Health affairs scholar最新文献_第4页

State variation in staffing and characteristics of nursing homes most impacted by new federal standards. 受新联邦标准影响最大的疗养院人员配备和特点的州差异。

IF 2.7

Health affairs scholar Pub Date : 2025-08-04 eCollection Date: 2025-08-01 DOI: 10.1093/haschl/qxaf154

Robert J Skinner, Jiani Yu, Mark A Unruh, Robert Tyler Braun, Hye-Young Jung, Phyllis Johnson, Rahul Fernandez, David G Stevenson

{"title":"State variation in staffing and characteristics of nursing homes most impacted by new federal standards.","authors":"Robert J Skinner, Jiani Yu, Mark A Unruh, Robert Tyler Braun, Hye-Young Jung, Phyllis Johnson, Rahul Fernandez, David G Stevenson","doi":"10.1093/haschl/qxaf154","DOIUrl":"10.1093/haschl/qxaf154","url":null,"abstract":"Introduction: New federal minimum staffing standards aim to increase staffing in nursing homes. As the future of the new rule remains uncertain, this study compares the new standard to existing state staffing standards and examines the characteristics of nursing homes who may meet the new requirement.Methods: We utilized the 2023 CMS Payroll-Based Journal Data to calculate staffing ratios and nurse turnover. We summarized staffing levels by nursing home size, ownership type, chain affiliation, and rurality. We compared state staffing policies using data from the Medicaid and Children's Health Insurance Program (CHIP) Payment and Access Commission (MACPAC). Statistical analyses included Student's t-tests and z-tests.Results: Nursing homes in 11 states had staffing levels below the new federal minimum. Across states, compliance with the new federal requirements ranged from 31% in states with the lowest staffing requirements to 65% in states with the highest. Higher state staffing standards were associated with better quality ratings and lower turnover.Conclusion: Our paper explores state efforts toward reaching staffing goals. While higher state staffing standards correlate with better nursing home quality ratings, many homes may struggle to meet the new federal requirements.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 8","pages":"qxaf154"},"PeriodicalIF":2.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877552","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

Ambulatory care for individuals dually eligible for Medicare and Medicaid. 为有资格享受医疗保险和医疗补助的个人提供门诊护理。

IF 2.7

Health affairs scholar Pub Date : 2025-07-31 eCollection Date: 2025-08-01 DOI: 10.1093/haschl/qxaf148

Joshua M Liao, Paula Chatterjee, Yueming Zhao, Isabelle J Carroll, Danielle S Browne, Austin S Kilaru, Aidan P Crowley, David Pagnotti, Torrey Shirk, Deborah S Cousins, Amol S Navathe

{"title":"Ambulatory care for individuals dually eligible for Medicare and Medicaid.","authors":"Joshua M Liao, Paula Chatterjee, Yueming Zhao, Isabelle J Carroll, Danielle S Browne, Austin S Kilaru, Aidan P Crowley, David Pagnotti, Torrey Shirk, Deborah S Cousins, Amol S Navathe","doi":"10.1093/haschl/qxaf148","DOIUrl":"10.1093/haschl/qxaf148","url":null,"abstract":"Introduction: Individuals dually eligible for insurance through both Medicaid and Medicare (\"duals\") have more comorbidities, higher costs, and poorer outcomes compared to other groups. Unfortunately, policy and care redesign initiatives suffer from limited knowledge about ambulatory care patterns among duals.Methods: Using 2022 Medicare fee-for-service claims and other sources of clinician and geographic data, we described care patterns for ambulatory services among dual vs non-duals. Our sample consisted of 967 820 dual and 4 600 486 non-dual individuals receiving a total of 67 122 906 ambulatory services from 106 545 practices and 815 827 clinicians.Results: We found that duals received fewer ambulatory, in particular subspecialty, services than non-duals, while duals received slightly more services through primary care physicians and advanced practice professionals. Among duals, most services were provided in office rather than federally qualified health centers or rural health clinics by a disproportionally small number of geographically dispersed practices and clinicians. High-dual practices and clinicians differed from non-high dual counterparts with respect to multiple characteristics.Conclusion: These differences highlight the opportunity to improve access and outcomes among duals by targeting policy and practice changes toward certain groups and clinicians.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 8","pages":"qxaf148"},"PeriodicalIF":2.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984014","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 changing neglected tropical disease landscape in Africa: implications for policy, practice, and strengthening health systems. 非洲被忽视的热带病形势的变化：对政策、实践和加强卫生系统的影响。

