Health affairs scholar最新文献_第5页

Disparities in Telemedicine Use among Native Hawaiian and Pacific Islander Individuals Insured through Medicaid 通过医疗补助计划获得保险的夏威夷原住民和太平洋岛民在远程医疗使用方面的差异

Health affairs scholar Pub Date : 2024-05-03 DOI: 10.1093/haschl/qxae057

Anna M. Morenz, Ashok Reddy, Amy Hsu, Anh Le, Edwin S. Wong, Joshua M. Liao

{"title":"Disparities in Telemedicine Use among Native Hawaiian and Pacific Islander Individuals Insured through Medicaid","authors":"Anna M. Morenz, Ashok Reddy, Amy Hsu, Anh Le, Edwin S. Wong, Joshua M. Liao","doi":"10.1093/haschl/qxae057","DOIUrl":"https://doi.org/10.1093/haschl/qxae057","url":null,"abstract":"\u0000 States have implemented policy changes to increase access to telemedicine services for individuals receiving Medicaid benefits. Native Hawaiian and Pacific Islander (NHPI) individuals suffered disproportionate harms from COVID-19 and have long experienced disparities in health care access compared to other racial and ethnic groups, making the issue of telemedicine access particularly salient for NHPI individuals on Medicaid. Utilizing 100% 2020-2021 Medicaid claims, we compared trends in telemedicine use between NHPI and non-Hispanic White individuals on Medicaid in Washington State and conducted a decomposition analysis to identify drivers of underlying disparities. In both years, NHPI individuals were 38-39% less likely to use any telemedicine than White individuals after adjusting for patient- and area-level characteristics. Decomposition analysis revealed that most of this difference was due to differential effects of characteristics, rather than group differences in characteristics. Namely, several characteristics that were associated with increased telemedicine use had more muted associations for NHPI versus White individuals, such as English as primary spoken language and female sex. These findings suggest the presence of limited acceptability of or group-specific barriers to telemedicine for NHPI individuals, including potential discrimination in being offered telemedicine visits. These issues should be understood and mitigated through close collaboration between health care leaders and NHPI communities.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141016463","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

Use of artificial intelligence and the future of peer review. 人工智能的使用与同行评审的未来。

Health affairs scholar Pub Date : 2024-05-03 eCollection Date: 2024-05-01 DOI: 10.1093/haschl/qxae058

Howard Bauchner, Frederick P Rivara

引用次数: 0

Balancing innovation and affordability in anti-obesity medications: the role of an alternative weight-maintenance program. 平衡抗肥胖药物的创新性和可负担性：替代性体重维持计划的作用。

Health affairs scholar Pub Date : 2024-05-02 eCollection Date: 2024-06-01 DOI: 10.1093/haschl/qxae055

David D Kim, Jennifer H Hwang, A Mark Fendrick

{"title":"Balancing innovation and affordability in anti-obesity medications: the role of an alternative weight-maintenance program.","authors":"David D Kim, Jennifer H Hwang, A Mark Fendrick","doi":"10.1093/haschl/qxae055","DOIUrl":"10.1093/haschl/qxae055","url":null,"abstract":"Despite remarkable clinical advances in highly effective anti-obesity medications, their high price and potential budget impact pose a major challenge in balancing equitable access and affordability. While most attention has been focused on the amount of weight loss achieved, less consideration has been paid to interventions to sustain weight loss after an individual stops losing weight. Using a policy simulation model, we quantified the impact of a weight-maintenance program following the weight-loss plateau from the initial full-dose glucagon-like peptide 1 (GLP-1) receptor agonists or incretin mimetic use. We measured long-term health care savings and the loss of some health benefits (eg, maintenance of weight loss, improvements in cardiometabolic risk factors, and reductions in diabetes and cardiovascular events). Our model suggested that, compared with continuous long-term full-dose GLP-1 receptor agonists or incretin mimetic drugs, the alternative weight-maintenance program would generate slightly fewer clinical benefits while generating substantial savings in lifetime health care spending. Using less expensive and potentially less effective alternative weight-maintenance programs may provide additional headroom to expand access to anti-obesity medications during the active weight-loss phase without increasing total health care spending.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11138958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201581","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

