Check out our new events, podcasts and articles on hospitals, equity &
care delivery
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John,
Today we released the March issue of
Health
Affairs
.
The March issue of Health Affairs covers a broad range of topics,
including hospital finances and billing, equity in clinical trials and
HIV/AIDS prevention, the effects of providing people with a
transportation benefit, and considerations in covering cancer screening.
Read The Full Issue
Hospitals
Jill Horwitz and Austin Nichols examine the relationship between
hospital ownership type and which service lines hospitals offer
.
After controlling for market and hospital characteristics, they
determine that although all types are more likely to offer a service if
it is relatively profitable, "nonprofit hospitals offer relatively
unprofitable services more than for-profit hospitals and less than
government hospitals. Profitable services typically exhibit the opposite
pattern."
Andrew Beck and coauthors compare the experiences of low-income children
referred to a medical-legal partnership at Cincinnati Children's
Hospital Medical Center with a matched cohort who were not referred and
find that those who were referred had a one-third lower rate of
hospitalization within one year.
The Furthering Access to Stroke Telemedicine (FAST) Act expanded
Medicare payment for telemedicine consultations for acute stroke, also
known as "telestroke." Andrew Wilcock and coauthors find that one
year after implementation, Medicare billing for telestroke increased in
urban and rural hospital emergency departments, but most hospitals that
could have initiated a claim never did so
-in
part, say the authors, because of the complexity of the billing process.
More On Hospitals
Equity
The Medicare Hospital Readmissions Reduction Program (HRRP) was modified
in 2019 to stratify hospitals according to the proportion of their
patients who are dual Medicare and Medicaid enrollees-a measure of
social risk.
Sukruth Shashikumar and coauthors examine the change in average annual
penalty percentage among safety-net hospitals
,
rural hospitals, and hospitals with a large share of Black and Hispanic/
Latino patients. All three groups experienced a small reduction in
penalties due to stratification, implying a "modest step toward equity
within the HRRP."
Pre-exposure prophylaxis (PrEP) is a highly effective method for
preventing HIV transmission, but its adoption among at-risk populations
has been slow.
Nina Harawa and coauthors find higher uptake rates for male than female
California Medicaid enrollees
and higher rates for White and Black men than for Hispanic men. However,
when considering HIV risk, people who are members of racial and ethnic
minority groups have lower PrEP uptake than Whites.
In 2015 the Food and Drug Administration launched a plan aimed at
improving the diversity of participants in clinical trials and the
transparency of trial results for newly approved drugs. Angela Green and
colleagues report that the initiative did not improve representation of
Black relative to White participants
,
and only 20 percent of studies reporting results after the plan went
into effect met a requirement to include race-specific reporting of
benefits and side effects.
More On Health Equity
Care Delivery
Thomas Tsai and coauthors find that about half of Affordable Care Act
Marketplace enrollees
live in counties where the health plan offering with the highest quality
rating is three stars out of five, whereas 46 percent have access to a
four or five-star-rated plan. Overall, there are no disparities in
access to high-rated plans in counties with a higher percentage of Black
or Hispanic residents.
Hector Rodriguez and coauthors find that physician practices with robust
capabilities
across domains of technology, management, and patient-centered focus
have lower total spending on Medicare fee-for-service beneficiaries
compared to practices with more limited capabilities, with savings
concentrated in outpatient spending.
Although Medicaid has provided a nonemergency medical transportation
benefit for decades, health plans have begun to offer the benefit more
recently.
Seth Berkowitz and coauthors find that participation in such a benefit
in a Medicare accountable care organization is associated with 9.2 more
outpatient visits and $4,420 in additional outpatient costs per person
per year, with no reductions in emergency department visits or inpatient
admissions. Program users express high satisfaction, an easing of
financial and personal burdens, and feelings of increased safety and
empowerment.
Analyzing referrals of hospitalized patients with opioid use disorder
(OUD) from a Boston, Massachusetts, safety-net hospital to post-acute
care, Simeon Kimmel and coauthors determine that more than eight in ten
are rejected
.
"Referrals associated with OUD had more than double the odds of
rejection compared with referrals not associated with an OUD diagnosis
when adjusting for clinical and demographic confounders," they
conclude.
New multicancer early detection tests can screen for up to fifty cancers
simultaneously, based on a simple blood draw. Patricia Deverka and
colleagues argue in their Policy Insight piece for clarifying how payers
evaluate the tests' clinical validity, utility, and economic value
.
They also highlight the importance of systematic collection of
real-world evidence.
Read The March Issue
Subscribe today to Health Affairs to access our current and past issues
.
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Attend This Event
Join Health Affairs for a free virtual event
!
In addition to the new journal edition, we produce a variety of events
that relate to our research and bring health policy professionals up to
speed on the latest in health policy research.
On March 22, join Seth Berkowitz from the University of North Carolina
School of Medicine for a detailed discussion of his paper's data
, methods, and
conclusions. Health Affairs Senior Editor Kathleen Haddad will host.
On March 28, join a Policy Spotlight event
with HRSA Administrator
Carole Johnson. On March 30, we are hosting a Lunch and Learn
on population health and
health spending.
View Full Event Schedule
Listen to These Podcasts
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Listen to our new podcast series, Health Affairs Pathways
.
Health Affairs Pathways explores the avenues and alleyways of the health
care system through a variety of storytelling - from investigative
journalism and health policy explainers to long-form interviews.
Unique series are created by fellows in the Health Affairs Podcast
Fellowship Program, designed to support early to mid-stage professionals
pursue an audio project, tell a unique health care story, and highlight
voices that might not be heard otherwise.
The first season from Lalita Abhyankar, a physician and storyteller
based in San Francisco, examined how consolidation in health care is
affecting independent primary care.
The second season - titled "While We Wait" - joins Avni Kulkarni and
Sania Ali as they examine mental health boarding and its inefficiencies.
The second season will debut on March 9, 2022.
On A Health Podyssey, Alan Weil will interview Seth Berkowitz, Jill
Horwitz, Hector Rodriguez, and Kathryn Phillips on upcoming episodes
about their research in the March issue. Listen to the latest episode,
where Melanie Sabado-Liwag discusses the ongoing impact of colonialism
and racism on the health inequities faced by Filipino Americans
.
Listen
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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 . Â
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
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