Health Care Safety-Net Programs After The Affordable Care Act
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.
Health Care Safety-Net Programs Continue to Serve Most Vulnerable
[cross-posted from the United States of Care blog]
Beyond Physicians: Interdisciplinary Teams in Integrated Care
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.
Fast-tracking Behavioral Health Care
Imagine struggling with a behavioral health issue, searching for a local psychiatrist, and finding out the provider you’ve chosen doesn’t accept insurance. You wouldn’t be alone: most psychiatrists in the United States don’t. But let’s say your plan has some out-of-network benefits, which means you pay the full cost up front and request an itemized receipt for every appointment.
Patrick Conway's Quest to Revolutionize North Carolina Health Care
Primary Care Appointments for Medicaid Beneficiaries With Advanced Practitioners
Lena Leszinsky, Molly Candon
Abstract [from journal]
Primary care access in Medicaid improved after the Patient Protection and Affordable Care Act despite millions of new beneficiaries. One possible explanation is that practices are scheduling more appointments with advanced practitioners. To test this theory, we used data from a secret shopper study in which callers simulated new Medicaid patients and requested appointments with 3,742 randomly selected primary care practices in 10 states. Conditional on scheduling an appointment, simulated patients asked whether the practitioner...
Are Fewer Physicians and Self-Service Health Care the Answer?
The Effect of Predictive Analytics-Driven Interventions on Healthcare Utilization
Among high-risk Medicare Advantage members with congestive heart failure, a proactive outreach program driven by a claims-based predictive algorithm reduced the likelihood of an emergency department (ED) or specialist visit in one year by 20% and 21%, respectively. The average number of visits dropped as well, with a 40% reduction in the volume of ED visits and a 27% reduction in the volume of cardiology visits after the first year.
Prompt Primary Care Linked to Fewer Rehospitalizations in Medicaid Patients
The Camden Coalition of Healthcare Providers (of hotspotting fame) has published some intriguing findings from a city-wide program to reduce rehospitalizations by linking hospitalized Medicaid patients to primary care follow-up within seven days of discharge.
Report From the LDI Norman Wall Memorial Lecture
Twelve Penn Researchers Receive 2019 LDI Pilot Grants
Supply of Primary Care Providers and Appointment Availability for Philadelphia's Medicaid Population
Supply of Primary Care Providers and Appointment Availability for Philadelphia's Medicaid Population
This brief analyzes the supply of primary care providers serving the Medicaid population in Philadelphia, and the geographic variability of this measure across the city. It also examines important measures of access – appointment availability and wait time for an initial appointment – that highlight challenges faced by Medicaid patients.
Primary Care Access for Philadelphia’s Medicaid Population
Following Medicaid expansion in Pennsylvania in 2015, more than one in five non-elderly adults in Philadelphia are now covered by Medicaid. This population faces unique challenges with accessing primary care, including fewer providers accepting Medicaid patients.
Ten Years Back and Ten Years Ahead: Innovation in Pediatric Primary Care
On October 22, policymakers, researchers, advocacy group representatives, physicians, and other experts will convene for CHOP PolicyLab's 10th anniversary forum: Charting New Frontiers in Children's Health Policy & Practice. Attendees will discuss the most pressing health issues facing children, adolescents, and families across the country. The post below from PolicyLab Faculty Member and LDI Sen
Trauma-Informed Care Training in Family Medicine Residency Programs Results From a CERA Survey
Melissa E. Dichter, Anne Teitelman, Heather Klusaritz, Douglas M. Maurer, Peter F. Cronholm,...
ABSTRACT [FROM JOURNAL]
Background and Objectives: Experiences of psychological trauma are common among primary care patient populations, and adversely affect patients’ health and health care utilization. Trauma-informed care (TIC) is a framework for identifying and responding to patients’ experiences of psychological trauma to avoid retraumatization. The purpose of this study was to evaluate the current state of TIC training in family medicine residency programs in the United States in order to identify opportunities for and barriers to TIC training.
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