Journal of Health Politics Policy and Law最新文献_第3页

Why Some Nonelderly Adult Medicaid Enrollees Appear Ineligible Based on Their Annual Income. 为什么一些非老年成人医疗补助计划参保者看起来不符合年收入条件。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-12-01 DOI: 10.1215/03616878-11373728

Geena Kim, Alexandra Minicozzi, Chapin White

{"title":"Why Some Nonelderly Adult Medicaid Enrollees Appear Ineligible Based on Their Annual Income.","authors":"Geena Kim, Alexandra Minicozzi, Chapin White","doi":"10.1215/03616878-11373728","DOIUrl":"10.1215/03616878-11373728","url":null,"abstract":"Context: Recent studies have highlighted Medicaid enrollment among middle- and higher-income populations and questioned whether the program is reaching those for whom it is intended.Methods: The authors use administrative tax data to measure Medicaid enrollment and income in 2017, they use survey data to measure monthly income, and they use administrative data to identify Medicaid enrollment pathways.Findings: Among 38.8 million nonelderly adults in Medicaid at any point in 2017, 24.4 million had annual income below their state's typical eligibility threshold, and 14.4 million (37%) had income above the threshold. Among those above the threshold, 3.5 million enrolled through a pathway allowing higher income (pregnant women, the \"medically needy,\" and others). The authors also estimate that more than 12 million had at least one month with income below the threshold, and roughly 4 million had at least five months with income below the eligibility threshold.Conclusions: Pathways allowing higher income account for one quarter of enrollees with annual incomes above typical thresholds. Among low-income adults, month-to-month variation in income is common and can account for most or all of the remaining enrollees with annual incomes above typical thresholds. A complete accounting of eligibility status would require merged data on income, Medicaid enrollment, and family structure.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"1051-1074"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249085","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

Implementing Primary Care Reform in France: Bargaining, Policy Adaptation, and the Maisons de Santé Pluriprofessionnelles. 法国实施初级医疗改革：谈判、政策调整和多职业医疗之家》。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-12-01 DOI: 10.1215/03616878-11373736

Anne Moyal

{"title":"Implementing Primary Care Reform in France: Bargaining, Policy Adaptation, and the Maisons de Santé Pluriprofessionnelles.","authors":"Anne Moyal","doi":"10.1215/03616878-11373736","DOIUrl":"10.1215/03616878-11373736","url":null,"abstract":"Context: The organization of primary care in France has long remained a secondary issue on the political agenda. The government began to address the difficulties of care access and coordination in the 2000s, when a seemingly viable solution emerged from the field: the maisons de santé pluriprofessionnelles (MSPs). In a corporatist system and a predominantly private sector, the government chose an incentive-based contractual policy to encourage providers to join these structures. This article analyzes the implementation of this policy, which depends on private providers' commitment.Methods: The article offers a comparative case study of six MSPs. Data were collected through semistructured interviews, observation sessions, and document analysis.Findings: First, the article shows that the emergence of MSPs has only been possible thanks to an unprecedented alliance between general practitioners, the state, and the health insurance fund. Second, it argues that MSP policy implementation relies on a complex bargaining process between private providers and public authorities that enables the former to shape it to their local needs.Conclusions: MSP implementation experiences raise questions both about the understanding of medical corporatism in France and the assimilation of policy changes and local variation through policy implementation.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"1015-1050"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249081","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

Regime Type and Data Manipulation: Evidence from the COVID-19 Pandemic. 制度类型与数据操纵：来自 COVID-19 大流行病的证据。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-12-01 DOI: 10.1215/03616878-11373750

