Health affairs scholar最新文献

Accessibility of diabetes education in the United States: barriers, policy implications, and the road ahead. 美国糖尿病教育的可及性：障碍、政策影响和未来之路。

Health affairs scholar Pub Date : 2024-08-21 eCollection Date: 2024-08-01 DOI: 10.1093/haschl/qxae097

Anna Tharakan, Eugenia McPeek Hinz, Emelia Zhu, Brad Denmeade, Jashalynn German, Wei Angel Huang, Amanda Brucker, Joanne Rinker, Chris Memering, Susan Spratt

{"title":"Accessibility of diabetes education in the United States: barriers, policy implications, and the road ahead.","authors":"Anna Tharakan, Eugenia McPeek Hinz, Emelia Zhu, Brad Denmeade, Jashalynn German, Wei Angel Huang, Amanda Brucker, Joanne Rinker, Chris Memering, Susan Spratt","doi":"10.1093/haschl/qxae097","DOIUrl":"https://doi.org/10.1093/haschl/qxae097","url":null,"abstract":"Diabetes Self-Management Education and Support (DSMES) programs are an effective, yet underutilized, resource to improve health outcomes and behaviors for people with diabetes. We examined the attendance and referral rates for people with diabetes to DSMES classes at an academic medical center, noting a 10% referral rate and 37% completion rate for those referred. We identified barriers to DSMES care at patient, provider, and health system levels. Current technology platforms and training fail to prioritize referrals to diabetes education; providers and people with diabetes are often unfamiliar with program content and benefits. Scheduling mechanisms often delay or lose interested patients in receiving vital education. Existing Medicare reimbursement strategies limit expansion of DSMES programs, generating significant wait times and limit capabilities for Diabetes Care and Education Specialists. We identify potential policy solutions and recommend alterations to existing referral and scheduling systems to expand existing technology platforms for DSMES programs and shift reimbursement policies to individualize and better support care for persons with diabetes.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116459","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

The state of health information organizations and plans to participate in the federal exchange framework. 医疗信息组织和计划参与联邦交换框架的情况。

Health affairs scholar Pub Date : 2024-08-21 eCollection Date: 2024-08-01 DOI: 10.1093/haschl/qxae098

Jordan Everson, Wei Chang, Vaishali Patel, Julia Adler-Milstein

{"title":"The state of health information organizations and plans to participate in the federal exchange framework.","authors":"Jordan Everson, Wei Chang, Vaishali Patel, Julia Adler-Milstein","doi":"10.1093/haschl/qxae098","DOIUrl":"10.1093/haschl/qxae098","url":null,"abstract":"In late 2023, the Office of the National Coordinator for Health Information Technology launched the Trusted Exchange Framework and Common Agreement (TEFCA) to enable nationwide health information exchange. Regional, local, and state health information organizations (HIOs) will be key components of nationwide exchange, and TEFCA could broaden HIOs' access to information. However, HIOs can choose whether to participate. We conducted a national survey of HIOs in 2023 to assess their plans to participate in TEFCA and broader measures of maturity. We identified 76 operational HIOs, down from 89 in 2019. These HIOs operated in 47 states and contained over 600 million patient records, indicating some duplication. Sixty-three percent of HIOs planned to participate in TEFCA, up 7 percentage points from 2019, and 32% of HIOs indicated that they did not know if they would participate. Health information organizations already engaged in exchange with other networks were more likely to plan to participate. The most common barrier (44%) was having not developed a strategic plan for TEFCA participation. While TEFCA appears to have successfully engaged the majority of HIOs, achieving nationwide exchange will require policy efforts to either attract the remaining HIOs or ensure that nonparticipating HIOs' providers have another option for TEFCA participation.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074842","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

Differential impacts of the COVID-19 pandemic on mental health service access among Medicaid-enrolled individuals. COVID-19 大流行对参加医疗补助计划的个人获得心理健康服务的不同影响。

Health affairs scholar Pub Date : 2024-08-20 eCollection Date: 2024-09-01 DOI: 10.1093/haschl/qxae104

K John McConnell, Sara Edelstein, Courtney Benjamin Wolk, Stephan Lindner, Jane M Zhu

