Prior to the Affordable Care Act (ACA), health care safety-net programs were the primary source of care for over 44 million uninsured people. While the ACA cut the number of uninsured substantially, about 30 million people remain uninsured, and many millions more are vulnerable to out-of-pocket costs beyond their resources. The need for the safety net remains, even as the distribution and types of need have shifted. This brief reviews the effects of the ACA on the funding and operation of safety-net institutions. It highlights the challenges and opportunities that health care reform presents to safety-net programs, and how they have adapted and evolved to continue to serve our most vulnerable residents.
In our recent blog post, we explore barriers to behavioral health care in the United States and discuss an alternate strategy: integrated care. Traditionally, integrated care has entailed behavioral health care delivered by a primary care provider.
Abstract [from journal]
Objectives: To examine changes in care practices over time by race and ethnicity and whether the decrease in hospital mortality and severe morbidities has benefited infants of minority over infants of white mothers.
Methods: Infants 22 to 29 weeks’ gestation born between January 2006 and December 2017 at a Vermont Oxford Network center in the United States were studied. We examined mortality and morbidity rate differences and 95% confidence intervals for African American and...
Recognizing Racism in Medicine: A Student-Organized and Community-Engaged Health Professional Conference
Abstract [from journal]
Purpose: This piece details the evaluation and implementation of a student-led educational intervention designed to train health professionals on the impact of racism in health care and provide tools to mitigate it. In addition, this conference, cosponsored by medical, nursing, and social work training programs, facilitates development of networks of...
There’s something unusual happening on patients’ 20th day in skilled nursing facilities (SNFs).
Factors over the life course affect the mental health of urban black men with serious injuries. Childhood adversity, pre-injury physical and mental health conditions, and intentional injury (violence) are risk factors for post-injury depression and posttraumatic stress. Clinicians should expand assessment beyond the acute injury event to identify those patients at risk for poor mental health outcomes.