Featured Post
May 4, 2021
More than any other sector in health care, nursing homes have suffered during the pandemic. Nursing home residents and staff account for 34% of all COVID-19 deaths, though they make up less than 1% of the population. As a result of COVID-19-related concerns, the number of Americans living in nursing home has dropped by more than 10%. The result is an unprecedented financial crisis for the industry, with nursing homes closing their doors, some laying off their employees, and others being unable to safely staff their facilities.
May 19, 2021
During the pandemic, the nationwide moratorium on evictions for rent non-payment had clear public health and economic goals: to reduce unnecessary COVID-19 transmission and avoid widespread homelessness. But the benefits of the moratorium, which has been challenged in court and is now set to expire on June 30, might go far beyond the pandemic: a new study finds that evictions have detrimental effects on the physical and mental health of young adults for many years to come. In a longitudinal study in Social Science and Medicine, Morgan K. Hoke and Courtney E. Boen find that eviction is associated with declines in mental and self-reported health as young people age.
May 13, 2021
To achieve the estimated 75%-80% vaccination rate needed for herd immunity, the nation will need to invest in reaching virtually all adults in the United States. This daunting task requires thinking about communities at risk for poor health outcomes, particularly communities of color.
Last week, the Biden administration shifted its strategy from mass vaccination sites to more local settings, targeting younger adults and those hesitant to get vaccinated. With the goal of getting at least 70% of the population vaccinated with at least one dose by July 4, access to convenient vaccination services will be critical. This means implementing pop-up and mobile clinics, particularly in rural areas, as well as dispersing an army of community outreach workers to help with transportation and childcare services in neighborhoods in which individuals face structural barriers to access. With these concerted efforts, many more people will be able to be vaccinated, and we can inch closer toward the coverage levels we need to “return to normal.”
April 26, 2021
The rapid expansion of Urgent Care Centers (UCC) over the past decade has raised the tantalizing possibility that UCCs could be a cost-effective alternative for visits that do not need the full capabilities of an emergency department (ED). On the surface, this seems to make sense. In our new study in Health Affairs, the average UCC visit cost only $171 compared to the staggering $1,646 for an ED visit. That per-visit difference likely explains why insurers have implemented strategies such as higher copayments to deter ED visits and encourage patients to use lower-cost alternatives. However, the relative convenience of UCCs could result in increased numbers of visits, which might increase overall spending. That’s exactly what we found.
April 20, 2021
Artificial intelligence (AI) and machine learning (ML) hold great promise to improve health outcomes, but also pose issues of inaccuracy and bias that can lead to patient injury. And with injury comes liability. In our recent article in the Milbank Quarterly, we explore the liability implications of AI/ML and propose a toolbox of liability reforms to smooth the implementation of this promising yet disruptive technology.
April 12, 2021
By delivering free naloxone and other harm reduction supplies discreetly and confidentially to people’s homes, what arrives in the mail could save a life. That’s the take-home message from an innovative approach to reducing opioid overdose deaths in Philadelphia, where the fatal overdose rate surpasses that of other large U.S. cities. Mailing is an effective yet largely underutilized strategy for increasing access to life-saving harm reduction supplies, one that policymakers should explicitly support given the urgent need.
In a recently published paper in International Journal of Drug Policy, we evaluated a partnership between NEXT Harm Reduction, the Philadelphia-based harm reduction group SOL Collective, and the Philadelphia Department of Public Health that provides free mailed naloxone to any Philadelphian who requests it. We analyzed the 422 naloxone requests received in Philadelphia from March 2020 through January 2021, throughout the pandemic.
April 8, 2021
In Health Affairs, LDI Senior Fellow Matthew Grennan, Ashley Swanson, and I present new evidence on medical device firms’ payments to physicians. Device firm relationships with physicians tend to be more involved than those between pharmaceutical reps and prescribers, but have received far less scrutiny.
April 7, 2021
[Cross-posted from CHOP PolicyLab]
In 2020, 1 in every 4 children across the United States lived in a household experiencing food insecurity, where their access to food was limited by their families’ financial resources.
The federal Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC, provides nutritional support and nutrition education to food-insecure pregnant women and children under the age of 5 who are living in poverty. Since launching in 1975, WIC has clear health benefits for children who participate, including lower rates of food insecurity and improved nutrition. Unfortunately, the U.S. Department of Agriculture (USDA) estimates that only about 50% of eligible women and children across the country currently receive WIC.
April 5, 2021
Individuals involved in the criminal justice system have high rates of opioid use disorder (OUD), but frequently have limited options for treatment. The Affordable Care Act’s Medicaid expansion gave states the opportunity to increase coverage for individuals with criminal justice involvement, but whether that translated into increased access to OUD treatment in this population is an open question. In our latest study in Health Affairs, we found that the receipt of medications for OUD increased significantly more for individuals referred by criminal justice agencies in states that expanded Medicaid compared to those states that did not.
April 1, 2021
The best blogs are like good conversations. They’re engaging, enlightening, and easy to understand. As an academic blogger, your job is to get and keep your reader’s interest. Once you have that, you can give your perspective on something—a study, a news item, or a policy—and increase the chances that your work can have an impact beyond the academic sphere.
March 31, 2021
The COVID-19 pandemic has forced us to face many uncomfortable realities. As critical care physicians, my colleagues and I work in intensive care units (ICUs) that have grown to accommodate the large numbers of patients who have become seriously ill from COVID-19 during the past year. However, the specter of scarcity has been looming. We know that a day may come when there are not enough ICU beds or ventilators for all the patients who need them. In such a situation, how will hospitals fairly choose who gets access to these scarce resources, knowing that the patients who are turned away may die?
March 30, 2021
In the past few months, we have seen what can be accomplished when the federal government marshalls its resources and mobilizes a nation to address a health crisis. While there is no vaccine for the epidemic of overdoses that has claimed more than 80,000 lives in the past year alone, we already have effective treatments for opioid use disorders and proven life-saving strategies. There is an urgent need for federal leadership to address an overdose crisis that has worsened throughout the pandemic.
March 25, 2021
As the remaining non-expansion states consider expanding Medicaid eligibility, a new study offers encouraging evidence that Medicaid patients’ access to surgical care can be maintained even when enrollment surges. In the American Journal of Surgery, my co-authors and I compared patients’ use of high-quality colorectal surgeons after the Affordable Care Act’s (ACA's) Medicaid expansion in two states: New York, an expansion state, and Florida, a non-expansion state.