Simon Wigley

{"title":"Regime Type and Data Manipulation: Evidence from the COVID-19 Pandemic.","authors":"Simon Wigley","doi":"10.1215/03616878-11373750","DOIUrl":"10.1215/03616878-11373750","url":null,"abstract":"Context: This study examines whether autocratic governments are more likely than democratic governments to manipulate health data. The COVID-19 pandemic presents a unique opportunity for examining this question because of its global impact.Methods: Three distinct indicators of COVID-19 data manipulation were constructed for nearly all sovereign states. Each indicator was then regressed on democracy and controls for unintended misreporting. A machine learning approach was then used to determine whether any of the specific features of democracy are more predictive of manipulation.Findings: Democracy was found to be negatively associated with all three measures of manipulation, even after running a battery of robustness checks. Absence of opposition party autonomy and free and fair elections were found to be the most important predictors of deliberate undercounting.Conclusions: The manipulation of data in autocracies denies citizens the opportunity to protect themselves against health risks, hinders the ability of international organizations and donors to identify effective policies, and makes it difficult for scholars to assess the impact of political institutions on population health. These findings suggest that health advocates and scholars should use alternative methods to estimate health outcomes in countries where opposition parties lack autonomy or must participate in uncompetitive elections.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"989-1014"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249084","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

Inside "Operation Change Agent": Mallinckrodt's Plan for Capturing the Opioid Market. 变革者行动 "内幕：Mallinckrodt 公司抢占阿片类药物市场的计划。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-08-01 DOI: 10.1215/03616878-11186127

Daniel Eisenkraft Klein, Ross MacKenzie, Ben Hawkins, Adam D Koon

{"title":"Inside \"Operation Change Agent\": Mallinckrodt's Plan for Capturing the Opioid Market.","authors":"Daniel Eisenkraft Klein, Ross MacKenzie, Ben Hawkins, Adam D Koon","doi":"10.1215/03616878-11186127","DOIUrl":"10.1215/03616878-11186127","url":null,"abstract":"Context: The United States is deeply entangled in an opioid crisis that began with the overuse of prescription painkillers. At the height of the prescription opioid crisis (2006-2012), Mallinckrodt Pharmaceuticals was the nation's largest opioid manufacturer. This study explores Mallinckrodt's strategies for expanding its market share by promoting a new opioid.Methods: The authors used the Opioid Industry Document Archive to analyze the incentive structures, sales contests, and rhetorical strategy behind Mallinckrodt's \"Operation Change Agent,\" a campaign to switch patients from OxyContin to Mallinckrodt-manufactured painkillers. A structured search of the archive in October 2022 retrieved 464 documents dated between 2010 and 2020.Findings: The authors identified a range of Mallinckrodt's sales force motivational techniques, including hypertargeting high-decile prescribers, providing free trial kits, using emotion-based language to connect with prescribers, and strategies for opposing prescriber resistance. Throughout, managers used specific incentivization metaphors to frame strategies in terms of sport and ultramarathons.Conclusions: This research on internal corporate strategy joins the growing challenges to industry claims that opioid sales teams simply educated providers and helped fill existing demand for their products. It has important implications for regulatory policy and consumer protections that can better protect health in the face of competitive market forces.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"599-630"},"PeriodicalIF":3.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698861","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

Equity Investment in Physician Practices: What's All This Brouhaha? 医生诊所的股权投资：这一切是怎么回事？

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-08-01 DOI: 10.1215/03616878-11186103

Mark V Pauly, Lawton Robert Burns

{"title":"Equity Investment in Physician Practices: What's All This Brouhaha?","authors":"Mark V Pauly, Lawton Robert Burns","doi":"10.1215/03616878-11186103","DOIUrl":"10.1215/03616878-11186103","url":null,"abstract":"There have been two waves of equity-based investment in physician practices. Both used a combination of public and private sources but in different mixes. The first investment wave, in the 1990s, was led by public equity and physician practice management companies, with less involvement by private equity (PE). The second investment wave followed the Affordable Care Act and was led by PE firms. It has generated concerns of wasteful spending, less cost-effective care, and initiatives harmful to patient welfare. This article compares the two waves and asks if they are parallel in important ways. It describes the similarities in the players, driving forces, acquisition dynamics, spurs to consolidation, types of equity involved, models to organize physicians, and levels of market penetration achieved. The article then tackles three unresolved issues: Does PE investment differ from other investment vehicles in concerning ways? Does PE possess capabilities that other investment vehicles lack and confer competitive advantage? Does physician practice investment offer opportunities for supernormal profits? It then discusses ongoing trends that may disrupt PE and curtail its practice investment. It concludes that past may be prologue, that is, what happened during the 1990s may well repeat, suggesting the PE threat is overblown.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"631-664"},"PeriodicalIF":3.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698860","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