IF 2.7

Health affairs scholar Pub Date : 2025-07-31 eCollection Date: 2025-07-01 DOI: 10.1093/haschl/qxaf136

Philip Downs, Andrew Tate, Danny Harvey, Margaret C Baker

引用次数: 0

Do MA plans follow incentives to attract enrollee groups with new supplemental benefits? MA计划是否遵循激励措施，以新的补充福利吸引参保团体？

IF 2.7

Health affairs scholar Pub Date : 2025-07-31 eCollection Date: 2025-09-01 DOI: 10.1093/haschl/qxaf153

Katherine M Ianni, J Michael McWilliams, Vilsa E Curto

{"title":"Do MA plans follow incentives to attract enrollee groups with new supplemental benefits?","authors":"Katherine M Ianni, J Michael McWilliams, Vilsa E Curto","doi":"10.1093/haschl/qxaf153","DOIUrl":"10.1093/haschl/qxaf153","url":null,"abstract":"Introduction: The Medicare Advantage (MA) payment system gives rise to incentives for plans to attract and retain beneficiaries from minoritized racial and ethnic groups and those dually eligible for Medicaid (duals) by offering these groups additional benefits.Methods: We examined how MA plans respond to these incentives using a 2020 policy change that granted broader flexibility in benefit design, allowing plans to offer Special Supplemental Benefits for the Chronically Ill (SSBCI).Results: We found that plans with higher shares of patients from these groups were more likely to offer SSBCI benefits: a 1 SD increase in a plan's non-White share was associated with a 20.8% point (P < .01) increase in the probability that the plan offered any SSBCI benefit. We found stronger associations in more competitive markets and for groups that can be more easily targeted with additional benefit offerings. We also found that Special Needs Plans (SNPs), which largely enroll duals, are more likely to offer SSBCI benefits than non-SNPs.Conclusion: These findings are consistent with the potential for population-based payment systems to shift resources towards underserved groups in ways that could encourage plans or providers to mitigate health care disparities; they also highlight the challenges and tradeoffs involved.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 9","pages":"qxaf153"},"PeriodicalIF":2.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002281","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

A policy roadmap for sustainable mass-testing. 可持续大规模测试的政策路线图。

IF 2.7

Health affairs scholar Pub Date : 2025-07-29 eCollection Date: 2025-08-01 DOI: 10.1093/haschl/qxaf151

Sergey N Krylov, Svetlana M Krylova, An T H Le, Seyed M Moghadas, Amin Mawani, Nima Tabatabaei, Manos Papagelis, Peter Tsasis, Mary E Wiktorowicz, R Shayna Rosenbaum

{"title":"A policy roadmap for sustainable mass-testing.","authors":"Sergey N Krylov, Svetlana M Krylova, An T H Le, Seyed M Moghadas, Amin Mawani, Nima Tabatabaei, Manos Papagelis, Peter Tsasis, Mary E Wiktorowicz, R Shayna Rosenbaum","doi":"10.1093/haschl/qxaf151","DOIUrl":"10.1093/haschl/qxaf151","url":null,"abstract":"Population-wide mass testing with affordable self-tests can drastically reduce lives lost and minimize economic and societal costs during pandemics, especially if deployed before vaccines. During COVID-19, however, the development of self-test manufacturing and distribution capacity lagged behind vaccine rollout and was dismantled once surges subsided, returning us to a prepandemic state. As no new capacity has since been secured, future mass-testing would again face costly delays. To mitigate this risk, we propose a policy roadmap for an economically viable mass-testing system that can be sustained between crises and rapidly scaled during emergencies. Public investment in R&D to improve the sensitivity of affordable self-tests-not to achieve a single benchmark, but to advance point-of-need technologies across medical and nonmedical applications-is essential. Improved sensitivity would enable new uses in routine health screening, food safety, and environmental monitoring, generating steady demand and production capacity that can expand as needed. This demand would support a robust system anchored by four mutually reinforcing pillars: scalable manufacturing, real-time data infrastructure, predictive analytics, and sustainable financing. Prioritizing sensitivity can transform mass testing from a reactive measure into a durable public health foundation.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 8","pages":"qxaf151"},"PeriodicalIF":2.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877550","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

Transportation barriers for Iowa Medicaid-enrolled adults with and without non-emergency medical transportation services. 爱荷华州参加医疗补助的成年人有或没有非紧急医疗运输服务的交通障碍。

IF 2.7

Health affairs scholar Pub Date : 2025-07-29 eCollection Date: 2025-08-01 DOI: 10.1093/haschl/qxaf142

