Health affairs scholar最新文献

Postpartum Medicaid extensions and follow-up care after pregnancy complications. 产后医疗补助延长和妊娠并发症后的后续护理。

IF 4.1

Health affairs scholar Pub Date : 2026-10-14 eCollection Date: 2026-10-01 DOI: 10.1093/haschl/qxag264

Teresa Janevic, Renata E Howland, Cecilia Ganduglia Cazaban, Andrew Tang, Joseph Wozny, Annabelle Ng, Frances M Howell, Chloe Dorsey, Toni Stern, Maria I Rodriguez, Ashley Fox, Ellerie Weber

{"title":"Postpartum Medicaid extensions and follow-up care after pregnancy complications.","authors":"Teresa Janevic, Renata E Howland, Cecilia Ganduglia Cazaban, Andrew Tang, Joseph Wozny, Annabelle Ng, Frances M Howell, Chloe Dorsey, Toni Stern, Maria I Rodriguez, Ashley Fox, Ellerie Weber","doi":"10.1093/haschl/qxag264","DOIUrl":"10.1093/haschl/qxag264","url":null,"abstract":"Introduction: For women with pregnancy complications, such as hypertensive disorders or gestational diabetes, the postpartum period is a critical, yet underutilized opportunity to prevent both pregnancy-related morbidity and longer-term chronic disease. Loss of insurance coverage postpartum is a barrier to treatment and prevention strategies.Methods: We examined if extending Medicaid through 12 months postpartum increased postpartum health care utilization for women with pregnancies complicated by diabetes or hypertension. We analyzed 2019-2023 deliveries in Medicaid claims data from New York (NY) and Texas (TX) using an interrupted time series design and segmented regression analysis.Results: We found that postpartum diabetes screening and outpatient utilization increased during the continuous enrollment provision (CEP) of the COVID-19 public health emergency, decreased during unwinding of the CEP in TX, and increased after implementation of postpartum extension legislation in NY. Postpartum hypertensive medication prescriptions increased slightly in TX and saw no change in NY.Conclusion: Given that NY and TX are states with large Medicaid-insured populations and diverse policy climates, the consistency of our findings suggests that postpartum extension of Medicaid is an effective strategy to increase follow-up care among Medicaid beneficiaries with pregnancy complications.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"4 10","pages":"qxag264"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198663","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

IF 4.1

Health affairs scholar Pub Date : 2026-10-08 eCollection Date: 2026-10-01 DOI: 10.1093/haschl/qxag236

Caroline R Efird, Claudia Park, Parth Mishra, Angela Barr, Andrew J Twinamatsiko, Christopher J King

{"title":"Recommended guidelines concerning artificial intelligence and health equity: a scoping review.","authors":"Caroline R Efird, Claudia Park, Parth Mishra, Angela Barr, Andrew J Twinamatsiko, Christopher J King","doi":"10.1093/haschl/qxag236","DOIUrl":"10.1093/haschl/qxag236","url":null,"abstract":"Introduction: The use of artificial intelligence (AI) technologies in healthcare has potential to improve patient care, expand access, and optimize efficiency. Yet, a growing body of evidence warns of health risks for marginalized and minoritized populations as a result of algorithmic bias.Methods: To synthesize leading scholars' recommendations for equitable AI implementation in healthcare settings and health services research, we conducted a scoping review of current literature.Results: We identified and analyzed 166 relevant, peer-reviewed articles. Most articles (70%) originated in the United States. Only 13% provided a specific definition of \"health equity.\" Included manuscripts generally emphasized that ethical human oversight must accompany AI-use. The engagement of diverse groups of stakeholders during model development, implementation, and evaluation is also paramount. Patient and provider education on AI's capabilities is also critical for building trust and equitable delivery of care.Conclusion: To enhance the field's ability to implement AI in ways that address health disparities and inequities, future research needs to amplify discipline-specific expertise and more global perspectives. By explicitly prioritizing health equity, transparency, inclusion, and education, there is potential to meaningfully regulate AI in healthcare to redress systemic inequities in care and advance health and well-being in populations throughout the world.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"4 10","pages":"qxag236"},"PeriodicalIF":4.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140005","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

Assessing eligibility of Medicare beneficiaries with chronic conditions for the ACCESS model. 评估患有慢性疾病的医疗保险受益人的资格。

IF 4.1

Health affairs scholar Pub Date : 2026-10-07 eCollection Date: 2026-10-01 DOI: 10.1093/haschl/qxag268

Terrence T Liu, Joshua A Jacobs, Heather Sateia, Kensaku Kawamoto, Molly B Conroy

