The Importance of Rural Health Clinics
We have new evidence that the presence of federally-certified Rural Health Clinics (RHCs) is associated with greater primary care appointment availability in rural areas, thanks to a new paper in Health Services Research (early view).
Eight Steps to Preventing Pregnancy-Related Mortality in Philadelphia
A new report on maternal deaths in Philadelphia sheds light on a persistent problem and recommends concrete, doable steps to reduce pregnancy-related mortality. The 30 members of the Philadelphia Maternal Mortality Review (MMR) team, including LDI Senior Fellows Sindhu Srinivas and coauthor Pooja Mehta identified and reviewed all cases of Philadelphia residents who died within one year of the end of pregnancy from 2010-2012.
Sizing Narrow Networks
There’s been a lot of talk about "narrow" networks in ACA plans, which trade off limited provider coverage for lower premiums. Using a new integrated dataset of physician networks in plans on the federal and state marketplaces, our latest LDI/RWJF Data Brief describes the breadth of physician networks across all silver plans sold in 2014.
The Skinny on Narrow Networks in Health Insurance Marketplace Plans
The Affordable Care Act (ACA) has prompted health plans to increase their use of “narrow networks” of providers as a cost containment strategy. The Leonard Davis Institute of Health Economics (LDI) has assembled the first integrated dataset of physician networks for the plans offered on the ACA marketplace. This data brief uses this new resource to describe the breadth of the physician networks in plans sold on the state and federal marketplaces.
Fix Pennsylvania's Medicaid Policy on IUDs
Cross-posted with the Philadelphia Inquirer
Imagine a woman in labor who goes to the hospital with a delivery plan she made in consultation with her obstetrician: yes to antibiotics in labor; no to an epidural for pain control; yes to neonatal circumcision; and yes to having an intrauterine device (IUD) placed immediately after childbirth.
Taking the Science of Financial Incentive Programs to a New Level: An Interview With Scott Halpern
Last week, Scott Halpern, Kevin Volpp and colleagues published a groundbreaking study in the NEJM demonstrating that financial incentives work in helping employees quit smoking, and that the design of the incentives matters.
Does Philadelphia Have Primary Care Deserts?
Cross-posted with the Field Clinic blog
Over the past two years, one of the top health care priorities in Philadelphia has been getting people signed up for health insurance. That is still a huge, unfinished task, but alongside it we need to make sure we have enough doctors in the right places to deliver care. For health care reform to deliver on its promise, people need good access to primary care.
Location Matters – Primary care availability in a major urban center
Depending on your neighborhood in Philadelphia, you may face a 10-fold difference in the supply of primary care practices located close to your home. This is the finding of a new study commissioned by the Philadelphia Department of Public Health and conducted by a research team that I headed.
Primary care access – Perspectives from LDI
Primary care is critically important for improving health outcomes and promoting public health. LDI Senior Fellows conduct research on primary care that digs deeper into the different components of access - the related but separate concepts of availability, accessibility, accommodation, affordability and acceptability.
Priced out of primary care?
Although the ACA has cut the level of uninsurance dramatically, roughly 30 million adults remain uninsured, many of them in states that did not expand Medicaid. Can these self-pay patients get an appointment with a primary care provider, and if so, at what price?
HIV diagnosis and care – Does setting matter?
Does the particular setting and location of HIV diagnosis and care affect HIV outcomes? Two recent studies by LDI Senior Fellow Baligh R. Yehia, MD, Assistant Professor of Medicine and Director of the Penn Medicine Program for LGBT Health, and his colleagues, seek to answer this question.
Neighborhood Social Environment and Patterns of Adherence to Oral Hypoglycemic Agents Among Patients With Type 2 Diabetes Mellitus
Heather F. de Vries, McClintock, Douglas J. Wiebe, Alison J. O'Donnell, Knashawn H. Morales, Dylan S. Small, Hillary R. Bogner
In Family and Community Health, Heather F. de Vries and colleagues, including Douglas Wiebe and Dylan Small, examine whether social environment is related to adherence to oral hypoglycemic agents among patients with type 2 diabetes mellitus. While individual characteristics are important contributors to medication adherence, much of the observed variation in adherence rates remains unexplained by these factors De Vries and colleagues compare residents in neighborhoods with high social affluence, high residential stability, and high neighborhood advantage to residents of...
Understanding Low-Income African American Women's Expectations, Preferences, and Priorities in Prenatal Care
Brownsyne Tucker Edmonds, Marjie Mogul, Judy Shea
In Family and Community Health, Judy Shea and colleagues seek to better understand low-income African-American women’s views on prenatal care. The analysis is the result a focus group study using a community-based participatory research framework. Shea and colleagues find that that friends/family and the baby’s health were the top factors that encouraged prenatal care attendance. Barriers to getting prenatal care included insurance, transportation, and ambivalence as to its importance. Facilitators included transportation services, social support, and education about available resources....
Healthy Nudges in the School Lunch Line
In an online commentary in JAMA Pediatrics, Mitesh Patel and Kevin Volpp comment on a new school-based randomized trial that tested whether increased food palatability, combined with choice architecture, improved the diet of elementary and middle school children.
A ‘punch list’ to ensure the ACA delivers for women
Sunday, March 8th is International Women’s Day. Take part in the Twitter conversation with #womensday and #makeithappen