- Center on Health Equity & Access
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Authors
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Telehealth Insights From an Integrated Care SystemExperiences from a large, integrated, value-based health system suggest that telehealth can be an effective care delivery approach. Public policies can improve telehealth access and care.
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Implementing Multistate Behavioral Health Pay-for-Performance Initiatives in Medicaid Managed CareThe authors describe a pay-for-performance initiative targeting behavioral health providers, which was introduced by a large Medicaid managed care organization across multiple states.
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Humira: The First $20 Billion DrugThe authors review a House Oversight Committee investigation report on AbbVie’s practices pertaining to adalimumab (Humira) to shed light on broader pharmaceutical market dynamics hindering a competitive market.
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In Evaluating Rheumatoid Arthritis Treatments, Involving Patients Is KeyStacy Courtnay is the community network chair for the Arthritis Foundation in Atlanta highlights a report that discusses how understanding patient experiences in RA can shift questions researchers ask.
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Patient Perspectives on Technology-Based Approaches to Social Needs ScreeningPatients are essential stakeholders in designing systems to capture social needs. The authors present key findings from patient interviews regarding social needs screening through technology-based modalities.
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Budget Impact Analysis of Biosimilar Natalizumab in the USProjected savings from biosimilar natalizumab were $452,611 over 3 years, driven by decreased drug acquisition costs and a utilization shift from reference to biosimilar natalizumab.
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Primary Care Visit Cadence and Hospital Admissions in High-Risk PatientsPatients with congestive heart failure and/or chronic obstructive pulmonary disease who had more quarterly primary care visits had lower rates of hospitalizations during the COVID-19 pandemic.
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Clinicians Should Be Able to Rely on Coverage for Category 2B Treatments: Eric Lander, MDEric Lander, MD, discussed the difficulty that clinicians and pharmacists face in getting insurance coverage for category 2B treatments in the National Comprehensive Cancer Network guidelines, which could affect how patients are treated for cancer.
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How Medicare Advantage Plans Use Data for Supplemental Benefits Decision-MakingThis article presents findings from interviews conducted with executives from 29 Medicare Advantage plans regarding plan decision-making processes related to new social risk factor–related benefits.
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Final Words: Aligning Innovation, Guidelines, and AccessPanelists expressed cautious optimism about high-risk acute myeloid leukemia (AML) treatment, emphasizing the need for ongoing research, personalized therapy based on molecular profiling, and strengthened collaboration between community and academic centers to improve patient outcomes, while recognizing that education and sharing best practices are key to advancing targeted therapies and achieving long-term cures.
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Medicare Payment Rule Threatens Access to Life-Sustaining Kidney CareThe authors call on Congress to reform Medicare reimbursement for dialysis, saying the recent rule puts clinics at risk of closure.
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Social Determinants of Health: Are Colonoscopies Always Fit for Duty?Social determinants of health are associated with colonoscopy noncompletion in a Medicaid patient population at the Providence Community Health Centers.
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HIVconsvX Vaccine Shows Safety, Immune Response in People on ARTThis research on a T-cell–targeting vaccine in HIV has implications for future study design to incorporate consideration of age and years on antiretroviral therapy (ART) to evaluate the level of immune reconstitution.
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Therapists’ Perspectives on Access to Telemental Health Among Medicaid-Enrolled YouthThis qualitative study elucidates therapists’ perspectives on barriers to and facilitators of access to telemental health among Medicaid-enrolled youth served by a large safety-net organization.
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Impact of Payment Models on Medical Specialist Physician Practice PatternsThis article explores the impact of payment models (fee for service vs salary based) on practice patterns, including wait times and care for patients with chronic diseases.
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Community Health Workers’ Critical Role in Trust Building Between the Medical System and Communities of ColorThe authors interrogate elements of routine medical practice in New York City to argue for reforms of hospital culture through relational trust-building capabilities of community health workers.
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Final Panel Thoughts on Uncomplicated UTI ManagementPanelists discuss how the management of uncomplicated urinary tract infections (UTIs) is evolving, with promising new therapies that address antibiotic resistance concerns, while emphasizing the continued importance of antimicrobial stewardship, personalized treatment approaches, preventive strategies, and comprehensive patient education to reduce recurrence rates and improve outcomes in this common but burdensome condition.
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Increased Likelihood of Psychiatric Readmission With Medicaid Expansion vs Legacy CoverageIndividuals who became eligible for Medicaid through Medicaid expansion have an increased likelihood of psychiatric readmission compared with their legacy-enrolled counterparts.
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Coverage With Evidence Development Study Shows Benefits in Patients With Migraine Treated With Remote Electrical NeuromodulationA coverage with evidence development (CED) study demonstrated significant and clinically meaningful benefits in patients with migraine treated with remote electrical neuromodulation (REN). Health plans should support clinicians’ REN prescriptions by ensuring adequate coverage.
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Service Line Care Delivery Model for COVID-19 Patient-Centric CareThe authors provide steps hospitals can take to align their care delivery model to effectively meet the demands of a public health crisis such as the current pandemic.
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Scaling Care Coordination Through Digital Engagement: Stepped-Wedge Trial Assessing ReadmissionsThis evaluation looks at a postdischarge digital engagement (PDDE) program using causal inference methods to examine the impact of PDDE on readmission.
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Type 2 Diabetes Patient Activation and mHealth Interventions Decreased Cardiovascular Disease RiskMobile health (mHealth) and a patient activation program could serve as a model for improving health outcomes for patients in outpatient clinical settings by decreasing atherosclerotic cardiovascular disease risk score.
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Advanced Care at Home at Scale in an Integrated Health Care SystemAdvanced care at home (otherwise known as hospital at home) can be scaled and provide care for a sizable portion of a hospital’s inpatient census, creating hospital capacity in an integrated delivery system.
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Pharmacist-Led Review of Empagliflozin and Ertugliflozin Following Formulary UpdateManagement of empagliflozin and ertugliflozin may be suboptimal following an insurance carrier’s formulary updates. Pharmacists may improve the management.
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High-Intensity Home-Based Rehabilitation in a Medicare Accountable Care OrganizationHigh-intensity home-based rehabilitation (HIHR) may substitute for facility-based postacute rehabilitation. Patients in HIHR had better functional outcomes at lower costs than patients in facility-based care.
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Responsibility for Treating Tobacco Dependence in Health Clinics Serving Medicaid EnrolleesThis article describes the implementation of Medicaid smoking cessation guidance in a large, urban federally qualified health center to examine how state-level provisions translated into clinic-level policies.
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How Fitusiran Changes the Treatment Landscape in Hemophilia: Guy Young, MDATLAS trial investigator Guy Young, MD, Children's Hospital Los Angeles and University of Southern California Keck School of Medicine, highlights the current treatment options for patients with hemophilia A or B, with or without inhibitors, since the FDA approval of fitusiran (Qfitlia; Sanofi).
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Patient and Supporter Factors Affecting Engagement With Diabetes TelehealthFamily support with medication management and recent urgent self-management concerns are 2 novel factors, among others, that predict completion of diabetes telehealth calls.
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Health Outcomes Under Full-Risk Medicare Advantage vs Traditional MedicarePhysician groups under 2-sided risk–based Medicare Advantage provide care associated with higher quality and efficiency compared with care by these same groups under fee-for-service Medicare.
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Accountable Care Organizations and Use of Surgery Among Patients With Alzheimer Disease and Related DementiasThe decision to pursue surgery in patients with Alzheimer disease and related dementias is challenging. Accountable care organizations may influence decisions to pursue surgery in this population.