Kandyce Larson, Brooke McInroy, Peter Damiano

{"title":"Transportation barriers for Iowa Medicaid-enrolled adults with and without non-emergency medical transportation services.","authors":"Kandyce Larson, Brooke McInroy, Peter Damiano","doi":"10.1093/haschl/qxaf142","DOIUrl":"10.1093/haschl/qxaf142","url":null,"abstract":"Introduction: State Medicaid programs must provide transportation to medical appointments through the non-emergency medical transportation (NEMT) benefit. Iowa is one of a few states not required to provide NEMT for adults in their Medicaid expansion program if not medically exempt or under age 21.Methods: Data from a 2022 survey assessed transportation barriers for 3 adult Iowa Medicaid groups (n = 2181): (1) expansion without NEMT, (2) expansion with NEMT through medical exemption/age, and (3) traditional Medicaid members. Primary outcomes were transportation-related missed health visits, unmet health care needs, unmet transportation needs, and transportation cost concerns. Logistic regression examined transportation barriers by Medicaid group and sociodemographic and health factors.Results: Recipients without NEMT reported fewer transportation barriers than recipients with NEMT. For example, 6% of expansion members without NEMT reported transportation-related missed health visits (past 6 months) vs 15% for expansion members with NEMT and 11% for traditional Medicaid members. Few Medicaid group differences remained in adjusted models. NEMT benefit impact was limited by low reported awareness and use of the benefit and higher vulnerabilities in NEMT-eligible populations.Conclusion: Adults in all Medicaid groups could benefit from transportation services, but innovation is needed to determine more effective ways to meet transportation needs.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 8","pages":"qxaf142"},"PeriodicalIF":2.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884586","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

Research and development investments for biologics independently developed by US biotechnology startups, 2017-2023. 2017-2023年美国生物技术创业公司自主研发的生物制剂研发投资。

IF 2.7

Health affairs scholar Pub Date : 2025-07-25 eCollection Date: 2025-07-01 DOI: 10.1093/haschl/qxaf139

Ilina C Odouard, So-Yeon Kang, Jessica Mo, Gerard F Anderson, G Caleb Alexander

{"title":"Research and development investments for biologics independently developed by US biotechnology startups, 2017-2023.","authors":"Ilina C Odouard, So-Yeon Kang, Jessica Mo, Gerard F Anderson, G Caleb Alexander","doi":"10.1093/haschl/qxaf139","DOIUrl":"10.1093/haschl/qxaf139","url":null,"abstract":"Introduction: Despite policy interest in pharmaceutical innovation, little is known about the investment needed for venture capital-backed startups to develop innovative biologics, a growing segment of the pharmaceutical marketplace.Methods: In a cross-sectional analysis of Food and Drug Administration (FDA) drug approval data, investment deal records, and clinical trials data, we estimated the investment needed for a biotechnology startup company to independently develop a biologic approved by the US FDA with priority review, an indicator of innovation. To isolate a homogenous set of cases, the sample focused on independent drug development of 13 drugs by 9 biotechnology startup companies that retained ownership of the drug from the start of development to FDA approval without being acquired or licensing the product.Results: We found that the median investment per FDA-approved biologic was $304.1 million (IQR: $289.9-$790.3 million) in uncapitalized costs, accounting for the cost of failures.Conclusion: This estimate represents the direct drug R&D investment needed for independent development of innovative biologic products by biotechnology startup companies.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":"3 7","pages":"qxaf139"},"PeriodicalIF":2.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736382","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

Building on health care access for children in Spanish-language settings. 为西班牙语环境中的儿童提供保健服务。

IF 2.7

Health affairs scholar Pub Date : 2025-07-24 eCollection Date: 2025-07-01 DOI: 10.1093/haschl/qxaf076

Rishika Selvakumar

引用次数: 0

Self-measured blood pressure service and device use increased among Medicaid enrollees from 2018-2022. 从2018年到2022年，医疗补助计划参保者的自我测量血压服务和设备使用有所增加。

IF 2.7

Health affairs scholar Pub Date : 2025-07-24 eCollection Date: 2025-08-01 DOI: 10.1093/haschl/qxaf143

Nathan Pauly, Jared Augenstein, Janet Williams, Kate Kirley, Emily Polk, Gregory Wozniak

引用次数: 0

Inequities in weathering California wildfires. 抵御加州野火的不公平现象。

IF 2.7

Health affairs scholar Pub Date : 2025-07-23 eCollection Date: 2025-08-01 DOI: 10.1093/haschl/qxaf147

Michelle S Wong, W Neil Steers, Donna L Washington

引用次数: 0