Do Incentive Payments Improve Home-Based Primary Care?
After five years, a small experiment to improve care for frail elderly patients receiving primary care at home has delivered some savings to Medicare—although it might be too small to know for sure. Authorized by the Affordable Care Act, the Independence at Home (IAH) Demonstration is part of a broader strategy of testing innovative ways to pay for value in health care—tying additional payment to higher quality care and cutting wasteful spending.
Opportunities and Challenges for Previsit Screening for Sexual and Gender Identity Among Adolescents in Primary Care
Jamie E. Mehringer, Nadia L. Dowshen
Abstract [from journal]
Many sexual minority youth are at higher risk for poor health outcomes because of stigma, shame, and discrimination they may face because of their identity. Professional guidelines, including the American Academy of Pediatrics' Bright Futures, encourage discussion of sexual attraction and behavior in adolescent health supervision visits so that clinicians can support healthy adolescent sexual development, assure that the health needs of youth of all sexual identities are met, and facilitate family acceptance and support of youth when needed...
Better Prescribing for Bad Backs
Low back pain is a major cause of disability among adults and a top reason patients are prescribed opioids. However, a recent study in the Journal of the American Board of Family Medicine finds that patients with new low back pain are receiving opioids less frequently, though prescribing rates remain uneven across the country.
Shreya Kangovi Wins Health Equity Award from RWJF and National Civic League
Penn Hosts Fourth Annual Meeting of the Population Health Science Workshop
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.