Health affairs scholar最新文献_第3页

Medicare Advantage enrollees' reports of unfair treatment during health care encounters. 医疗保险优势计划参保者关于在就医过程中受到不公平待遇的报告。

Health affairs scholar Pub Date : 2024-05-29 eCollection Date: 2024-05-01 DOI: 10.1093/haschl/qxae063

Megan Mathews, Megan K Beckett, Steven C Martino, Julie A Brown, Nate Orr, Sarah Gaillot, Marc N Elliott

{"title":"Medicare Advantage enrollees' reports of unfair treatment during health care encounters.","authors":"Megan Mathews, Megan K Beckett, Steven C Martino, Julie A Brown, Nate Orr, Sarah Gaillot, Marc N Elliott","doi":"10.1093/haschl/qxae063","DOIUrl":"10.1093/haschl/qxae063","url":null,"abstract":"We investigated unfair treatment among 1863 Medicare Advantage (MA) enrollees from 21 MA plans using 2022 survey data (40% response rate) in which respondents indicated whether they were treated unfairly in a health care setting based on any of 10 personal characteristics. We calculated reported unfair treatment rates overall and by enrollee characteristics. Nine percent of respondents reported any unfair treatment, most often based on health condition (6%), disability (3%), or age (2%). Approximately 40% of those reporting any unfair treatment endorsed multiple categories. People who qualified for Medicare via disability reported unfair treatment by disability, age, income, race and ethnicity, sex, sexual orientation, and gender/gender identity more often than those who qualified via age. Enrollees dually eligible for Medicare and Medicaid or eligible for a Low-Income Subsidy (DE/LIS) reported unfair treatment by disability, income, language/accent, race and ethnicity, culture/religion, and sex more often than non-DE/LIS enrollees. Compared with White respondents, racial and ethnic minority respondents more often reported unfair treatment by race and ethnicity, language/accent, culture/religion, and income. Female respondents were more likely than male respondents to report unfair treatment based on age and sex.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11135643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141177135","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

Multi-cancer early detection (MCED) tests: prioritizing equity from bench to bedside. 多种癌症早期检测（MCED）试验：从工作台到病床优先考虑公平性。

Health affairs scholar Pub Date : 2024-05-23 eCollection Date: 2024-05-01 DOI: 10.1093/haschl/qxae039

Sarah J Miller, Jamilia R Sly, Christian Rolfo, Philip Mack, Augusto Villanueva, Melissa Mazor, Ellerie Weber, Jenny J Lin, Cardinale B Smith, Emanuela Taioli

引用次数: 0

Implementing automated Medicaid eligibility renewals was not associated with higher levels of program participation 实施自动医疗补助资格更新与计划参与度的提高无关

Health affairs scholar Pub Date : 2024-05-22 DOI: 10.1093/haschl/qxae071

Daniel B Nelson, Phillip M Singer, Vicki Fung

{"title":"Implementing automated Medicaid eligibility renewals was not associated with higher levels of program participation","authors":"Daniel B Nelson, Phillip M Singer, Vicki Fung","doi":"10.1093/haschl/qxae071","DOIUrl":"https://doi.org/10.1093/haschl/qxae071","url":null,"abstract":"\u0000 Increasing participation in Medicaid among eligible individuals is critical for improving access to care among low-income populations. The administrative burdens of enrolling and renewing eligibility are a major barrier to participation. To reduce these burdens, the Affordable Care Act required states to adopt automated renewal processes that use available databases to verify ongoing eligibility. By 2019, nearly all states adopted automated renewals, but little is known about how this policy affected Medicaid participation rates. Using the 2015-2019 American Community Survey, we found that participation rates among non-disabled, non-elderly adults and children varied widely by state with an average of 70.8% and 90.7%, respectively. Among Medicaid-eligible adults, participation was lower among younger adults, males, unmarried individuals, childless households, and those living in non-expansion states compared with their counterparts. State adoption of automated renewals varied over time, but participation rates were not associated with adoption. This finding could reflect limitations to current automated renewal processes or barriers to participation outside of the eligibility renewal process, which will be important to address as additional states expand Medicaid and pandemic-era protections on enrollment expire.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141108113","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

Towards a Coordinated Approach for Managing Accelerated Patient Access to Potentially Beneficial Medicines: reporting the perspectives of a multi-stakeholder, international workshop 采用协调方法管理患者加速获得具有潜在益处的药物：报告多方利益相关者国际研讨会的观点

