Journal of general internal medicine
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Integration of health-related social needs (HRSNs) data into clinical care is recognized as a driver for improving healthcare. However, few published studies on HRSNs and their impact are available. CMS sought to fill this gap through the Accountable Health Communities (AHC) Model, a national RCT of HRSN screening, referral, and navigation. Data from the AHC Model could significantly advance the field of HRSN screening and intervention in the USA. ⋯ To our knowledge, this is only the second published study to report screening data from the AHC Model. Future research focused on the impact of multiple co-occurring needs on health outcomes is warranted.
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Over 15.3 million Americans relied on the individual health insurance market for health coverage in 2021. Yet, little is known about the relationships between the organizational characteristics of individual market health insurers and quality of coverage, particularly with respect to clinical outcomes. ⋯ Provider-sponsored health plans in the health insurance marketplaces are associated with higher-quality care, as measured by CMS clinical quality measures.
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Using race-a socially assigned identity that does not adequately capture human genetic variation-to guide clinical care can result in poor outcomes for racially minoritized patients. This study assessed (1) how physicians conceptualize and use race in their clinical care (race-based care) and (2) physician characteristics associated with race-based care. ⋯ Physicians had varied perceptions of race, but many believed race was biological. Concern and support for race-based practice were related to beliefs regarding the evidence for using race in care and the appropriateness of race as a variable in medical research. Older physicians were more likely to use race, which could be due to increased exposure to race-based medical literature, in addition to generational differences in conceptualizations of race. Additional research on the evolution of physicians' perceptions of race, and the role of medical literature in shaping these perceptions, is needed.
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Medicare introduced billing codes in 2016 to encourage clinicians to engage in advance care planning (ACP) and promote goal-concordantend-of-life care, but uptake has been modest. While prior research examined individual-level factors in ACP billing, organization-level factors associated with physician practices billing for ACP remain unknown. ⋯ Several years after Medicare introduced ACP reimbursements for physicians, relatively few practices bill for ACP. ACP billing was more likely in large practices with a greater percentage of primary care physicians. To increase ACP billing uptake, policymakers and health system leaders might target interventions to larger practices where a small number of physicians already bill for ACP and to specialty practices that serve as the primary source of care for seriously ill patients.
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Endocrine specialty clinics (SCs) are occupied by a high percentage of stable follow-up patients, limiting access to new patients with greater needs. ⋯ The innovation and feasibility of opening SC access through the use of a team-based graduation program to transfer stable diabetes patients back to their home clinic was demonstrated. This innovation has the potential to support health system triage of new patients to limited access specialty care.