Automating benefits delivery: lowering health insurance costs for unemployment insurance recipients. 福利发放自动化：降低失业保险领取者的医疗保险成本。

Health affairs scholar Pub Date : 2024-05-02 eCollection Date: 2024-05-01 DOI: 10.1093/haschl/qxae054

Langou Lian, Marina Lovchikova, Andrew Feher

引用次数: 0

Health and political economy: building a new common sense in the United States 健康与政治经济学：在美国建立新的常识

Health affairs scholar Pub Date : 2024-05-01 DOI: 10.1093/haschl/qxae041

Victor Roy, Darrick Hamilton, Dave A Chokshi

{"title":"Health and political economy: building a new common sense in the United States","authors":"Victor Roy, Darrick Hamilton, Dave A Chokshi","doi":"10.1093/haschl/qxae041","DOIUrl":"https://doi.org/10.1093/haschl/qxae041","url":null,"abstract":"Abstract The prevailing economic paradigm, characterized by free market thinking and individualistic cultural narratives, has deeply influenced contemporary society in recent decades, including health in the United States. This paradigm, far from being natural, is iteratively intertwined with politics, social group stratification, and norms, together shaping what is known as political economy. The consequences are starkly evident in health, with millions of lives prematurely lost annually in the United States. Drawing on economic re-thinking happening in fields like climate and law, we argue for a new “common sense” towards a health-focused political economy. Central to this proposed shift is action in 3 interconnected areas: capital, care, and culture. Re-orienting capital to prioritize longer-term investments, such as in public options for health care and baby bonds, can promote health and affirmatively include historically marginalized groups. Recognizing that caregiving is economically valuable and necessary for health, approaches like local cadres of community health workers across the United States would be part of building robust caregiving infrastructures. Advancing momentum in these directions, in turn, will require displacing dominant cultural narratives. As the health arena pursues change in the face of real obstacles, recent efforts reinvigorating industrial policy and addressing concentrated market power can serve as inspiration.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141041798","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

Use of artificial intelligence and the future of peer review 人工智能的使用与同行评审的未来

Health affairs scholar Pub Date : 2024-05-01 DOI: 10.1093/haschl/qxae058

Howard Bauchner, F. Rivara

引用次数: 0

Automating benefits delivery: lowering health insurance costs for unemployment insurance recipients 福利发放自动化：降低失业保险领取者的医疗保险成本

Health affairs scholar Pub Date : 2024-05-01 DOI: 10.1093/haschl/qxae054

Langou Lian, Marina Lovchikova, Andrew Feher

引用次数: 0

The business case for quality: estimating lives saved and harms avoided in a value-based purchasing model. 质量的商业案例：在基于价值的采购模式中估算挽救的生命和避免的伤害。

Health affairs scholar Pub Date : 2024-04-30 eCollection Date: 2024-05-01 DOI: 10.1093/haschl/qxae052

Peter Amico, Elizabeth E Drye, Peter Lee, Carolee Lantigua, Dana Gelb Safran

{"title":"The business case for quality: estimating lives saved and harms avoided in a value-based purchasing model.","authors":"Peter Amico, Elizabeth E Drye, Peter Lee, Carolee Lantigua, Dana Gelb Safran","doi":"10.1093/haschl/qxae052","DOIUrl":"https://doi.org/10.1093/haschl/qxae052","url":null,"abstract":"Ever-increasing concern about the cost and burden of quality measurement and reporting raises the question: How much do patients benefit from provider arrangements that incentivize performance improvements? We used national performance data to estimate the benefits in terms of lives saved and harms avoided if US health plans improved performance on 2 widely used quality measures: blood pressure control and colorectal cancer screening. We modeled potential results both in California Marketplace plans, where a value-based purchasing initiative incentivizes improvement, and for the US population across 4 market segments (Medicare, Medicaid, Marketplace, commercial). The results indicate that if the lower-performing health plans improve to 66th percentile benchmark scores, it would decrease annual hypertension and colorectal cancer deaths by approximately 7% and 2%, respectively. These analyses highlight the value of assessing performance accountability initiatives for their potential lives saved and harms avoided, as well as their costs and efforts.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961361","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