Health affairs scholar Pub Date : 2024-05-22 DOI: 10.1093/haschl/qxae069

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

{"title":"Towards a Coordinated Approach for Managing Accelerated Patient Access to Potentially Beneficial Medicines: reporting the perspectives of a multi-stakeholder, international workshop","authors":"Marie Phillips, Patricia Synnott, Chris Henshall, Sean Tunis, Lloyd Sansom, Daniel Ollendorf","doi":"10.1093/haschl/qxae069","DOIUrl":"https://doi.org/10.1093/haschl/qxae069","url":null,"abstract":"\u0000 Accelerated and conditional regulatory pathways for drug approvals are intended to enable earlier patient access to potentially life-saving treatments, or treatments that provide benefits in addressing a significant unmet need. However, there are questions about how well such pathways work, how appropriately they are applied, and how the work of regulators can be better coordinated with that of health technology assessment (HTA) and payer bodies, providers and health systems, and other stakeholders. In June 2023, a multi-stakeholder, international workshop was convened in Adelaide, Australia to deliberate the challenges, goals, and opportunities to improve accelerated access pathways. Workshop attendees included representatives from patient organizations, regulators, HTA/payer bodies, universities (ethicists, health economists), and companies developing and marketing new medicines from Australia, Asia, Europe, and North America. We reviewed the contents of this workshop to identify areas of agreement and disagreement, report the key themes of the discussion, and delineate next steps for improving accelerated access pathways. We found that there was general agreement among workshop attendees that accelerated access could be improved significantly by strengthening processes for stakeholder coordination, and that coordinated efforts will be required to implement meaningful change moving forward.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141110844","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

Access to insurance navigation support through the State Health Insurance Assistance Program (SHIP) 通过州健康保险援助计划 (SHIP) 获得保险导航支持

Health affairs scholar Pub Date : 2024-05-21 DOI: 10.1093/haschl/qxae072

Melissa M Garrido, David Biko, Allison Dorneo, Paul Shafer, Austin B. Frakt

{"title":"Access to insurance navigation support through the State Health Insurance Assistance Program (SHIP)","authors":"Melissa M Garrido, David Biko, Allison Dorneo, Paul Shafer, Austin B. Frakt","doi":"10.1093/haschl/qxae072","DOIUrl":"https://doi.org/10.1093/haschl/qxae072","url":null,"abstract":"\u0000 Medicare enrollment is complex, particularly for low-income individuals who are dually eligible for Medicare and Medicaid, and the wrong plan choice can adversely impact beneficiaries’ out of pocket costs and access to providers and medications. The State Health Insurance Assistance Program (SHIP) is a federal program that provides counseling on Medicare coverage, but the degree to which SHIP services are accessible to low-income beneficiaries is unknown. We interviewed SHIP counselors and coordinators to characterize factors affecting access to and quality of SHIP services for low-income beneficiaries. Availability of volunteers was cited as the primary barrier to SHIP services. Topics related to dual eligibility for Medicare and Medicaid were frequently covered in counseling sessions, and staff expressed a desire for more training related to Medicaid and integrated care programs. Our results suggest that additional counselors and increased training on topics relevant to dually eligible individuals may improve SHIP’s ability to provide health insurance-related information to low-income Medicare beneficiaries.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141115718","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

Childcare disruptions and maternal health during the COVID-19 pandemic. COVID-19 大流行期间的儿童保育中断和孕产妇健康。

Health affairs scholar Pub Date : 2024-05-21 eCollection Date: 2024-05-01 DOI: 10.1093/haschl/qxae061

Colleen L MacCallum-Bridges, Lindsay K Admon, Jamie R Daw

{"title":"Childcare disruptions and maternal health during the COVID-19 pandemic.","authors":"Colleen L MacCallum-Bridges, Lindsay K Admon, Jamie R Daw","doi":"10.1093/haschl/qxae061","DOIUrl":"10.1093/haschl/qxae061","url":null,"abstract":"During the COVID-19 pandemic, nearly all US states enacted stay-at-home orders, upending usual childcare arrangements and providing a unique opportunity to study the association between childcare disruptions and maternal health. Using data from the 2021-2022 National Survey of Children's Health, we estimated the association between childcare disruptions due to the COVID-19 pandemic and self-reported mental and physical health among female parents of young children (ages 0-5 years). Further, we assessed racial, ethnic, and socioeconomic disparities in (1) the prevalence of childcare disruptions due to the COVID-19 pandemic and (2) the association between childcare disruptions and mental or physical health. Female parents who experienced childcare disruptions due to the COVID-19 pandemic were less likely to report excellent or very good mental (-7.4 percentage points) or physical (-2.5 percentage points) health. Further, childcare disruptions were more common among parents with greater socioeconomic privilege (ie, higher education, higher income), but may have been more detrimental to health among parents with less socioeconomic privilege (eg, lower education, lower income, and single parents). As state and federal policymakers take action to address the maternal health crisis in the United States, our findings suggest that measures to improve childcare stability may also promote maternal health and health equity.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11108245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077472","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

Role of Supply Chain Intermediaries in Steering Hospital Product Choice: Group Purchasing Organizations and Biosimilars 供应链中介在引导医院产品选择中的作用：集团采购组织与生物仿制药

