinnis

{"title":"Vital Directions For Health And Health Care: Priorities For 2025.","authors":"Victor J Dzau, J Michael McGinnis","doi":"10.1377/hlthaff.2024.01200","DOIUrl":"10.1377/hlthaff.2024.01200","url":null,"abstract":"In 2016, ahead of the US presidential election, the National Academy of Medicine launched the strategic initiative Vital Directions for Health and Health Care-a series of papers on critical areas of US health care written by the nation's experts and intended to provide nonpartisan guidance to the incoming administration. The National Academy of Medicine continued the initiative in 2021. The current series, titled Vital Directions for Health and Health Care: Priorities for 2025, contains six articles on priority areas in US health and medicine that demand urgent attention. Here we provide an overview of the articles, which spotlight key areas for action and transformative change: revitalizing the biomedical research enterprise, modernizing public health, charting new directions for women's health, safely integrating artificial intelligence throughout the health care system, addressing the impact of climate change on health and equity, and transforming the US health care system to one that performs at par with the systems of other industrialized nations. Common themes include coordinating a strategic vision, correcting adverse economic incentives, investing in the health care workforce, reducing fragmentation, and emphasizing equity. Each article offers actionable priorities for the new administration to improve health outcomes for all Americans.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"134-139"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0