Paving the path for implementation of clinical genomic sequencing globally: Are we ready? 为在全球范围内实施临床基因组测序铺平道路：我们准备好了吗？

Health affairs scholar Pub Date : 2024-04-29 eCollection Date: 2024-05-01 DOI: 10.1093/haschl/qxae053

Deborah A Marshall, Nicolle Hua, James Buchanan, Kurt D Christensen, Geert W J Frederix, Ilias Goranitis, Maarten Ijzerman, Jeroen P Jansen, Tara A Lavelle, Dean A Regier, Hadley S Smith, Wendy J Ungar, Deirdre Weymann, Sarah Wordsworth, Kathryn A Phillips

{"title":"Paving the path for implementation of clinical genomic sequencing globally: Are we ready?","authors":"Deborah A Marshall, Nicolle Hua, James Buchanan, Kurt D Christensen, Geert W J Frederix, Ilias Goranitis, Maarten Ijzerman, Jeroen P Jansen, Tara A Lavelle, Dean A Regier, Hadley S Smith, Wendy J Ungar, Deirdre Weymann, Sarah Wordsworth, Kathryn A Phillips","doi":"10.1093/haschl/qxae053","DOIUrl":"10.1093/haschl/qxae053","url":null,"abstract":"Despite the emerging evidence in recent years, successful implementation of clinical genomic sequencing (CGS) remains limited and is challenged by a range of barriers. These include a lack of standardized practices, limited economic assessments for specific indications, limited meaningful patient engagement in health policy decision-making, and the associated costs and resource demand for implementation. Although CGS is gradually becoming more available and accessible worldwide, large variations and disparities remain, and reflections on the lessons learned for successful implementation are sparse. In this commentary, members of the Global Economics and Evaluation of Clinical Genomics Sequencing Working Group (GEECS) describe the global landscape of CGS in the context of health economics and policy and propose evidence-based solutions to address existing and future barriers to CGS implementation. The topics discussed are reflected as two overarching themes: (1) system readiness for CGS and (2) evidence, assessments, and approval processes. These themes highlight the need for health economics, public health, and infrastructure and operational considerations; a robust patient- and family-centered evidence base on CGS outcomes; and a comprehensive, collaborative, interdisciplinary approach.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11115369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088221","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

Medicaid spending and utilization of gene and RNA therapies for rare inherited conditions. 医疗补助支出以及罕见遗传性疾病基因和 RNA 疗法的使用情况。

Health affairs scholar Pub Date : 2024-04-26 eCollection Date: 2024-05-01 DOI: 10.1093/haschl/qxae051

Ilina C Odouard, Jeromie Ballreich, Mariana P Socal

{"title":"Medicaid spending and utilization of gene and RNA therapies for rare inherited conditions.","authors":"Ilina C Odouard, Jeromie Ballreich, Mariana P Socal","doi":"10.1093/haschl/qxae051","DOIUrl":"10.1093/haschl/qxae051","url":null,"abstract":"Gene and RNA therapies are promising treatments for many rare diseases. Pediatric populations that could benefit from these drugs are overrepresented among state Medicaid programs. Using Medicaid State Drug Utilization Data, we examined Medicaid spending and utilization of rare disease gene and RNA therapies. Between 2017 and 2022, the number of available gene and RNA therapies increased from 3 to 13, yearly Medicaid spending increased from $148.3 million to $879.7 million, and the number of yearly treatments (a proxy for number of patients) increased from 327 to 1638. Nearly all spending was attributed to spinal muscular atrophy (SMA) and Duchenne muscular dystrophy drugs. States participating in Medicaid pooled purchasing initiatives had 39% higher treatments per 100 000 enrollees with no differences in spending. Compared to states without a carve-out, states that carved SMA drugs out of managed Medicaid contracts had higher utilization (54%). Spending among carve-out states varied according to managed care enrollment, being higher for those with <80% of enrollees in managed care as compared with those with ≥80% of enrollees in managed care. This suggests that multi-state purchasing initiatives and managed care carve-outs can help increase access to gene and RNA therapies among Medicaid beneficiaries, but it is unclear if these strategies are effective at managing spending.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11104525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072474","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