{"title":"Differential impacts of the COVID-19 pandemic on mental health service access among Medicaid-enrolled individuals.","authors":"K John McConnell, Sara Edelstein, Courtney Benjamin Wolk, Stephan Lindner, Jane M Zhu","doi":"10.1093/haschl/qxae104","DOIUrl":"10.1093/haschl/qxae104","url":null,"abstract":"The COVID-19 public health emergency (PHE) caused significant disruptions in the delivery of care, with in-person visits decreasing and telehealth use increasing. We investigated the impact of these changes on mental health services for Medicaid-enrolled adults and youth in Washington State. Among enrollees with existing mental health conditions, the first year of the PHE was associated with a surge in specialty outpatient mental health visits (13% higher for adults and 7% higher for youth), returning to pre-PHE levels in the second year. Conversely, youth with new mental health needs experienced a decline in specialty outpatient visit rates by ∼15% and 37% in the first and second years of the PHE, respectively. These findings indicate that while mental health service use was maintained or improved for established patients, these patterns did not extend to Medicaid-enrolled youth with new mental health needs, potentially due to barriers such as difficulty in finding providers and establishing new patient-provider relationships remotely. To bridge this gap, there is a need for a multi-faceted approach that includes improving service accessibility, enhancing provider availability, and optimizing initial care encounters, whether in-person or virtual, to better support new patients.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116463","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

An increasing number of states filled Conrad 30 waivers for recruiting international medical graduates. 越来越多的州为招聘国际医学毕业生填写了康拉德 30 号豁免书。

Health affairs scholar Pub Date : 2024-08-19 eCollection Date: 2024-09-01 DOI: 10.1093/haschl/qxae103

Tarun Ramesh, Sarah E Brotherton, Gregory D Wozniak, Hao Yu

引用次数: 0

Over- and underreporting of prices: most hospitals are not compliant with the Hospital Price Transparency Rule. 多报或少报价格：大多数医院不遵守《医院价格透明规则》。

Health affairs scholar Pub Date : 2024-08-19 eCollection Date: 2024-09-01 DOI: 10.1093/haschl/qxae099

Mitchell Mead, Andrew M Ibrahim

{"title":"Over- and underreporting of prices: most hospitals are not compliant with the Hospital Price Transparency Rule.","authors":"Mitchell Mead, Andrew M Ibrahim","doi":"10.1093/haschl/qxae099","DOIUrl":"10.1093/haschl/qxae099","url":null,"abstract":"Concern has been raised about the effectiveness of the Hospital Price Transparency Rule to facilitate a clear understanding of health care prices due to poor reporting by hospitals. However, the relationship between what services the hospital provides and what prices they report is not clear. We assessed reported prices in the Turquoise Health database and compared them at the hospital level with the CMS Provider of Services File to identify if a shoppable service was provided at a hospital. We found significant mismatch between the hospital prices being reported and the services being provided. For example, 56% of hospitals providing at least 1 shoppable service that requires public price reporting did not report any prices. Of hospitals reporting prices, most hospitals (66%) reported prices for only a portion of the services they provide. In addition, 12% of hospitals reported prices for services they do not provide. Only 6% of hospitals had complete concordance with price reporting and services they actually provide. Current compliance enforcement and penalties do not appear to be adequate to achieve the goals of the Hospital Price Transparency Rule.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116464","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

Perceptions of multi-cancer early detection tests among communities facing barriers to health care. 面临医疗保健障碍的社区对多种癌症早期检测试验的看法。

Health affairs scholar Pub Date : 2024-08-16 eCollection Date: 2024-09-01 DOI: 10.1093/haschl/qxae102

Kristi L Roybal, Robyn A Husa, Maria Connolly, Catherine Dinh, Kara M K Bensley, Staci J Wendt

{"title":"Perceptions of multi-cancer early detection tests among communities facing barriers to health care.","authors":"Kristi L Roybal, Robyn A Husa, Maria Connolly, Catherine Dinh, Kara M K Bensley, Staci J Wendt","doi":"10.1093/haschl/qxae102","DOIUrl":"10.1093/haschl/qxae102","url":null,"abstract":"Marginalized racial and ethnic groups and rural and lower income communities experience significant cancer inequities. Blood-based multi-cancer early detection tests (MCEDs) provide a simple and less invasive method to screen for multiple cancers at a single access point and may be an important strategy to reduce cancer inequities. In this qualitative study, we explored barriers and facilitators to MCED adoption among communities facing health care access barriers in Alaska, California, and Oregon. We used reflexive thematic analysis to analyze general barriers to cancer screening, MCED-specific barriers, facilitators of MCED adoption, and MCED communication strategies. We found barriers and facilitators to MCED adoption across 4 levels of the social-ecological model: (1) individual, (2) interpersonal, (3) health care system, and (4) societal. These included adverse psychological impacts, positive perceptions of MCEDs, information and knowledge about cancer screening, the quality of the patient-provider relationship, a lack of health care system trustworthiness, logistical accessibility, patient supports, and financial accessibility. Optimal MCED communication strategies included information spread through the medical environment and the community. These findings underscore the importance of understanding and addressing the multilevel factors that may influence MCED adoption among communities facing health care access barriers to advance health equity.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116465","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

