Health affairs scholar最新文献_第6页

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

Financial Assistance and Payment Plans for Underinsured Patients Shopping for “Shoppable” Hospital Services 为医保不足的患者提供经济援助和付款计划购买 "可购物 "的医院服务

Health affairs scholar Pub Date : 2024-05-10 DOI: 10.1093/haschl/qxae062

Samantha Randall, Josephine Rohrer, Nicholas Wong, Nina Linh Nguyen, Erin E Trish, Erin L. Duffy

{"title":"Financial Assistance and Payment Plans for Underinsured Patients Shopping for “Shoppable” Hospital Services","authors":"Samantha Randall, Josephine Rohrer, Nicholas Wong, Nina Linh Nguyen, Erin E Trish, Erin L. Duffy","doi":"10.1093/haschl/qxae062","DOIUrl":"https://doi.org/10.1093/haschl/qxae062","url":null,"abstract":"\u0000 Recent price transparency laws are designed to better inform patients as they compare hospital options and “shop” for healthcare services. In addition to prices, underinsured patients seeking care need information on financial assistance, discounts, payment plans, and upfront payment requirements to compare the affordability of care across hospitals. Little is known about the availability of this information and the experience of prospective patients seeking it. We contacted a random sample of 10% of general short-term hospitals across the U.S. in this “secret-shopper” telephone study to assess financial options and navigation challenges faced by underinsured patients in need of a non-emergency procedure. The administrative friction was substantial. Most hospitals have three siloed offices for (1) financial assistance, (2) payment plans and discounts, and (3) upfront payment requirements. All relevant offices were unreachable in three attempted calls at 18.1% of hospitals. Among hospitals with available information, the majority have financial options for patients: 86.7% of hospitals offer financial assistance and 97.0% of hospitals offer payment plans to underinsured patients for non-emergency care. The length and terms of payments plans varied widely for hospital-administered and third-party financing arrangements. Upfront payments were sometimes required, potentially posing barriers for patients without cash or credit access.","PeriodicalId":94025,"journal":{"name":"Health affairs scholar","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994086","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

Among Medicare Beneficiaries, ACA Coverage Expansions Reduced Utilization of Ambulatory Care, Particularly among Duals 在医疗保险受益人中，《美国医疗保险法》覆盖范围的扩大减少了门诊护理的使用，尤其是在双职工中

Health affairs scholar Pub Date : 2024-05-08 DOI: 10.1093/haschl/qxae059

Chapin White, Noelia Duchovny, Rebecca Sachs, Josh Varcie

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 : 2024-05-06 eCollection 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":"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":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11071682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961358","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

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