Health affairs scholar最新文献_第2页

Reviving public provisioning in US health care.

Health affairs scholar Pub Date : 2025-03-17 eCollection Date: 2025-03-01 DOI: 10.1093/haschl/qxaf013

Hayden Rooke-Ley, Dana Brown, Colleen Grogan

引用次数: 0

The fundamental importance of social insurance for health equity.

Health affairs scholar Pub Date : 2025-03-17 eCollection Date: 2025-03-01 DOI: 10.1093/haschl/qxae170

Seth A Berkowitz

引用次数: 0

Advancing a political economy approach to health using lessons from US antitrust and climate policy.

Health affairs scholar Pub Date : 2025-03-17 eCollection Date: 2025-03-01 DOI: 10.1093/haschl/qxaf008

Elizabeth Popp Berman

{"title":"Advancing a political economy approach to health using lessons from US antitrust and climate policy.","authors":"Elizabeth Popp Berman","doi":"10.1093/haschl/qxaf008","DOIUrl":"10.1093/haschl/qxaf008","url":null,"abstract":"Advocates of a political economy approach to US health policy center an analysis of power and the broad political, social, and economic landscape that enables or harms health. They must contend, however, with a dominant policy orientation focused on ensuring individual access to the existing healthcare system. This Policy Inquiry reviews the recent history of US antitrust and climate/industrial policy, both domains where policy movements taking a political economy approach have had significant and unexpected recent success, to draw lessons for health policy, in which a \"care economy\" movement aligned with political economy has had some momentum, but not produced major policy change. Advocates of a political economy approach to US health policy should continue to build on the momentum of the care economy movement while also looking for ways to tie healthcare market reform into the shifts in industrial policy and antitrust. Across both spaces, advocates should center the building of issue networks, make connections to historically resonant political themes, and, where possible, find ways to tap into the energy of youth organizers-all strategies shared across antitrust and climate policy.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 3","pages":"qxaf008"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652878","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

States' COVID-19 policy contexts and suicide rates among US working-age adults.

Health affairs scholar Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.1093/haschl/qxaf024

Emily E Wiemers, Shannon M Monnat, Douglas A Wolf, Jennifer Karas Montez, Joshua Grove, Iliya Gutin, Elyse Grossman

{"title":"States' COVID-19 policy contexts and suicide rates among US working-age adults.","authors":"Emily E Wiemers, Shannon M Monnat, Douglas A Wolf, Jennifer Karas Montez, Joshua Grove, Iliya Gutin, Elyse Grossman","doi":"10.1093/haschl/qxaf024","DOIUrl":"https://doi.org/10.1093/haschl/qxaf024","url":null,"abstract":"Despite expectations that suicide rates would surge during the pandemic, the national suicide rate declined in the United States in 2020 before returning to pre-pandemic levels in 2021. Explanations of the decline in suicides at the national level include a \"pulling-together effect\" in the face of a crisis and a shorter than expected pandemic recession. However, suicide rates and the change over time in suicide rates vary substantially across US states. At various times during the pandemic states enacted physical-distancing and economic support policies that may have affected suicide rates. We examined the association between state-level physical-distancing and economic support policy contexts and suicide rates among US adults ages 25-64 years during the COVID-19 pandemic. We found that a 1-SD increase in the stringency of a state's physical-distancing policies was associated with a 5.3% reduction in male suicide rates but was not associated with female suicide rates. Economic support policies were not associated with suicide rates for the period as a whole. The results support the growing evidence that COVID-19 policies had indirect and unintended consequences beyond their direct effect on COVID-19 transmission and death, in this case to reduce suicides among working-age males.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 3","pages":"qxaf024"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652821","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

LGB (lesbian, gay, and bisexual) state policy protections and substance use disparities.

Health affairs scholar Pub Date : 2025-03-14 eCollection Date: 2025-03-01 DOI: 10.1093/haschl/qxaf029

Alice Guan, Paul Wesson, David V Glidden, Rita Hamad, Judy Y Tan, Scarlett L Gomez

{"title":"LGB (lesbian, gay, and bisexual) state policy protections and substance use disparities.","authors":"Alice Guan, Paul Wesson, David V Glidden, Rita Hamad, Judy Y Tan, Scarlett L Gomez","doi":"10.1093/haschl/qxaf029","DOIUrl":"10.1093/haschl/qxaf029","url":null,"abstract":"LGB (lesbian, gay, and bisexual) individuals have higher rates of tobacco and alcohol use than the general population. While protective social policies have been found to reduce these disparities, their long-term impact remains largely unknown. In this study, we used data from waves 3 (2001-2002) and 4 (2008-2009) of the National Longitudinal Study of Adolescent to Adult Health to assess the impact of exposure to LGB state policy protections during emerging adulthood on substance use in young adulthood. Using multivariable Poisson models, we evaluated whether emerging adulthood was a critical period of exposure and quantified the relative reduction in substance use disparities between LGB and heterosexual individuals living in more protective states. Findings suggest that LGB individuals living in states with more policy protections during emerging adulthood had a significantly lower prevalence of tobacco use and binge drinking in young adulthood compared with those in less protective states. These findings were not observed among heterosexual individuals, indicating that policy effects were specific to LGB individuals. Furthermore, these protections appeared to reduce overall substance use disparities, especially among female participants. It is critical to continue evaluating policy protections to safeguard the health of the LGB community, especially considering the potential erosion of these vital protections.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 3","pages":"qxaf029"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652887","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 characteristics associated with behavioral health emergency medical services calls.