Lessons for cannabinoid regulation from electronic nicotine delivery system product regulation. 电子尼古丁给药系统产品监管对大麻素监管的启示。

Health affairs scholar Pub Date : 2024-08-16 eCollection Date: 2024-08-01 DOI: 10.1093/haschl/qxae101

Brian Yagi, Stan Veuger, Brian J Miller, Paul Larkin

引用次数: 0

Predictors of telehealth use after the Minnesota Telehealth Act: analysis using the Minnesota All Payer Claims Database. 明尼苏达州远程医疗法案》颁布后远程医疗使用的预测因素：使用明尼苏达州所有支付方索赔数据库进行分析。

Health affairs scholar Pub Date : 2024-08-16 eCollection Date: 2024-08-01 DOI: 10.1093/haschl/qxae100

Arkadipta Ghosh, Ethan Jacobs, Elizabeth Greener, Alyssa Evans, Mark Lee, Rui Wang, Pamela Mink, Michael Burian

引用次数: 0

Advancing the Future of Equitable Access to Health Care: Recommendations from International Health Care Leaders 推进公平获得医疗服务的未来：国际医疗保健领导人的建议

Health affairs scholar Pub Date : 2024-08-09 DOI: 10.1093/haschl/qxae094

Beth Boyer, Katie Huber, Eyal Zimlichman, Robert S Saunders, Mark McClellan, Charles N. Kahn, Ryan Noach, Claudia Salzberg

{"title":"Advancing the Future of Equitable Access to Health Care: Recommendations from International Health Care Leaders","authors":"Beth Boyer, Katie Huber, Eyal Zimlichman, Robert S Saunders, Mark McClellan, Charles N. Kahn, Ryan Noach, Claudia Salzberg","doi":"10.1093/haschl/qxae094","DOIUrl":"https://doi.org/10.1093/haschl/qxae094","url":null,"abstract":"\u0000 Disparities in access to health care are persistent and contribute to poor health outcomes for many populations around the world. Barriers to access are often similar across countries, despite differences in how health systems are structured. Health care leaders can work to address these barriers through bold, evidence-based actions. The Future of Health (FOH), an international community of senior health leaders, collaborated with the Duke-Margolis Institute for Health Policy to identify priority organizational and policy actions needed to improve equitable access to health care through a consensus-building exercise, a targeted literature review, and an expert discussion group. This paper describes four key action areas for health care leaders that FOH members identified as critical to enabling the future of equitable access to health care: ensuring prioritization of and accountability for equitable access to care; establishing comprehensive, organization-wide strategies to address barriers to access; clearly defining and incentivizing improvement on key measures related to reducing disparities in access; and establishing cross-sector partnerships to improve equitable access.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141925326","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

Putting Meat on the Bone: How to Fast-Track Innovative Medicines to Those Who Need Them and Generate Data to Justify Continued Use 有的放矢：如何将创新药物快速提供给需要者，并生成数据证明继续使用的合理性

Health affairs scholar Pub Date : 2024-08-09 DOI: 10.1093/haschl/qxae095

Daniel Ollendorf, Chris Henshall, Marie Phillips, Patricia Synnott, Lloyd Sansom, Sean Tunis

{"title":"Putting Meat on the Bone: How to Fast-Track Innovative Medicines to Those Who Need Them and Generate Data to Justify Continued Use","authors":"Daniel Ollendorf, Chris Henshall, Marie Phillips, Patricia Synnott, Lloyd Sansom, Sean Tunis","doi":"10.1093/haschl/qxae095","DOIUrl":"https://doi.org/10.1093/haschl/qxae095","url":null,"abstract":"\u0000 Regulatory agencies worldwide have taken significant steps to expedite approval and market authorization of medicines based on their potential to address areas of significant unmet medical need and severe disease burden. But initial approval of such medicines is often accompanied by limited evidence of benefit, posing a conundrum for payers and health systems who may desire greater certainty of their value. This paper describes a system of “accelerated access” to manage these tensions and coordinate activities across stakeholders, based on discussions held at a multi-stakeholder convening in June 2023. We focus on 6 core, near-term actions that can be taken to improve the current system: clarifying criteria for expedited regulatory approval; enhancing stakeholder coordination; creating expedited pathways in payer and health technology assessment settings; developing joint regulatory/payer/HTA guidance on study design and data needs; linking pricing policy to data uncertainty; and improving patient and public understanding of the processes involved as well as the risks and benefits of the relevant medicines. Many of these actions will require additional resources and personnel, and some will necessitate unprecedented levels of coordination. Nevertheless, each action is designed to work with minimal adjustments to the current system rather than demanding an entirely new approach.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141924197","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