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Annals of Global Health 2023It is a prevalent misconception that healthcare professionals are specialists and thus can effectively manage their health. This is probably true, but given recent...
It is a prevalent misconception that healthcare professionals are specialists and thus can effectively manage their health. This is probably true, but given recent pandemics and the rise in violence in medical settings, one is compelled to question whether their health and safety are sufficient for a robust healthcare system. This is important because protecting and promoting the health, safety, and well-being of health workers will improve the quality of patient care and increase the resilience of health services in the face of outbreaks and public health emergencies. We thus strive to answer this question and suggest potential remedies to this growing public health issue.
Topics: Humans; Disease Outbreaks; Government Programs; Health Personnel; Health Workforce; Medical Assistance
PubMed: 37692379
DOI: 10.5334/aogh.4167 -
Medical Care Dec 2023Evaluation of Medicare-Medicaid integration models' effects on patient-centered outcomes and costs requires multiple data sources and validated processes for linkage and...
BACKGROUND
Evaluation of Medicare-Medicaid integration models' effects on patient-centered outcomes and costs requires multiple data sources and validated processes for linkage and reconciliation.
OBJECTIVE
To describe the opportunities and limitations of linking state-specific Medicaid and Centers for Medicare & Medicaid Services administrative claims data to measure patient-centered outcomes for North Carolina dual-eligible beneficiaries.
RESEARCH DESIGN
We developed systematic processes to (1) validate the beneficiary ID linkage using sex and date of birth in a beneficiary ID crosswalk, (2) verify dates of dual enrollment, and (3) reconcile Medicare-Medicaid claims data to support the development and use of patient-centered outcomes in linked data.
PARTICIPANTS
North Carolina Medicaid beneficiaries with full Medicaid benefits and concurrent Medicare enrollment (FBDE) between 2014 and 2017.
MEASURES
We identified need-based subgroups based on service use and eligibility program requirements. We calculated utilization and costs for Medicaid and Medicare, matched Medicaid claims to Medicare service categories where possible, and reported outcomes by the payer. Some services were covered only by Medicaid or Medicare, including Medicaid-only covered home and community-based services (HCBS).
RESULTS
Of 498,030 potential dual enrollees, we verified the linkage and FBDE eligibility of 425,664 (85.5%) beneficiaries, including 281,174 adults enrolled in Medicaid and Medicare fee-for-service. The most common need-based subgroups were intensive behavioral health service users (26.2%) and HCBS users (10.8%) for adults under age 65, and HCBS users (20.6%) and nursing home residents (12.4%) for adults age 65 and over. Medicaid funded 42% and 49% of spending for adults under 65 and adults 65 and older, respectively. Adults under 65 had greater behavioral health service utilization but less skilled nursing facility, HCBS, and home health utilization compared with adults 65 and older.
CONCLUSIONS
Linkage of Medicare-Medicaid data improves understanding of patient-centered outcomes among FBDE by combining Medicare-funded acute and ambulatory services with Medicaid-funded HCBS. Using linked Medicare-Medicaid data illustrates the diverse patient experience within FBDE beneficiaries, which is key to informing patient-centered outcomes, developing and evaluating integrated Medicare and Medicaid programs, and promoting health equity.
Topics: Adult; Humans; Aged; United States; Medicaid; Medicare; Home Care Services; Costs and Cost Analysis; Patient Outcome Assessment
PubMed: 37963032
DOI: 10.1097/MLR.0000000000001895 -
Psychiatric Services (Washington, D.C.) Jan 2024The authors aimed to analyze psychiatrists' and other physicians' acceptance of insurance and the associations between insurance acceptance and specific physician- and...
OBJECTIVE
The authors aimed to analyze psychiatrists' and other physicians' acceptance of insurance and the associations between insurance acceptance and specific physician- and practice-level characteristics.
METHODS
Using the restricted version of the National Ambulatory Medical Care Survey, January 2007-December 2016, the authors analyzed acceptance of private insurance, public insurance, and any insurance among psychiatrists compared with nonpsychiatrist physicians. Because data were considered restricted, all analyses were conducted at federal Research Data Center facilities.
RESULTS
The unweighted sample included an average of 4,725 physicians per 2-year time grouping between 2007 and 2016, with an average of 7% being psychiatrists. Nonpsychiatrists participated in all insurance networks at higher rates than did psychiatrists, and the acceptance gap was wider for public (Medicare and Medicaid) than private (noncapitated and capitated) insurance. Among psychiatrists, those practicing in metropolitan statistical areas and those in solo practices were significantly less likely than their peers in other locations and treatment settings to accept private, public, or any insurance. These findings were also observed among nonpsychiatrists, although to a lesser extent.
CONCLUSIONS
In addition to general policy interventions to improve insurance network adequacy for psychiatric care, additional measures or incentives to promote insurance network participation should be considered for psychiatrists in solo practices and those in metropolitan areas.