Health affairs scholar Pub Date : 2025-03-14 eCollection Date: 2025-04-01 DOI: 10.1093/haschl/qxaf054

Ashlyn Burns, Haleigh Kampman, Nir Menachemi

引用次数: 0

Medicaid managed care organizations' experiences with network adequacy.

Health affairs scholar Pub Date : 2025-03-13 eCollection Date: 2025-04-01 DOI: 10.1093/haschl/qxaf049

Jane M Zhu, Ruth Rowland, Daniel Polsky, Inga Suneson, Simon F Haeder, Deborah J Cohen, K John McConnell

{"title":"Medicaid managed care organizations' experiences with network adequacy.","authors":"Jane M Zhu, Ruth Rowland, Daniel Polsky, Inga Suneson, Simon F Haeder, Deborah J Cohen, K John McConnell","doi":"10.1093/haschl/qxaf049","DOIUrl":"10.1093/haschl/qxaf049","url":null,"abstract":"Access to behavioral health care continues to be a challenge in Medicaid, where most enrollees are restricted to networks of providers and facilities contracted with managed care organizations (MCOs). While state and federal regulations have sought to ensure access to care, little is known about how health plans perceive and respond to these network adequacy standards. We interviewed 27 administrators and executives across 19 local, regional, and national Medicaid MCOs to assess their behavioral health networks and perceived barriers and facilitators in these efforts. We purposively sampled MCOs for maximum heterogeneity, with early findings used to refine subsequent recruitment targets until thematic saturation. We used an iterative inductive coding approach with code discrepancies analyzed and reconciled until consensus was reached. Five major themes arose: existing regulations often failed to capture true access gaps; MCOs used supplementary approaches to monitor network adequacy; limited corrective actions were available; access measures were more meaningful when grounded in enrollee experiences; and provider directory accuracy was challenged by logistical barriers. In this first study to examine MCOs' experiences with network adequacy monitoring, our findings suggest key deficiencies with current regulations and opportunities to support MCOs more broadly as policymakers seek to strengthen network adequacy regulations.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 4","pages":"qxaf049"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797467","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 analysis of US net cancer drug launch prices and clinical efficacy and certainty of evidence from 2008 to 2022.

Health affairs scholar Pub Date : 2025-03-13 eCollection Date: 2025-04-01 DOI: 10.1093/haschl/qxaf051

Sumaya Abuloha, Benjamin P Harvey, Shu Niu, Alaa Alshehri, Melissa Miri, Katherine Clifford, James Chambers, Mikael Svensson

{"title":"An analysis of US net cancer drug launch prices and clinical efficacy and certainty of evidence from 2008 to 2022.","authors":"Sumaya Abuloha, Benjamin P Harvey, Shu Niu, Alaa Alshehri, Melissa Miri, Katherine Clifford, James Chambers, Mikael Svensson","doi":"10.1093/haschl/qxaf051","DOIUrl":"10.1093/haschl/qxaf051","url":null,"abstract":"Over the last 15 years, cancer drug prices have increased substantially in the United States (US), with question marks on whether this can be justified based on improved patient outcomes. This study aimed to analyze the relationship between US cancer drug net launch prices and clinical efficacy and certainty of evidence. FDA-approved cancer drug indications from 2008 to 2022 were extracted and matched with net launch price data, 5 distinct measures of clinical efficacy, and measures on the certainty of evidence around the clinical efficacy. Descriptive statistics and linear regression models were used to assess if higher net launch prices were associated with better patient outcomes. Cancer drug launch prices (net per 1 year/course of treatment) have increased from around $100 000 in 2008 to $200 000 in 2022. The results did not support the idea that drugs with higher net launch prices had more impressive clinical efficacy or more robust evidence around the clinical efficacy. US cancer launch prices do not seem to be value-based, which may imply distorted incentives for the allocation of research and development investments.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 4","pages":"qxaf051"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797459","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

Supporting the home care workforce across the Southern United States: impetus, exploration, and policy strategies.

Health affairs scholar Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.1093/haschl/qxaf031

Britt Sanderson, Sam Obbin, Kiera Williams, Stephen McCall, Matt Michaelson

引用次数: 0

Incremental cost of state funds for new enrollment in Section 1332 waivers.

Health affairs scholar Pub Date : 2025-03-12 eCollection Date: 2025-04-01 DOI: 10.1093/haschl/qxaf050

David M Anderson, Daniel Ludwinski

引用次数: 0