{"title":"Assessing eligibility of Medicare beneficiaries with chronic conditions for the ACCESS model.","authors":"Terrence T Liu, Joshua A Jacobs, Heather Sateia, Kensaku Kawamoto, Molly B Conroy","doi":"10.1093/haschl/qxag268","DOIUrl":"10.1093/haschl/qxag268","url":null,"abstract":"Introduction: The Advancing Chronic Care with Effective Scalable Solutions (ACCESS) model is a new outcome-aligned payment model intended to support technology-enabled chronic disease management among Traditional Medicare (TM) beneficiaries. However, the national population potentially eligible for ACCESS remains poorly characterized, particularly those with multiple chronic conditions.Methods: Using nationally representative survey data from the 2023 Medical Expenditure Panel Survey, we described the health characteristics and health care utilization patterns of TM beneficiaries potentially eligible for the ACCESS model.Results: A total of 56.3% of beneficiaries (estimated 9.1 million) were potentially eligible to participate in the model, 24% of beneficiaries (estimated 2.2 million) had multiple chronic conditions, and beneficiary telehealth use for cardio-kidney-metabolic and musculoskeletal conditions was limited.Conclusion: The sizable proportion of TM beneficiaries potentially eligible for more than one ACCESS track suggests a deliberate approach to care coordination to support technology-enabled chronic disease management in older adults.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"4 10","pages":"qxag268"},"PeriodicalIF":4.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217817","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

Prevalence of ties to industry-funded organizations among patient and consumer representatives on FDA advisory committees. 在FDA咨询委员会的患者和消费者代表中，与行业资助组织的联系普遍存在。

IF 4.1

Health affairs scholar Pub Date : 2026-10-07 eCollection Date: 2026-10-01 DOI: 10.1093/haschl/qxag269

Genevieve P Kanter, Toni Mankowitz

{"title":"Prevalence of ties to industry-funded organizations among patient and consumer representatives on FDA advisory committees.","authors":"Genevieve P Kanter, Toni Mankowitz","doi":"10.1093/haschl/qxag269","DOIUrl":"10.1093/haschl/qxag269","url":null,"abstract":"Introduction: FDA advisory committees are primarily composed of scientific experts, but also include a patient representative and a consumer representative providing public perspectives. Although the FDA has enacted policies to curb conflicts of interest common among its scientific members, it has paid less attention to potential conflicts arising from patient and consumer representatives who have ties to organizations financially supported by pharmaceutical companies.Methods: We analyzed the prevalence of industry funding of advocacy organizations in which patient and consumer representatives were actively involved in the year they attended FDA advisory committee meetings between 2013 and 2022.Results: Between 2013 and 2022, nearly 2 in 5 (38%) FDA advisory committee meetings included either a patient or consumer representative with active ties to a pharmaceutical-funded advocacy organization. For several FDA committees, this share was greater than 50%. More than 1 in 10 (11%) advisory committee meetings included a representative affiliated with an organization receiving funds from the sponsor of the drug under review.Conclusion: These prevalence rates show that these organizational relationships extend beyond isolated cases and signal a broader problem warranting FDA policy attention.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"4 10","pages":"qxag269"},"PeriodicalIF":4.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225788","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

County Indigent Care programs fill coverage gaps left by Medicaid restrictions: evidence from Texas. 县贫困护理计划填补了医疗补助限制留下的覆盖空白：来自德克萨斯州的证据。

IF 4.1

Health affairs scholar Pub Date : 2026-10-03 eCollection Date: 2026-10-01 DOI: 10.1093/haschl/qxag267

Arthur S Hong, Grant R J Paul, Frederick P Cerise, Abram O Gordon, Navid Sadeghi, Joshua M Liao, Jenisa Rc, Ethan A Halm

{"title":"County Indigent Care programs fill coverage gaps left by Medicaid restrictions: evidence from Texas.","authors":"Arthur S Hong, Grant R J Paul, Frederick P Cerise, Abram O Gordon, Navid Sadeghi, Joshua M Liao, Jenisa Rc, Ethan A Halm","doi":"10.1093/haschl/qxag267","DOIUrl":"10.1093/haschl/qxag267","url":null,"abstract":"Introduction: Medicaid restrictions exclude some low-income adults, especially in nonexpansion states and among immigrants. Local governments are payers of last resort. Texas offers an important case study: state law requires counties to maintain Indigent Care programs to extend healthcare coverage for uninsured low-income residents, yet no recent report describes their structure.Methods: We cataloged programs in all 254 counties, using publicly available data, contact with county officials, and a state open records request, characterizing reporting, eligibility, and services, along with estimates of uninsured working-age adults in counties with broader eligibility and services, overall and by county metropolitan status.Results: Required annual reports were unavailable for 144/254 (57%) counties, and 19/254 (7%) had eligibility or benefits inconsistent with state law (minimum eligibility of 21% of federal poverty level-FPL; $30 000 of care including prescription and skilled nursing). 39/254 (15%) set income eligibility ≥138% FPL, reaching 50% of uninsured adults but only 14% of uninsured adults in nonmetropolitan counties. 5/254 counties (2%) combined higher income thresholds with broad service availability; all were metropolitan, containing 47% of uninsured adults statewide.Conclusion: Indigent Care reaches those excluded from Medicaid, but eligibility and services varied widely, and more generous programs were only in metropolitan counties.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"4 10","pages":"qxag267"},"PeriodicalIF":4.1,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217821","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