Topics: Aged; Humans; United States; Psychiatrists; Medicare; Psychiatry; Physicians; Medicaid
PubMed: 37424301
DOI: 10.1176/appi.ps.202100669 -
Journal of the American Board of Family... Jan 2024The Medicare Advantage Program, home to nearly half of the eligible Medicare population, has recently come under increased scrutiny. The Government Accountability Office...
The Medicare Advantage Program, home to nearly half of the eligible Medicare population, has recently come under increased scrutiny. The Government Accountability Office called on the Centers for Medicare & Medicaid Services to monitor "disenrollment of MA beneficiaries in the last year of life, validate MA-provided encounter data, and strengthen audits used to identify and recover improper payments to MA plans." The House Subcommittee on Oversight and Investigations of the Committee on Energy & Commerce, dedicated a hearing to "Protecting America's Seniors: Oversight of Private Sector Medicare Advantage Plans." In addition, a recently conducted audit of the Office of the Inspector General of the Department of Health and Human Services raised concerns over "denials of prior authorization requests" and "beneficiary access to medically necessary care." In this article we consider the backdrop for the growing scrutiny of the MA program and the implications thereof to its future trajectory.
Topics: Aged; Humans; United States; Medicare Part C
PubMed: 37857442
DOI: 10.3122/jabfm.2023.230111R1 -
Health Affairs (Project Hope) Oct 2023
Topics: Aged; Humans; United States; Medicare Part C; Health Maintenance Organizations
PubMed: 37782873
DOI: 10.1377/hlthaff.2023.00851 -
JAMA Health Forum Aug 2023
Topics: Aged; United States; Humans; Hospices; Medicare
PubMed: 37651120
DOI: 10.1001/jamahealthforum.2023.3532 -
JAMA Nov 2023
Topics: Drug Costs; Medicare; Negotiating; Prescription Drugs; Prescriptions; United States
PubMed: 37728954
DOI: 10.1001/jama.2023.19506 -
Public Health Nursing (Boston, Mass.) 2023
Topics: Medicare; Privatization; United States
PubMed: 37408331
DOI: 10.1111/phn.13222 -
American Journal of Public Health Dec 2023We investigated the adequacy of Supplemental Nutrition Assistance Program (SNAP) benefits for Indiana households. Methods included focus groups, interviews, and a...
We investigated the adequacy of Supplemental Nutrition Assistance Program (SNAP) benefits for Indiana households. Methods included focus groups, interviews, and a statewide survey of 652 households. SNAP benefit-level increases over the course of the COVID-19 pandemic increased their adequacy overall yet were still inadequate for some households. As of June 2022, Indiana households reported their SNAP benefits lasting 13 days a month. The inadequacy of SNAP benefits reveals that some participating households still experience food insecurity, which has adverse public health implications. (. 2023;113(S3):S224-S226. https://doi.org/10.2105/AJPH.2023.307408).
Topics: Humans; Indiana; Food Assistance; Pandemics; Poverty; Family Characteristics; Food Supply
PubMed: 38118080
DOI: 10.2105/AJPH.2023.307408 -
PloS One 2023As a new type of consumer subject in the market that was formerly dominated by multiple person families, single households are driving the change in the buying...
OBJECTIVE
As a new type of consumer subject in the market that was formerly dominated by multiple person families, single households are driving the change in the buying structure. Food purchase activities have undergone significant changes since the outbreak of the COVID-19. The objective of this study was to assess and compare variations in food consumption, purchase and handling during the COVID-19 pandemic between single person households (SPH) and multiple person households.
METHOD
A cross-sectional study conducted among 211 individuals in communities in Harris and Waller Counties, Texas. Sociodemographic, food purchase, food consumption and food handling activities during the COVID-19 pandemic were assessed with a validated COVID-19 Nutrition questionnaire.
RESULTS
Non-Hispanic Black participants constituted 42.6%, and 28.4% were Hispanics. Participants were made up of mostly aged 18-24 years (39.3%), 47.9% single household composition, 30.4% in full time employment, and 29.1% partook in food assistance programs. A large proportion of them had never used grocery pickup services, online grocery shopping and a farmers' market. During the COVID-19 pandemic, majority of the participants used more of large supermarkets, restaurant/fast food, and online grocery but food consumption seemed to remain the same for the majority of participants. For beverages, majority of participants consumed more water, less soda, and no alcohol. There was a significant association between single person household and higher restaurant/fast foods purchase. Many of the participants reported weight gain and less physical activity during the pandemic.
CONCLUSION
Restaurant meal purchases was more prevalent in single-person families. The results from the study have the potential to contribute to how public policy officials, food service, and health authorities forecast how different categories of consumers will react in pandemics and may be used to inform area-specific alleviation strategies to minimize the impact of the COVID-19 pandemic and future events.
Topics: Humans; Pandemics; Cross-Sectional Studies; Single Person; COVID-19; Consumer Behavior; Fast Foods; Food Supply; Food Assistance
PubMed: 38019731
DOI: 10.1371/journal.pone.0294361