Wide Disparities in Women’s Health and Reproductive Care
A Commonwealth Fund scorecard comparing state health system performance on women’s health and reproductive care reveals significant disparities across the U.S. In particular, the researchers find wide gaps between geographic regions and between racial and ethnic groups in deaths among women of reproductive age and in access to essential health services. The report’s findings suggest that disparities could widen, with impacts experienced most acutely by women of color and women with low income living in states with restricted access to comprehensive reproductive care.
The Affordable Care Act’s guarantee of coverage for a wide range of free preventive health services remains intact for now following a long-awaited appellate court decision in the case, Braidwood Management v. Becerra. But as George Washington University’s Sara Rosenbaum and MaryBeth Musumeci explain on To the Point, years of litigation may lie ahead, with hundreds of preventive benefits for more than 150 million privately insured Americans at stake.
In 2022, more than 2.7 million Medicare patients received a referral for home health care. Many of them likely did not receive this care, however. On To the Point, experts from KNG Health Consulting report on research showing that the home health care delivery rate for Medicare patients fell from 66 percent to 59 percent between 2016 and 2022. The researchers say COVID-19, the closure of many home health agencies, staffing shortages, and patient preferences were all factors in the decline. To ensure referrals are fulfilled, the authors say hospitals would need to consider improving their follow-up with patients and expanding use of telehealth, among other measures.
In the past 14 years, the federal government and states have tested numerous models of value-based payment for primary care. According to a 2022 survey, what percentage of primary care physicians reported receiving any value-based payments?
24 percent
35 percent
46 percent
57 percent
Scroll down to see if you got it right.
Avian Flu Outbreak Shows Importance of Public Health
The spread of avian flu is making the case for stronger local public health systems all over again. While federal officials increasingly rely on local public health and agricultural teams to conduct testing, educate workers, and build trust, local agencies are often underfunded and overwhelmed. In their new article for Health Affairs Forefront, Joshua M. Sharfstein, M.D., and Nicole Lurie, M.D., call for steady federal support for state and local public health departments, tied to clear expectations — a key recommendation of the Commonwealth Fund Commission on a National Public Health System. They also say local public health should have an elevated role in federal policymaking.
The regulation of generative artificial intelligence (GAI) devices in medical care poses unique challenges to policymakers, software developers, clinicians, and society at large. In their opinion piece for NEJM AI, former Commonwealth Fund President David Blumenthal, M.D., and Google’s Bakul Patel propose treating these tools — whose knowledge base dwarfs that of any human — more like clinicians, who must complete degree programs, pass licensing exams, and participate in continuing education. A similar system of training, testing, licensing, and supervision, the authors say, could be created for clinical GAI tools to ensure their quality and safety.
Top MA Plans Less Available in Disadvantaged Areas
Medicare Advantage plans with five-star quality ratings are less likely to be found in counties with higher poverty and unemployment, according to a new study in JAMA Network Open by the Commonwealth Fund’s Avni Gupta and colleagues. Such geographic disparities may be contributing to unequal health outcomes and limiting federal funds from reaching the regions most in need. The researchers note that Medicare policies that address area-level vulnerability in the star rating system could help promote equity.
The New York Times recently described how a mobile treatment program in the Bronx is using vans to deliver methadone to people who are addicted to opioids, including fentanyl. Transforming Care explores other promising regional approaches for engaging people who are at risk of opioid overdose.
QUIZ: Answer
The answer is C, 46 percent of PCPs reported receiving any value-based payments.
By understanding the challenges practitioners face, policymakers and payers can make value-based payments more responsive to the reality of how primary care practices operate, Ann S. O’Malley and colleagues write in a Commonwealth Fund report. The authors identify a number of solutions, such as ensuring practices receive sufficient upfront payments, investing in primary care trainees to augment the workforce, and replacing condition-specific performance metrics with ones that support access and continuity of care.
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