Rationing by Inconvenience: How Insurance Denials Induce Administrative Burdens. 因不便而配给：保险拒绝如何造成行政负担》（How Insurance Denials Induce Administrative Burdens.

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-08-01 DOI: 10.1215/03616878-11186111

Miranda Yaver

{"title":"Rationing by Inconvenience: How Insurance Denials Induce Administrative Burdens.","authors":"Miranda Yaver","doi":"10.1215/03616878-11186111","DOIUrl":"10.1215/03616878-11186111","url":null,"abstract":"Context: How do health coverage denials keep care out of reach for American patients by imposing unevenly distributed administrative burdens? This article argues that the process of appealing insurers' denials imposes administrative burdens on patients inequitably, deepening the divide between those with meaningful access to health coverage and those for whom benefits are out of reach.Methods: The author conducted a nationwide survey of 1,340 US adults on their experiences with coverage denials; this was supplemented with 110 semistructured interviews with patients, physicians, and former health insurance executives.Findings: Those who were less affluent were significantly less likely than their wealthier counterparts to appeal denials of coverage. Patients who underestimated the rate at which patients prevail in insurance appeals were less likely to appeal their own denials. Black Medicaid patients and those who were in worse health were significantly less likely to prevail in the appeals they pursued. Many unappealed denials were attributable to the significant administrative burdens associated with appeal, including learning and psychological costs.Conclusions: Administrative burdens associated with appealing denials of coverage can deepen health inequities along class and race lines, suggesting a need for policy interventions to make it easier to navigate the health insurance bureaucracy.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"539-565"},"PeriodicalIF":3.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698862","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

Social Stigma and COVID-19 Vaccine Refusal in France. 法国的社会污名与拒绝接种 COVID-19 疫苗。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-08-01 DOI: 10.1215/03616878-11186095

Patrick Peretti-Watel, Lisa Fressard, Benoît Giry, Pierre Verger, Jeremy Keith Ward

{"title":"Social Stigma and COVID-19 Vaccine Refusal in France.","authors":"Patrick Peretti-Watel, Lisa Fressard, Benoît Giry, Pierre Verger, Jeremy Keith Ward","doi":"10.1215/03616878-11186095","DOIUrl":"10.1215/03616878-11186095","url":null,"abstract":"Context: In 2021, French health authorities strongly promoted vaccination against COVID-19. The authors assumed that refusing this vaccine became a stigma, and they investigated potential public stigma toward unvaccinated people among the French population.Methods: A representative sample of the French adult population (N = 2,015) completed an online questionnaire in September 2021. The authors focused on participants who were already vaccinated against COVID-19 or intended to get vaccinated (N = 1,742). A cluster analysis was used to obtain contrasted attitudinal profiles, and the authors investigated associated factors with logistic regressions.Findings: Regarding attitudes toward unvaccinated people, a majority of respondents supported several pejorative statements, and a significant minority also endorsed social rejection attitudes. The authors found four contrasting attitudinal profiles: moral condemnation only (32% of respondents), full stigma (26%), no stigma (26%), and stigma rejection (16%). Early vaccination, civic motives for it, faith in science, rejection of political extremes, and being aged 65 or older were the main factors associated with stigmatizing attitudes toward unvaccinated people.Conclusions: The authors found some evidence of stigmatization toward unvaccinated people, but further research is needed, especially to investigate perceived stigmatization among them. The authors discuss their results with reference to the concept of \"folk devils\" and from a public health perspective.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"567-598"},"PeriodicalIF":3.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698863","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

