Health Equity & Access Weekly Roundup: March 3, 2025

To keep up with the evolving health policy changes as President Donald J. Trump's administration implements new initiatives and reverses past policies, check out The American Journal of Managed Care®'s new resource of ongoing coverage, "Health Policy in Flux: Trump Administration Updates."

Health System Policy Failures Drive Cervical Cancer Disparities in Rural South

A new report from the Southern Rural Black Women’s Initiative for Economic and Social Justice and Human Rights Watch highlights systemic failures in cervical cancer prevention and care among Black women in the Mississippi Delta, a region already burdened by extreme poverty and poor health outcomes. Despite cervical cancer being largely preventable through HPV vaccination and routine screenings, barriers such as lack of access to health care, Medicaid expansion refusal, misinformation, and structural racism have led to disproportionately high mortality rates. Interviews with experts and affected women reveal deep-rooted policy failures that perpetuate these disparities. The report calls for urgent policy reforms, including Medicaid expansion, increased rural health care funding, and enhanced outreach efforts for HPV vaccination and screenings, to eliminate preventable deaths and ensure equitable access to care.

AMA Survey Highlights Growing Burden of Prior Authorization on Physicians, Patients

The 2024 American Medical Association (AMA) prior authorization (PA) physician survey examined the impact PAs have on patient care, physician burnout, and health care costs. Of the 1000 surveyed physicians, 93% reported that PA delays care, 82% said it can lead to treatment abandonment, and 94% noted its negative impact on clinical outcomes, with nearly 30% witnessing serious adverse events. PA also increases health care costs, forcing patients to endure ineffective treatments, seek emergency care, or pay out of pocket. Physicians complete an average of 39 PAs weekly, spending 13 hours on the process, with 89% citing it as a significant contributor to burnout. Despite promises from major insurers to reduce PA burdens, little progress has been made, and concerns are growing over artificial intelligence (AI)–driven PA denials. AMA President Bruce A. Scott, MD, stated that automated PA decisions without proper oversight create additional barriers, calling for reforms that prioritize physician and patient decision-making.

Potential Spillover Effects on Traditional Medicare When Physicians Bear Medicare Advantage Risk

A new study examines the impact of Medicare Advantage risk payment arrangements on patients with traditional Medicare by comparing outcomes for traditional beneficiaries treated by physicians with high versus low exposure to Medicare Advantage risk models. The analysis found that patients with traditional Medicare treated by physicians with high Medicare Advantage risk exposure had significantly better quality and efficiency outcomes across 22 of 26 measures, including reduced hospital admissions and emergency department visits and higher medication adherence. The findings suggest that the benefits of Medicare Advantage risk payment models extend beyond patients with the plan, potentially improving overall health care efficiency and quality.

Addressing Health Care Disparities Using a Health Plan Quality Measures Index

The Health Insurance Disparities Index (HeIDI) was developed to measure disparities in health care quality between individuals with commercial/private insurance and those with Medicaid using publicly available HEDIS data. New research found a worsening of disparities from 2017 to 2022, especially during and after the COVID-19 pandemic. HeIDI provides a straightforward method for assessing health care disparities and can be used by policymakers, health plans, and state agencies to monitor trends and guide interventions, according to the study. It highlights systemic inequities, particularly affecting lower-income and minority populations.

Expanding Clinical Trial Access Amid DEI Challenges

The push for diversity in clinical trials remains crucial, especially as political shifts, including an executive order from President Trump and the FDA's removal of draft guidance on trial diversity, threaten progress. In an interview, Karen Winkfield, MD, PhD, the Ingram Professor of Cancer Research at Vanderbilt Ingram Cancer Center, professor of medicine at Meharry Medical College, and executive director of the Meharry-Vanderbilt Alliance, highlights the barriers to patient participation in clinical research, including limited trial availability and lack of physician outreach. She emphasizes the role of AI in improving trial matching and the importance of fostering a culture where trials are integral to care. Additionally, she discusses the Meharry-Vanderbilt Alliance’s efforts in building trust, educating communities, and improving access to trials, particularly for historically underserved populations.