Health affairs (Project Hope)最新文献_第2页

Factors Influencing Rural Hospitals' Decisions To Join An Alternative Payment Model: A Mixed-Methods Study. 影响农村医院加入替代支付模式决策的因素：一项混合方法研究。

Health affairs (Project Hope) Pub Date : 2025-07-01 DOI: 10.1377/hlthaff.2024.01609

Kimberly J Rak, Donald S Bourne, Jacqueline Barnes, Nicole Ober, Zhaojun Sun, Judy C Chang, Eric T Roberts, Manisha Bhattacharya, Bruce L Jacobs, Jeremy M Kahn, Lindsay M Sabik

{"title":"Factors Influencing Rural Hospitals' Decisions To Join An Alternative Payment Model: A Mixed-Methods Study.","authors":"Kimberly J Rak, Donald S Bourne, Jacqueline Barnes, Nicole Ober, Zhaojun Sun, Judy C Chang, Eric T Roberts, Manisha Bhattacharya, Bruce L Jacobs, Jeremy M Kahn, Lindsay M Sabik","doi":"10.1377/hlthaff.2024.01609","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.01609","url":null,"abstract":"Hospitals' participation in voluntary Alternative Payment Models has implications for model evaluation and performance. This mixed-methods study examined factors underlying hospitals' decision to participate in the Pennsylvania Rural Health Model (PARHM), a voluntary model under the Center for Medicare and Medicaid Innovation that combined hospital global budgets and care transformation plans. Quantitative analyses tested for pre-PARHM differences in characteristics, and qualitative analyses examined contextual factors identified in interviews with hospital administrators across participating and eligible nonparticipating hospitals. At baseline, hospitals that joined PARHM had smaller total margins, fewer inpatient discharges, and greater likelihood of being independent compared with nonparticipating hospitals. Qualitative findings suggested that the desire to improve financial stability and maintain independence influenced decisions to participate, whereas the desire to preserve operational autonomy and flexibility for future growth influenced the choice not to participate. These findings can inform the development and targeting of future Alternative Payment Models, with specific considerations for rural hospitals.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 7","pages":"796-805"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585986","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

New Cancer Drug Approvals: Less Than Half Of Important Clinical Trial Uncertainties Reported By The FDA To Clinicians, 2019-22. 新的癌症药物批准：FDA向临床医生报告的重要临床试验不确定性不到一半，2019-22

Health affairs (Project Hope) Pub Date : 2025-07-01 DOI: 10.1377/hlthaff.2024.01134

Avi Cherla, Steven Woloshin, Anita K Wagner, Olivier J Wouters, Courtney Davis, Elias Mossialos, Huseyin Naci

{"title":"New Cancer Drug Approvals: Less Than Half Of Important Clinical Trial Uncertainties Reported By The FDA To Clinicians, 2019-22.","authors":"Avi Cherla, Steven Woloshin, Anita K Wagner, Olivier J Wouters, Courtney Davis, Elias Mossialos, Huseyin Naci","doi":"10.1377/hlthaff.2024.01134","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.01134","url":null,"abstract":"Uncertainties about the benefits and harms of new drugs are common at the time of drugs' approval. It is unclear to what extent the Food and Drug Administration (FDA) communicates these uncertainties in the FDA-approved prescribing information (the drug label), which is the primary channel of communication between the FDA and physicians. Although physicians might not regularly consult the drug label for prescribing decisions, other information sources used by physicians either index or incorporate information from the label. We searched FDA review documents for uncertainties identified by FDA reviewers with new cancer drugs. We considered the subset of uncertainties highlighted in the FDA's Benefit-Risk Framework as important to the FDA's approval decision. During the period 2019-22, the FDA approved fifty-two new cancer drugs. In review documents, FDA reviewers identified a total of 213 clinical trial uncertainties with new cancer drugs, 50 percent of which were considered to be important uncertainties to the FDA's approval decision. Labels for physicians reported information on 26 percent of all uncertainties and 48 percent of uncertainties that were important to the FDA's approval decision. Communicating uncertainties about the evidence of drugs in the label is essential for informing physicians about drugs' safe and effective use.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 7","pages":"830-838"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586003","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

Preferred Sources For Suicide Prevention And Crisis Services Among Segments Of The US Adult Population. 美国成年人群中自杀预防和危机服务的首选来源