Polarization, the Pandemic, and Public Trust in Health System Actors. 两极分化、大流行和公众对卫生系统行为者的信任。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-06-01 DOI: 10.1215/03616878-11075562

Alessandro Del Ponte, Alan S Gerber, Eric M Patashnik

{"title":"Polarization, the Pandemic, and Public Trust in Health System Actors.","authors":"Alessandro Del Ponte, Alan S Gerber, Eric M Patashnik","doi":"10.1215/03616878-11075562","DOIUrl":"10.1215/03616878-11075562","url":null,"abstract":"Context: Public opinion on the performance of health system actors is polarized today, but it remains unclear which actors enjoy the most or the least trust among Democrats and Republicans, whether the COVID-19 pandemic has influenced how people view their own physicians, and whether doctors have retained the ability to influence public beliefs about policy issues.Methods: The authors conducted two national surveys in 2022 and 2023 to examine these questions.Findings: Democrats rated the performance of medical research scientists and public health experts during the pandemic more highly than did Republicans and independents. About three in ten Republicans said the pandemic decreased their trust in their personal doctors. Nonetheless, most Americans reported confidence in physicians. The authors replicated the findings of Gerber and colleagues (2014) to demonstrate that respondents continued to have more positive views of doctors than other professionals and that public opinion was responsive to cues from a doctors' group.Conclusions: What polarizes Democrats and Republicans today is not the question of whether medical scientists and public health experts are competent but whether the advice offered by these actors is in the public interest and should guide policy makers' decisions. Democrats strongly believe the answer to these questions is yes, while Republicans exhibit skepticism.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"375-401"},"PeriodicalIF":3.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178024","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

Impervious to Elite Influence: Americans' ACA Attitudes, 2009-2020. 不受精英影响:美国人对ACA的态度，2009-2020。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-06-01 DOI: 10.1215/03616878-11066328

Daniel J Hopkins

引用次数: 0

Partisanship and the Pandemic: How and Why Americans Followed Party Cues on COVID-19. 党派关系和大流行:美国人如何以及为什么在COVID-19上遵循政党线索。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-06-01 DOI: 10.1215/03616878-11066336

Isaac D Mehlhaff, Matías C Tarillo, Ayelén Vanegas, Marc J Hetherington

{"title":"Partisanship and the Pandemic: How and Why Americans Followed Party Cues on COVID-19.","authors":"Isaac D Mehlhaff, Matías C Tarillo, Ayelén Vanegas, Marc J Hetherington","doi":"10.1215/03616878-11066336","DOIUrl":"10.1215/03616878-11066336","url":null,"abstract":"The United States underperformed its potential in responding to the COVID-19 pandemic. The authors use original survey data from April 2020 to March 2022 to show that political partisanship may have contributed to this inconsistent response by distinguishing elites and citizens who took the crisis seriously from those who did not. This division was not inevitable; when the crisis began, Democrats and Republicans differed little in their viewpoints and actions relative to COVID-19. However, partisans increasingly diverged when their preferred political leaders provided them with opposing cues. The authors outline developments in party politics over the last half century that contributed to partisan division on COVID-19, most centrally an anti-expertise bias among Republicans. Accordingly, Republicans' support for mitigation measures, perception of severity of COVID-19, and support for vaccines gradually decreased after the initial outbreak. Partisan differences also showed up at the state level; Trump's vote share in 2016 was negatively associated with mask use and positively associated with COVID-19 infections. Diverging elite cues provided fertile ground for the partisan pandemic, underscoring the importance of political accountability even in an era of polarization.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"351-374"},"PeriodicalIF":3.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178023","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