Journal of general internal medicine
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Compared to traditional Medicare (TM), Medicare Advantage (MA) plans impose out-of-pocket cost limits and offer extra benefits, potentially providing financial relief for MA enrollees, especially for those with food insecurity. ⋯ These findings suggest that the promise of financial protection offered by MA plans has not been fully realized, particularly for those with food insecurity.
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Real-time clinical care, policy, and research decisions need real-time evidence synthesis. However, as we found during the COVID-19 pandemic, it is challenging to rapidly address key clinical and policy questions through rigorous, relevant, and usable evidence. ⋯ We faced challenges in (1) balancing scientific rigor with the speed in which evidence synthesis was needed, (2) sorting through rapidly evolving large bodies of evidence, and (3) assessing the impact of evidence synthesis products on clinical care, policy, and research. We found solutions in (1) engaging stakeholders early, (2) utilizing artificial intelligence capabilities, (3) building infrastructure to establish living reviews, and (4) planning for dissemination to maximize impact.
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Telemedicine has emerged as a vital healthcare delivery model, especially pronounced during the COVID-19 pandemic. Our study uniquely focuses on an institutional lens, examining US hospitals to offer targeted policy implications. ⋯ The findings underscore the rapid yet uneven adoption of telemedicine services in U.S. hospitals. The results point to the need for comprehensive policy interventions to address the challenges identified and realize telemedicine's full potential in healthcare delivery and resilience.
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Following the Centers for Medicare and Medicaid Services' approval of the Acute Hospital Care at Home waiver, an increasing number of health care organizations launched Home Hospital (HH) programs in the USA. Ongoing barriers include access to HH expertise and a standard, comprehensive set of implementation tools. We created the HH Early Adopters Accelerator to bring together a network of health care organizations to develop tools ("knowledge products") necessary for HH implementation. ⋯ The Accelerator created high-quality, comprehensive knowledge products that healthcare organizations found useful for safe HH implementation 1 year later. The Accelerator approach can feasibly help healthcare organizations safely bridge the gap between innovation and standard practice.
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Data on the potential protective effect of psychological safety (PS) on well-being and satisfaction among physicians are lacking. ⋯ A majority of faculty physicians reported working in a psychologically safe environment. Greater PS was associated with lower odds of burnout and ILJ. Investment in gender and diversity equity training may be one concrete step in advancing PS in the workplace.