Health affairs (Project Hope) Pub Date : 2025-07-01 DOI: 10.1377/hlthaff.2024.01163

Jonathan Purtle, Alex Dahlen, Amanda Mauri, Blake R Erickson, Michael P Lindsey

{"title":"Preferred Sources For Suicide Prevention And Crisis Services Among Segments Of The US Adult Population.","authors":"Jonathan Purtle, Alex Dahlen, Amanda Mauri, Blake R Erickson, Michael P Lindsey","doi":"10.1377/hlthaff.2024.01163","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.01163","url":null,"abstract":"Recent policy initiatives such as the 988 Suicide and Crisis Lifeline aim to increase the use of crisis services. We conducted a probability survey of 5,006 US adults in 2023 and used latent class analysis to identify population segments that vary in crisis help-seeking preferences. We identified five segments: \"Seek Help Nowhere,\" \"Definitely Not 988, Yes Friends And Family-Distressed,\" \"Seek Help Everywhere,\" \"Seek Help Most Places, But Not Religious Network,\" and \"Relatively Indifferent-Not Distressed.\" Having serious prior-thirty-day psychological distress was positively associated with membership in the Definitely Not 988 segment and was negatively associated with the Relatively Indifferent segment. Respondents who were not aware of the 988 Lifeline were more likely to be in the Seek Help Nowhere and Definitely Not 988 segments. Political party affiliation was associated with membership in all segments. Communication campaigns that encourage the use of crisis services and help seeking may consider tailoring messages for these different audience segments.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 7","pages":"869-877"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586005","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

A Transfer That Shouldn't Wait. 一个不应该等待的转会。

Health affairs (Project Hope) Pub Date : 2025-07-01 DOI: 10.1377/hlthaff.2024.01242

Travis Wassermann

引用次数: 0

In Remembrance: John K. Iglehart, Founding Editor. 纪念：John K. Iglehart，创始编辑。

Health affairs (Project Hope) Pub Date : 2025-07-01 DOI: 10.1377/hlthaff.2025.00808

Donald E Metz

引用次数: 0

Health Spending, Rural Hospitals, Maternal Care, And More. 医疗支出、农村医院、孕产妇保健等。

Health affairs (Project Hope) Pub Date : 2025-07-01 DOI: 10.1377/hlthaff.2025.00802

Donald E Metz, The Editorial Staff

引用次数: 0

Skilled Nursing Facility Value-Based Purchasing Failed To Achieve Hospital Readmission Reductions And Other Targets. 熟练护理机构基于价值的采购未能实现医院再入院减少和其他目标。

Health affairs (Project Hope) Pub Date : 2025-06-01 DOI: 10.1377/hlthaff.2024.01402

Robert E Burke, Franya Hutchins, Jonathan Heintz, Scott Appel, Julie Norman, Syama Patel, Atul Gupta, Liam Rose, Rachel M Werner

{"title":"Skilled Nursing Facility Value-Based Purchasing Failed To Achieve Hospital Readmission Reductions And Other Targets.","authors":"Robert E Burke, Franya Hutchins, Jonathan Heintz, Scott Appel, Julie Norman, Syama Patel, Atul Gupta, Liam Rose, Rachel M Werner","doi":"10.1377/hlthaff.2024.01402","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.01402","url":null,"abstract":"Medicare's Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program is the largest pay-for-performance initiative ever implemented to improve care in SNFs. The program ties SNF performance in reducing thirty-day hospital readmissions among Medicare fee-for-service beneficiaries admitted from the hospital for postacute care to financial rewards or penalties of up to 2 percent of annual Medicare fee-for-service payments to SNFs. Using 2011-21 data from the Medicare Provider Analysis and Review files and other sources, we conducted a difference-in-differences analysis to determine whether the SNF VBP Program was successful in reducing thirty-day readmissions among the target population. Our analysis compared patient outcomes over time in SNFs in the highest quartile of Medicare-paid bed-days (which would be most sensitive to the financial impacts of the program) with those in the lowest quartile. We found that the program had no impact on thirty-day hospital readmissions, thirty-day mortality rates, SNF length-of-stay, or 100-day community discharge rates overall or in specific SNF subgroups during the period 2015-21. In light of changes made to the SNF VBP Program in fiscal year 2024, ongoing monitoring and additional research will be critical to efforts that assess the program's impact and inform SNF quality improvement policies and programs in the years ahead.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 6","pages":"722-730"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210618","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

