The American journal of managed care
-
To (1) explore relationships among food insecurity, neighborhood disadvantage, and health care utilization in adults from a single health system and (2) determine whether food insecurity and neighborhood disadvantage predict acute health care utilization within 90 days of hospital discharge. ⋯ When considering social determinants of health for health system patients, food insecurity was a stronger predictor of acute health care utilization than was neighborhood disadvantage. Identifying patients with food insecurity and targeting appropriate interventions to high-risk populations may improve provider follow-up and acute health care utilization.
-
Home care that maintains continuity of health care services after cardiac surgery is considered a complementary component of clinical care. We estimated that effective home care given with a multidisciplinary approach would contribute to decreasing symptoms and readmissions to the hospital after cardiac surgery. ⋯ This study's findings suggest that home care, with a focus on continuity of care, decreases symptoms and readmissions to the hospital and improves the self-efficacy of patients after cardiac surgery.
-
Observational Study
Experience incentivizing reduction of racial and ethnic disparities in a Medicaid hospital quality incentive program.
We aimed to describe the experience of a state Medicaid agency incentivizing reduction of racial and ethnic disparities in a hospital quality incentive program (QIP). ⋯ Construction of a composite measure, use of a summary disparity statistic, and measure selection are key considerations in the design and interpretation of equity-focused payment programs. This analysis revealed improved aggregate quality performance and a modest reduction in racial and ethnic disparities for measures included in the HD composite for at least 4 years. Further research is needed to evaluate the association between equity-oriented incentives and health disparities.
-
Observational Study
Mental health diagnoses and services utilization vary by wage level.
The relationship between employee wage status and mental health care utilization has not been characterized in large-scale analyses. This study assessed health care utilization and cost patterns for mental health diagnoses according to wage category among employees with health insurance. ⋯ Lower mental health condition prevalence and greater use of high-intensity health care resources highlight the need to more effectively identify and manage mental health conditions among lower-wage workers.
-
The share of Medicare stand-alone prescription drug plans with a preferred pharmacy network has grown from less than 9% in 2011 to 98% in 2021. This article assesses the financial incentives that such networks created for unsubsidized and subsidized beneficiaries and their pharmacy switching. ⋯ Preferred networks have important implications for beneficiaries' out-of-pocket spending and the low-income subsidy program. Further research is needed about the impact on the quality of beneficiaries' decision-making and cost savings to fully evaluate preferred networks.