Journal of general internal medicine
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On July 1, 2021, North Carolina's Medicaid Transformation mandatorily switched 1.6 million Medicaid beneficiaries from fee-for-service to managed care plans. We examined the early enrollee experience in terms of engagement in plan selection, provider continuity, use of primary care visits, and assistance with social needs. ⋯ Medicaid enrollees in North Carolina may have had limited awareness and engagement in the transition process and experienced a reduction in primary care visits. As the state's transition process gains a foothold, future policy needs to improve enrollee engagement and develop evidence on healthcare utilization and patient outcomes.
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Health care organizations' partnerships with community-based organizations (CBOs) are increasingly viewed as key to improving patients' social needs (e.g., food, housing, and economic insecurity). Despite this reliance on CBOs, little research explores the relationships that health care organizations develop with CBOs. ⋯ Health care organizations tailored the intensity of their relationships with CBOs based on their goals. Administrators viewed informal relationships with limited interactions between organizations sufficient for many activities. Our study offers key insights into how and when health care organizations may want to develop partnerships with CBOs.
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Communication issues have been shown to contribute to healthcare errors. For years healthcare professionals have been told to "speak up." What "speak up" means is unclear, as it has been defined and operationalized in many ways. Thus, this study aimed to systematically review the literature regarding definitions and measurements of speaking up in the healthcare system and to develop a single, comprehensive definition and operationalization of the concept. ⋯ Speaking up is considered important for patient safety. Yet, there has been a lack of agreement on the definition and operationalization of speaking up. This review demonstrates that speaking up should be reconceptualized to provide a single definition for speaking up in healthcare.