Health affairs scholar Pub Date : 2024-05-15 DOI: 10.1093/haschl/qxae067

E. B. Dean, Reekarl Pierre, Samuel Carter, Amelia M Bond

{"title":"Role of Supply Chain Intermediaries in Steering Hospital Product Choice: Group Purchasing Organizations and Biosimilars","authors":"E. B. Dean, Reekarl Pierre, Samuel Carter, Amelia M Bond","doi":"10.1093/haschl/qxae067","DOIUrl":"https://doi.org/10.1093/haschl/qxae067","url":null,"abstract":"\u0000 Over 95% of hospitals in the United States use pooling alliances, known as Group Purchasing Organizations (GPOs), to purchase medications, devices, and supplies. While GPOs create savings for hospitals through lowered prices and reduced administrative burden, critics allege that these supply chain intermediaries reduce competition, particularly if GPOs concentrate purchasing from larger, dominant manufacturers. Using a mixed-method design, we studied whether GPOs influence hospital purchasing behavior and explored the contracting mechanisms used by GPOs. Focusing on four high-cost biologic molecules that face competition from generic-like biosimilars between 2015-2019, we found that biosimilar uptake was 16-23% higher among Traditional Medicare patients in hospitals associated with two of the three top GPOs as compared to smaller GPOs. The increase in biosimilar use was driven by single biosimilar brands that varied by GPO. Based on qualitative interviews, these two GPOs used more aggressive contracting strategies to steer member hospitals to specific biosimilar brands. To date, the use of GPOs and these aggressive contracting strategies appear to have increased biosimilar use, suggesting savings for payers and patients. However, single-source GPO contracting could inhibit competition or create shortages in the long term. Transparency on GPO practices and pricing strategies is needed for further GPO evaluations.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140977119","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

Beyond “business as usual”: Lessons from FIFA for fair benefit-sharing in global health 超越 "一切照旧"：国际足联在全球卫生领域公平分享利益方面的经验教训

Health affairs scholar Pub Date : 2024-05-15 DOI: 10.1093/haschl/qxae068

Brian Wahl, Gabriel Butin, Spring Gombe, Nina Schwalbe

{"title":"Beyond “business as usual”: Lessons from FIFA for fair benefit-sharing in global health","authors":"Brian Wahl, Gabriel Butin, Spring Gombe, Nina Schwalbe","doi":"10.1093/haschl/qxae068","DOIUrl":"https://doi.org/10.1093/haschl/qxae068","url":null,"abstract":"\u0000 While researchers and agencies from low- and middle-income countries often contribute significantly to public health surveillance data, which is crucial for effective pandemic prevention, preparedness, and response activities, they often do not receive adequate compensation for their contributions. Incentivizing data sharing is important for informing public health responses to pathogens with pandemic potential. However, existing data sharing legal frameworks have limitations. In this context, we looked beyond “business the usual suspects” to explore the applicability of a benefit-sharing model developed and implemented by the International Federation of Association Football (FIFA) in international association football. This model rewards grassroots contributions and redistributes benefits, promoting a fair balance of interests across diverse economic contexts. We discuss adapting FIFA's mechanisms, including training compensation and solidarity payments, to create a novel benefit-sharing framework in global health. Given the complexity of global health, we note ways in which components of the FIFA model would need to be adapted for global health. Challenges such as integrating into existing legal frameworks, ensuring broad international buy-in, and accommodating different pandemic periods are examined. While adapting the FIFA model presents challenges, it offers a promising approach to achieving more equitable data sharing and benefit distribution in global health.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140977727","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

Healthcare Provider Movement Increased Through COVID-19 通过 COVID-19 增加医疗服务提供者的流动

Health affairs scholar Pub Date : 2024-05-15 DOI: 10.1093/haschl/qxae065

Qian Luo, Yoon Hong Park, Candice Chen, Stephen Petterson

引用次数: 0

Funding of evidence included within public comments submitted to inform Medicare national coverage determinations. 对公众意见中包含的证据进行资助，以便为医疗保险国家承保范围的确定提供信息。

Health affairs scholar Pub Date : 2024-05-13 eCollection Date: 2024-06-01 DOI: 10.1093/haschl/qxae064

Angela Lu, Robin Z Ji, Marley P D Magee, Joseph S Ross, Reshma Ramachandran, Rita F Redberg, Sanket S Dhruva

{"title":"Funding of evidence included within public comments submitted to inform Medicare national coverage determinations.","authors":"Angela Lu, Robin Z Ji, Marley P D Magee, Joseph S Ross, Reshma Ramachandran, Rita F Redberg, Sanket S Dhruva","doi":"10.1093/haschl/qxae064","DOIUrl":"10.1093/haschl/qxae064","url":null,"abstract":"The Centers for Medicare & Medicaid Services (CMS) relies on public comments submitted in response to proposed national coverage determinations to assist the agency in determining the coverage of items and services for Medicare beneficiaries. In a cross-sectional study, we characterized the cited evidence and what funding supported the cited evidence submitted in public comments to CMS for all therapeutic medical device national coverage determinations finalized between June 2019 and June 2022. Of 681 public comments, 159 (23%) cited at least 1 identifiable published scientific journal article. Within these 159 public comments, 198 unique articles were cited, 170 (86%) of which included funding statements or author disclosures. Among these, 96 (56%) disclosed funding from manufacturers that would benefit from Medicare coverage and/or were written by author(s) who received funding from these manufacturers. In summary, most public commenters for national coverage determinations did not cite published scientific journal articles to support their positions. Among those who did, more than half of articles were directly funded by manufacturers that would benefit from coverage. Greater funding of independent, non-industry-supported research may help provide unbiased evaluations of benefits and harms to support Medicare coverage decisions.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452461","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