Food assistance programs serve the majority of low-income, homebound older adults, yet food insecurity remains. 粮食援助项目为大多数低收入、居家的老年人提供服务，但粮食不安全问题依然存在。

IF 4.1

Health affairs scholar Pub Date : 2026-10-01 DOI: 10.1093/haschl/qxag260

Yiqing Qian, Mary Louise Pomeroy, Kaitlyn Tang, Laura J Samuel, Kali S Thomas, Katherine A Ornstein

{"title":"Food assistance programs serve the majority of low-income, homebound older adults, yet food insecurity remains.","authors":"Yiqing Qian, Mary Louise Pomeroy, Kaitlyn Tang, Laura J Samuel, Kali S Thomas, Katherine A Ornstein","doi":"10.1093/haschl/qxag260","DOIUrl":"10.1093/haschl/qxag260","url":null,"abstract":"Introduction: Low-income homebound older adults face a disproportionately high risk of food insecurity, yet national evidence of food assistance program uptake among this population is limited.Methods: Using nationally representative data of Medicare beneficiaries aged 65 and older from the National Health and Aging Trends Study Round 13, we examined Supplemental Nutrition Assistance Program (SNAP) and Meals on Wheels (MOW) participation among 1091 low-income community-dwelling older adults who were homebound and income-eligible for SNAP.Results: More than half (55.5%) of low-income homebound older adults, representing 2.18 million nationally, participated in at least one program: 35.1% received SNAP only, 10.9% received MOW only, and only 9.4% received both. Despite receiving food assistance, 36.4% still reported food insecurity. We identified 1.75 million low-income homebound older adults who did not receive SNAP or MOW (non-recipients), among whom 24.0% experienced food insecurity and 21.8% lived alone. Among non-recipients, those experiencing food insecurity reported significantly more functional dependencies and were more likely to live alone than those who were food secure.Conclusion: Policies that expand program capacity, strengthen screening for food insecurity, and streamline enrollment could improve access for this high-need population.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"4 10","pages":"qxag260"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140046","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

'So easy to destroy, so hard to build': understanding impacts of federal rule changes on the Title X program, 2018-2024. “摧毁如此容易，建立如此困难”：了解2018-2024年联邦规则变化对第十条计划的影响

IF 4.1

Health affairs scholar Pub Date : 2026-09-28 eCollection Date: 2026-09-01 DOI: 10.1093/haschl/qxag235

Rebecca G Simmons, Jami Baayd, Caitlin Quade, Jessica N Sanders, Audrey Widner, Alexandra Gero, Sarah Compton

{"title":"'So easy to destroy, so hard to build': understanding impacts of federal rule changes on the Title X program, 2018-2024.","authors":"Rebecca G Simmons, Jami Baayd, Caitlin Quade, Jessica N Sanders, Audrey Widner, Alexandra Gero, Sarah Compton","doi":"10.1093/haschl/qxag235","DOIUrl":"10.1093/haschl/qxag235","url":null,"abstract":"Introduction: Title X is the only federal program that directly funds family planning care. Recent Rule Changes have resulted in back-and-forth shifts to the program. Our goal was to understand how the federal Title X Rule Changes have impacted grantees and their perceptions of future program participation.Methods: In 2024, we conducted qualitative interviews with 25 grantees and national partners and held listening session focus groups with 37 grantees and subrecipients.Results: We identified 5 themes: (1) Title X is seen as both programmatically burdensome and essential; (2) the 2019 Rule Change demonstrated how grantee organizational and state contexts impact their responses and decision-making; (3) external environmental factors created additional systems stressors; (4) the 2021 Rule Change resulted in return to the network but reintegration/ readjustment were taxing; and (5) existing grantee differences still impact capacity for future participation.Conclusions: We found that while Title X is viewed by grantees as a vital component of the reproductive health safety net, Rule Changes significantly increase the burden (regardless of program participation) of service delivery. Importantly for policymakers, subsequent recovery after program restoration is nonlinear and highly dependent on grantee characteristics and the local environments in which they operate.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"4 9","pages":"qxag235"},"PeriodicalIF":4.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077097","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

