Featured Post
February 26, 2020
Last week LDI hosted a day-long conference on Medicare for All & Beyond. Our goal was to participate in one of today’s most pressing conversations in health care—how to expand health insurance to the 28 million people in the United States who are currently uninsured. We welcomed close to 300 people from across the spectrum to participate in this conversation, to consider the critical questions underlying today’s debate, and to look in depth at the challenges we face in expanding insurance coverage in our country. The conference gave us all plenty to mull over.
[cross-posted from CHOP PolicyLab]
Community benefit spending by our nation’s nonprofit hospitals has always been a hot-button issue. To qualify for nonprofit status, health care systems are required to report annually to the Internal Revenue Service how they direct resources towards the community. And the results, for years, have been underwhelming.
In the midst of the COVID-19 epidemic, many people may not have seen our new JAMA Network Open study published last month, which further illustrates this evolving story. The pandemic also provides us an opportunity to examine the issue of community benefit spending through a new lens.
July 2, 2020
As the country looks to reopen and epidemiologists anticipate future waves of coronavirus (COVID-19) cases, we must address an equally important “pandemic:” the virus’ far-reaching mental health and trauma-related consequences. Whether balancing activities of essential work with exposure risk, bearing witness to suffering or loss, or feeling anguish or guilt for not “doing more” during this time, our society is facing great adversity with potentially devastating consequences. Evidence-based frameworks exist to guide our individual and collective response and prevent the pandemic’s trauma-related effects. What does a trauma-informed framework tell us about how to respond to this mounting crisis to mitigate the aftershocks from the pandemic?
July 1, 2020
[cross-posted from Health Affairs]
In the span of mere weeks, the novel coronavirus (COVID-19) has upended modern life. Schools and businesses across the country have been shuttered, and the global economy faces the worst downturn since the Great Depression. While the pandemic itself is unprecedented, the situation is particularly alarming given the absence of virtually any therapeutics or vaccines that can treat or prevent COVID-19. Pharmaceutical companies large and small have rapidly expanded research efforts over the past weeks, and there are now more than 70 COVID-19 drug and vaccine trials registered with the Food and Drug Administration (FDA).
June 30, 2020
[cross-posted from Annenberg]
While effective vaccines to control the current pandemic are likely at least a year away, public health officials believe the time to build confidence in those vaccines is now. A new report from the Sabin-Aspen Vaccine Science & Policy Group presents an in-depth analysis into the root causes of vaccine hesitancy and actionable steps to address it. Author of How Behavior Spreads and an expert in network science, Professor Damon Centola contributed an essay, entitled "The Complex Contagion of Doubt in the Anti-Vaccine Movement," to the report. He recently answered a few questions about the anti-vaccination movement and how to curb it.
June 29, 2020
In the longest and largest study to date, hospital participation in Medicare’s bundled payments program for four medical conditions was associated with a 1-2% savings over three years, with no change in mortality. The savings were primarily achieved through reduced spending on skilled nursing care and greater spending on home health in the 90 days after hospital admission for acute myocardial infarction, congestive heart failure, chronic obstructive pulmonary disease, or pneumonia.
June 17, 2020
In October 2018, the Centers for Medicare & Medicaid Services (CMS) launched the Bundled Payments for Care Improvement Advanced (BPCI Advanced) program to continue expanding bundled payments nationwide. Participating hospitals and physician group practices are eligible for financial incentives if they meet quality and cost benchmarks for 90-day episodes beginning with either a hospital admission or an outpatient procedure. In a previous post and article, we described the 832 hospitals that began participating in October 2018.
June 12, 2020
[cross-posted from Health Affairs]
Americans are dying at startling rates, not only of COVID-19 but of all its reverberating effects. To save US lives, we will need to solve not one problem but four. First, we need to reduce community spread of the virus; contact tracing has been highlighted as a solution but is unlikely to be effective unless it is coupled with culturally appropriate, trusted support. Second, millions of people are losing their jobs and struggling to pay for necessities such as food, housing, and medication. Third, many people with chronic conditions such as diabetes and asthma have had to forgo routine care that is critical to maintain their health because they have lost employer-sponsored health insurance or because routine appointments have been suspended. And finally, the stress and isolation of the pandemic is affecting Americans’ mental health, and experts worry that suicide deaths will spike.
June 11, 2020
[cross-posted from CHOP PolicyLab]
Each year there are approximately 400,000 children in the child welfare system in the United States. Children in foster care represent a critically vulnerable population. Nothing illustrates this more than findings from our recent JAMA Pediatrics study, through which we found that children in foster care were 42% more likely to die compared to children in the general population and the difference has increased over time.
Which begs the question, why?
May 28, 2020
A new study suggests that hospitals, payers, and patients might learn something useful about the quality of skilled nursing facilities (SNFs) by checking online Yelp reviews. These reviews could provide important information beyond publicly reported ratings to inform decisions about postacute care.
May 27, 2020
[cross-posted from Wharton Stories]
In response to the coronavirus pandemic, almost every U.S. state has imposed lockdown orders. But as some states begin to relax their lockdown orders, policymakers need to consider both how reopening affects the economy and how it affects public health. To date, there’s been very little interdisciplinary work quantifying this tradeoff between economic and epidemiological outcomes. We at the Penn Wharton Budget Model are rolling out a new analysis to inform policymakers of these tradeoffs. Our integrated model captures both sides of the economic-public health equation for each state, as well as the nation as a whole. Here are 5 key takeaways our analysis.
May 27, 2020
An opioid overdose is significantly more than an isolated event. Patients who present to the emergency department (ED) with overdose have a 6 percent risk of dying in the following year. As with other high-risk acute conditions, we expect patients who survive overdose to receive evidence-based treatment after leaving the hospital. Whether the overdose was due to prescription opioids or injection drugs, the first occurrence or recurrent, in people with diagnosed opioid use disorder (OUD) or not - we know that timely follow-up care can save lives. But our recent national study showed that just 16% of privately insured patients obtain that essential care.
May 26, 2020
To address the global health crisis of COVID-19 and its effects on the practice of oral and maxillofacial surgery (OMS), Penn Dental Medicine held a virtual OMS COVID-19 Response Conference on April 9, 2020. The event, organized by Drs. Anh Le and Neeraj Panchal of Penn OMS, featured leading oral and maxillofacial surgeons and administrators from multiple institutions discussing how COVID-19 has transformed the specialty. We recently published proceedings from the conference in the Journal of Oral and Maxillofacial Surgery.