I recently attended the AcademyHealth Annual Research Meeting (ARM) thanks to the support of the Alice S. Hersh Scholarship and the Leonard Davis Institute (LDI). At the ARM, two themes stood out for me: the re-emergence of managed care as a vehicle for replacing volume with value, and behavioral economics.
Although the supply of nurses is likely to meet overall demand, the nature of a nurse’s job is changing dramatically as nurses assum expanded roles in redesigned health care systems for a broad range of patients in ambulatory settings and community-based care.
In a new LDI/INQRI Research Brief, Erin Fraher, Joanne Spetz, and LDI Senior Fellow Mary Naylor analyze the challenges and opportunities that health system transformation presents to the country’s 2.9 million registered nurses. They explore the new roles and responsibilities for nurses in alternate delivery models such as Accountable Care Organizations and medical homes, and call for changes in nurse education, regulation, and policy.
In a new NEJM Perspective, LDI Fellow Ari Friedman, Brendan Saloner, and Renee Hsia analyze different policies to reduce emergency department (ED) use in Medicaid patients. They advocate strongly for providing Medicaid patients with better alternatives to the ED, rather than discouraging nonemergency ED use by imposing steep copayments.
Recently we’ve noticed a great deal of emerging research evidence and analysis on provider consolidation and integrated care. An abundance of riches! Here we’ve pulled out the angles of the different analyses and brought together key resources.
Update May 2015
Understanding Low-Income African American Women's Expectations, Preferences, and Priorities in Prenatal Care
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....
As a recipient of the Alice Hersh Scholarship, I had the privilege of attending AcademyHealth’s 2015 National Health Policy Conference in Washington D.C. In addition to many interesting sessions, I had the opportunity to meet many leaders in the health care space, from health services researchers and policy makers to providers and business leaders.
As the Affordable Care Act’s health insurance marketplaces begin their second year of open enrollment, LDI examines the current and potential impact of the ACA on the health of minority populations. This third post of a five-part series examines how new models of care delivery encouraged by reform will affect minority populations.
Healthcare System Supports for Young Adult Patients with Pediatric Onset Chronic Conditions: A Qualitative Study
In the Journal of Pediatric Nursing, Dava Szalda and colleagues examine how adult primary care teams can facilitate the transition and ongoing care of adults with pediatric onset chronic illness. Currently, over 90% of pediatric patients with chronic medical conditions are living into adulthood. For some pediatric onset chronic conditions there are more adults living with an illness than children. This qualitative study explores practice supports and barriers to care for this population, comparing them to other patients with chronic illness in order to identify facilitators that...
(An edited version of this post appeared in Philly.com)
US health care spending has never grown as slowly as it did last year.
Dwight D. Eisenhower was in the Oval Office when the US government began recording health care spending in 1960. Since that time, growth in health care spending has never been lower than the 3.6% annual rate reported by researchers from the Centers for Medicare and Medicaid Services a few weeks ago in the journal Health Affairs.
The existence of a primary care physician shortage, even prior to the ACA, is not universally accepted. A new report by the Institute on Medicine found “no credible evidence” that the nation faces a looming physician shortage in primary care specialties. There is greater consensus about a maldistribution of physicians, in terms of specialty, geography, and practice settings.
A new LDI/INQRI Research Brief, written by Mark Pauly, PhD, Mary Naylor, RN, PhD, and me, reviews the evidence of an existing or looming primary care shortage in the wake of the ACA. Will the combined effects of an aging population, an increase in coverage and demand for care, and a decrease in the number of physicians going into primary care create widespread gaps in access? Who will treat the newly insured, and will this exacerbate existing workforce shortages?