Legislative trajectory of mental health and substance use-focused bills in the US Congress, 1989-2023. 1989-2023年美国国会精神健康和物质使用法案的立法轨迹

IF 4.1

Health affairs scholar Pub Date : 2026-09-26 eCollection Date: 2026-10-01 DOI: 10.1093/haschl/qxag263

Bismarck C Odei, Sonu Bae, Mackenzie Paxton, Brooklyn Richins, Caroline McLeskey, Olinto Linares-Perdomo, Damon Klebe

引用次数: 0

Private equity ownership and artificial intelligence adoption by hospitals in the United States. 美国医院的私募股权所有权和人工智能采用。

IF 4.1

Health affairs scholar Pub Date : 2026-09-25 eCollection Date: 2026-10-01 DOI: 10.1093/haschl/qxag261

Rocco Friebel, Daniel Arnold, Michael Anderson, Jonathan Cantor, Yashaswini Singh

{"title":"Private equity ownership and artificial intelligence adoption by hospitals in the United States.","authors":"Rocco Friebel, Daniel Arnold, Michael Anderson, Jonathan Cantor, Yashaswini Singh","doi":"10.1093/haschl/qxag261","DOIUrl":"10.1093/haschl/qxag261","url":null,"abstract":"Introduction: Private equity (PE) firms own a growing share of United States hospitals and claim that capital infusions support technology investment. We examined the association between PE hospital ownership and the likelihood of artificial intelligence (AI) technology adoption.Methods: We linked the 2024 American Hospital Association Annual Survey to a database of PE acquisitions and exits. Mixed-effects logistic models estimated any, clinical, and operational AI adoption by hospital ownership type, adjusting for hospital and market characteristics. In secondary analyses, we examined challenges to AI implementation.Results: PE-owned hospitals had higher adjusted adoption of any AI (difference, 24.5 percentage points; 95% confidence interval, 11.2 to 37.8) and clinical AI (difference, 27.5 percentage points; 95% confidence interval, 14.0 to 41.1) than other for-profit hospitals but did not differ from not-for-profit hospitals. Operational adoption did not differ by ownership. In secondary analyses, not-for-profit hospitals reported any, cost and resource, and regulatory and safety challenges more often than PE-owned hospitals; PE-owned hospitals reported staff-training challenges more often than other for-profit hospitals.Conclusion: PE-owned and not-for-profit hospitals had similar adoption of any and clinical AI, and both exceeded other for-profit hospitals, consistent with a capital access advantage that does not extend to the broader for-profit sector.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"4 10","pages":"qxag261"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140044","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

Party identification and public attitudes toward raw milk, water fluoridation, and acetaminophen use. 对原料奶、水氟化和对乙酰氨基酚使用的党派认同和公众态度。

IF 4.1

Health affairs scholar Pub Date : 2026-09-24 eCollection Date: 2026-09-01 DOI: 10.1093/haschl/qxag237

Filip Viskupič, David L Wiltse, Md Shahriar Mahmud, Claus Kadelka

{"title":"Party identification and public attitudes toward raw milk, water fluoridation, and acetaminophen use.","authors":"Filip Viskupič, David L Wiltse, Md Shahriar Mahmud, Claus Kadelka","doi":"10.1093/haschl/qxag237","DOIUrl":"10.1093/haschl/qxag237","url":null,"abstract":"Background: Fluoridation of drinking water, milk pasteurization, and acetaminophen use in pregnancy have become highly visible and controversial public health issues.Methods: In September and October 2025, we fielded a national survey to examine the beliefs about and support for policies regulating water fluoridation, raw milk, and acetaminophen use in the United States. We used descriptive statistics and multivariate logistic regression to analyze the data.Results: We found that about half of the participants believed fluoridated tap water was safe to drink, that raw milk was not as safe to drink as pasteurized milk, and that taking acetaminophen during pregnancy did not cause autism. About a third of respondents reported that water fluoridation should be banned, sale of raw milk should be liberalized, and that the government should issue new guidelines against the use of acetaminophen during pregnancy. Logistic regression analysis showed that people with lower confidence in scientists and self-identified Republicans were more likely to hold beliefs and policy positions that diverged from general scientific consensus.Conclusions: Overall, we found that a large part of society has embraced beliefs and policy positions not based on general scientific consensus, and that all three issues we examined have become deeply politicized.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"4 9","pages":"qxag237"},"PeriodicalIF":4.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043008","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