Articles focus on hospitals, workforce, equity & more
 ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

Problems viewing this email?

View Message In Browser

Health policy research, commentary, and analysis

John,

Today, we released the December issue of Health Affairs.

In this newsletter, I wanted to share and highlight some of the major
findings from this month's research articles.

This month's journal covers topics ranging from hospitals and the health
care workforce to health equity, pharmaceutical pricing, Medicare,
Medicaid, and more.

Read The Full Issue

Hospitals

Amid growing attention on hospitals suing their patients for unpaid
bills, Zack Cooper and coauthors find that the number of lawsuits
increased by 37 percent in Wisconsin from 2001 to 2018
.
There were 1.86 lawsuits per 1,000 Black residents compared to 1.32 per
1,000 non-Hispanic White residents, with higher rates of lawsuits by
nonprofit hospitals and in less densely populated counties.

Examining the state role in antitrust enforcement, Brent Fulton and
coauthors conclude that "relatively few proposed hospital mergers were
challenged under antitrust laws or administrative merger review
processes in the last ten years
,
despite over 90 percent of MSAs [metropolitan statistical areas] having
a highly concentrated hospital market."

Medicaid expansion has been found to improve hospital finances overall,
but critical access hospitals face particular challenges and generally
have low operating margins. Paula Chatterjee and coauthors report that
these hospitals in Medicaid expansion states did not have statistically
significant postexpansion increases in operating margins
,
staffing levels, or quality measures relative to hospitals in
nonexpansion states.

Workforce

Analyzing data from over 80,000 full-time physicians, Christopher Whaley
and coauthors find that male physicians earn approximately $2 million,
or 25 percent, more than female physicians

over the course of a simulated forty-year career. These results account
for potentially confounding factors including hours worked, practice
type and location, and years of experience.

In a separate paper, Whaley and coauthors explored physician
compensation in the context of rapid growth in health system acquisition
of physician practices. Vertical integration is associated with a 0.8
percent reduction in regression-adjusted income among physicians overall
.
Surgical specialists saw small increases in income, while nonsurgical
specialists had small declines.

Direct care workers in long-term care, including personal care aides and
nursing assistants, make up one-fifth of the US health care workforce.
According to Esther Friedman and colleagues, almost all states
experienced an increase in the size of their home care workforce between
2009 and 2020
,
and most saw a decrease in their nursing home workforce, relative to the
number of people who need these services.

Read The Full Issue

Equity

In the early weeks of COVID-19 vaccine availability, one-quarter of
Florida's doses were distributed through pharmacies at Publix grocery
stores. Jennifer Attonito and coauthors find that these stores tend to
be located in areas with an older, higher-income, and larger share White
resident population
.
In addition: "Percentage of households at or below poverty and
percentage of the population identifying as Hispanic were negatively
associated with total number of vaccination sites."

Kayte Spector-Bagdady and coauthors explore the reasons for racial and
ethnic disparities in research biospecimen and data bank recruitment and
enrollment at a major academic medical center, Michigan Medicine. Not
only are patients eligible to enroll more likely to be older, White, and
male and live in socioeconomically advantaged neighborhoods

than the overall population served by the hospital, but, also, "Black
or African American and Asian patients were almost twice as likely to
decline enrollment compared with [non-Hispanic] White patients."

Kevin Nguyen and coauthors examine rates of kidney failure among US
adults. While kidney failure rates declined overall, disparities between
low-poverty and high-poverty counties widened between 2000 and 2017
.
High-poverty counties-those with about one-quarter of the population
living below the federal poverty level-saw an increase in kidney
failure rates of 7.8 percent.

Medicare & Medicaid

Michael Chernew and coauthors find a growing gap between claims-based
and survey-based measures of health status among accountable care
organization (ACO) enrollees
,
suggesting that coding practices are behind rising risk scores.

Adam Markovitz and colleagues examine nine measures used to provide
substantial financial bonuses to higher-quality Medicare Advantage (MA)
plans
.
Comparing MA enrollees with a commercially insured population before and
after the bonus program was implemented, they conclude that the program
"was not associated with consistent changes in quality performance,
with post-period quality performance increasing for some measures,
decreasing for others, and remaining relatively flat for overall quality
performance."

Asset tests are imposed by states to limit Medicaid coverage to people
who lack resources to pay for care. Noelle Cornelio and coauthors
estimate how four possible changes to asset tests

would affect the number of low-income seniors living in the community
who would qualify for full Medicaid benefits.

Read The Full Issue

 

[link removed]

Advertisement

Get the most out of your subscription today by checking out the current
and past issues
.

Attend these Events

Join Health Affairs for a free virtual event
! In addition to the new
journal edition, we produce a variety of events that relate to research
published in Health Affairs and bring professionals up to speed on the
latest in health policy research.

On December 9, meet author Kevin Nguyen during a special Journal Club
session where he'll
discuss his research article "Despite National Declines In Kidney
Failure Incidence, Disparities Widened Between Low- And High-Poverty US
Counties
"
from the December issue.

On December 15, join Health Affairs Executive Publisher Jane
Hiebert-White as she leads a Professional Development session
on measuring the impact
of your research in academia, the media, and beyond.

Visit The Full Events Schedule

Listen to this Podcast

[link removed]

Alongside the issue release, we invite authors from the issue to speak
with Editor-in-Chief Alan Weil on our A Health Podyssey podcast, which
features interviews with leading and up-and-coming researchers in health
services and health policy.

Don't miss the latest episodes, where Ashish Jha discusses health care
payment reform

and Sabrina Poon breaks down the controversial two-midnight rule and its
effects on hospital admissions
.

A new episode with Jennifer Attonito discussing her research published
in the December issue on the sociodemographic disparities in access to
COVID-19 vaccines upon initial rollout in Florida
will
go live tomorrow morning.

See All Podcasts

Read The Full December Issue

 

[link removed]

[link removed]

 

[link removed]

 

[link removed]

 

[link removed]

 

mailto:[email protected]

About Health Affairs

Health Affairs is the leading peer-reviewed journal
at the intersection of health,
health care, and policy. Published monthly by Project HOPE, the journal
is available in print and online. Late-breaking content is also found
through healthaffairs.org , Health Affairs Today
, and Health Affairs Sunday
Update .  

Project HOPE is a global health and
humanitarian relief organization that places power in the hands of local
health care workers to save lives across the globe. Project HOPE has
published Health Affairs since 1981.

Copyright © Project HOPE: The People-to-People Health Foundation, Inc.

Health Affairs, 1220 19th Street, NW, Suite 800, Washington, DC 20036, United States

Privacy Policy

To unsubscribe from this email, click here
.
_________________

Sent to [email protected]

Unsubscribe:
[link removed]

Health Affairs, 1220 19th Street, NW, Suite 800, Washington, DC 20036, United States