Medicare Part D Redesign Savings May Be Lower For Beneficiaries With Spending Below The Out-Of-Pocket Cap. 对于支出低于自付上限的受益人来说，医疗保险D部分重新设计的储蓄可能更低。

Health affairs (Project Hope) Pub Date : 2025-06-01 DOI: 10.1377/hlthaff.2024.01527

Stacie B Dusetzina, Youngmin Kwon, Nancy L Keating, Haiden A Huskamp

{"title":"Medicare Part D Redesign Savings May Be Lower For Beneficiaries With Spending Below The Out-Of-Pocket Cap.","authors":"Stacie B Dusetzina, Youngmin Kwon, Nancy L Keating, Haiden A Huskamp","doi":"10.1377/hlthaff.2024.01527","DOIUrl":"https://doi.org/10.1377/hlthaff.2024.01527","url":null,"abstract":"The Medicare prescription drug plan redesign under the Inflation Reduction Act of 2022 aims to simplify the Part D benefit while capping out-of-pocket spending for Part D-covered drugs. Whether and which Medicare beneficiaries will see savings from the redesigned benefit is unclear. We evaluated plan coverage and cost sharing for commonly used brand-name and generic drugs to estimate potential out-of-pocket spending changes for beneficiaries using the same drug and plan in both 2024 and 2025. We found that beneficiaries filling prescriptions for high-cost drugs would have expected mean savings of approximately $1,400 between 2024 and 2005. Beneficiaries who had spending lower than the out-of-pocket cap of $2,000 would have less consistent savings as a result of plans increasing the use of coinsurance versus copayments for preferred brands and increases in premiums among some stand-alone Part D plans. The variability across plans in expected out-of-pocket spending and premiums under the redesigned drug benefit reinforces the need for Medicare beneficiaries to shop for plans that best match their expected medication use.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 6","pages":"650-658"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210673","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

Claim Denials: Low-Income Patients From Disadvantaged Racial And Ethnic Groups Experienced The Largest Burdens. 索赔拒绝：来自弱势种族和族裔群体的低收入患者负担最重。

Health affairs (Project Hope) Pub Date : 2025-06-01 DOI: 10.1377/hlthaff.2024.01277

Michal Horný, Olivia Yu, Alex Hoagland

{"title":"Claim Denials: Low-Income Patients From Disadvantaged Racial And Ethnic Groups Experienced The Largest Burdens.","authors":"Michal Horný, Olivia Yu, Alex Hoagland","doi":"10.1377/hlthaff.2024.01277","DOIUrl":"10.1377/hlthaff.2024.01277","url":null,"abstract":"Insurance claim denials are a common source of administrative burden, especially for patients with private health insurance. Contesting denied claims requires considerable investment from physicians and patients or caregivers, including both institutional knowledge of health policies and billing practices and the means to engage in reconciliation. We used a novel national data set comprising remittance data and patient demographics to describe disparities in the rates of seeking and receiving claim denial corrections across demographic and socioeconomic dimensions. We found that patients from historically disadvantaged racial and ethnic groups or with low household incomes experienced the largest burdens from claim denials. Patients with household incomes less than $50,000 annually were least likely to have denied claims contested and, conditionally, have cost-sharing obligations reduced. Racial minority patients were more likely than non-Hispanic White patients to have cost-sharing obligations reduced but achieved lower mean savings per successfully contested denial. Policy makers working to promote equitable health care access should make available more resources for contesting and rectifying administrative errors and enact policies to prevent billing errors and consequent claim denials.","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 6","pages":"707-715"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210667","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

Site-Neutral Payment Reform: Little Impact On Outpatient Medicare Spending Or Hospital-Physician Integration. 地点中立支付改革：对门诊医疗保险支出或医院-医生整合影响不大。

Health affairs (Project Hope) Pub Date : 2025-06-01 Epub Date: 2025-05-21 DOI: 10.1377/hlthaff.2024.00972

Brady Post, Ngoc Thai, Md Noor-E-Alam, Gary J Young

引用次数: 0