Category Archives: All

Want to Be an Antiracist? Expand Medicaid (Or End It)

By | March 25, 2021

Over 30% of Black, Latinx, and Indigenous populations in the US are enrolled in Medicaid programs; more than half of all Medicaid enrollees are people of color. As such, Medicaid policies disproportionately affect populations of color. As more institutions reckon with historical and current injustices due to centuries of racism and racist policies, understanding how… Read More »

Winners of the 2021 Student Blog Contest!

Now more than ever, we need students engaged in improving healthcare access, delivery, and quality. The Medical Care Blog is committed to elevating student voices. We have just wrapped up our student blog competition that was co-sponsored by the Medical Care Section of APHA! The posts submitted by students ranged broadly, from administrative to political… Read More »

Part D Senior Savings: Medicare’s New Approach to Paying for Insulin

For older adults in the United States, obtaining and paying for prescriptions can be a challenge. Although most Americans over age 65 are eligible for prescription drug coverage under the Medicare Part D, understanding and navigating the benefit can be difficult. The Center for Medicare and Medicaid Innovation (CMMI) recently launched a new payment model… Read More »

Toward Vaccine Equity

By | March 23, 2021

The pandemic has consistently exposed the underlying inequities and effects of systemic racism on American Indian (AI) and other marginalized communities. The health equity challenge of 2021 is around COVID-19 vaccine equity. Over the first months since the vaccine has become available, communities of color are not getting shots in the arm at the same… Read More »

Time for the COVID-19 vaccine plan to include primary care

President Biden released the National Strategy for the COVID-19 Response and Pandemic Preparedness on January 21, 2020. It is an ambitious attempt to decrease the spread of the novel coronavirus and get hundreds of millions of Americans immunized. This COVID-19 vaccine plan, however, is missing a key element. Namely, primary care. An incomplete national strategy for… Read More »

Treating the Opioid Crisis: Current Trends and What’s Next, Part 2

Last week, we discussed three noteworthy trends from the past decade in treating the opioid crisis. The first was recognizing medication for opioid use disorder (MOUD) as the standard of care. The second was formalizing an addiction medicine specialty. And the third was expanding the availability of MOUD. This week, we’ll consider three additional trends in… Read More »

Treating the Opioid Crisis: Current Trends and What’s Next

Throughout the past decade, the U.S. has seen a dramatic shift in addiction medicine research, clinical practice, and related stigma in seeking care. In a pair of blog posts, we will explore the top six trends related to treating the opioid crisis. And we’ll consider what may be next. The Opioid Epidemic Opioid addiction has… Read More »

Suicide Risk and Prevention Among Women

By | February 2, 2021

We have reached a 30-year high in the rate of suicide in the United States. Suicide risk and prevention efforts among women are the focus of a recent Medical Care supplemental issue. Efforts at prevention and recovery have been especially important for the Departments of Defense and Veterans Affairs. As mentioned in the introduction to… Read More »

CMS Launches Compare Website Replacement: How does it measure up?

This fall, CMS launched two new websites: Care Compare and the Provider Data Catalog (PDC).  Both tools replaced the eight existing Compare tools and data.medicare.gov, which were sunset last year. The data included on Care Compare is intended to help Medicare beneficiaries make informed decisions about their care. While there have been articles and press releases… Read More »

Artificially intelligent social risk adjustment

By | December 10, 2021

What accounts for large differences in life expectancy from one neighborhood to another? This post explains what our team has discovered so far using an “artificially intelligent” approach to understanding social risk at the local level. Where you live affects how long you live In 2018, when the National Center for Health Statistics released the… Read More »

The Complexity of COVID-19 Vaccine Distribution in Rural Areas

During the past year, the COVID-19 pandemic has highlighted health inequality created by social determinants of health (SDoH) in the United States. SDoH include all aspects of the living environment, social support, safety, well-being, and resource availability, directly or indirectly influencing physical health outcomes. Consideration of SDoH is critical for successful comprehensive COVID-19 vaccine rollout.… Read More »

Is Medicaid expansion enough to encourage people to get Mental Health care?

By | January 7, 2021

Low-income households across the US are more likely to be uninsured or under-insured.  Medicaid Expansion paves a path for low-income Americans to obtain access to care.  Working-aged underinsured individuals tend to get later medical care and too little care–resulting in poorer health outcomes. Even insured individuals may delay necessary care because of cost. A 2018… Read More »

End-of-year post: 2020 edition

By | December 28, 2020

This past year at The Medical Care Blog has been quite an adventure. Like the rest of humanity, we were thrown into a whole new reality with the COVID-19 pandemic. Our first posts about SARS-CoV-2 (the novel coronavirus) and COVID-19 (the disease it causes) began in mid-March and haven’t stopped since. All told — across… Read More »

Telehealth in Jails and Prisons: Part 2

By | December 18, 2020

This is Part 2 of my interview with Saira Haque, PhD a telehealth expert and the Director of RTI’s Data Interoperability and Clinical Informatics program, and Nick Richardson, PhD a research analyst in RTI’s Applied Justice Research division. Part 1 is here. What are the benefits to using telehealth? Dr. Haque: As mentioned earlier, it… Read More »

Telehealth in Jails and Prisons: Part 1

By | December 21, 2020

As the COVID-19 pandemic continues, telehealth is becoming increasingly ingrained within our healthcare system. This includes environments beyond the traditional office or hospital setting. With 2.3 million people currently residing in US jails or prisons, healthcare delivery to justice-involved individuals (JIIs) is an important component to consider. (Note: the term “justice-involved individual (JII)” refers to those… Read More »

Student Voices at The Medical Care Blog

By | December 14, 2020

The Medical Care Blog regularly welcomes and features the voices of students from public health, medicine and other health professional fields. Most of our student contributors are earlier in their careers than the health care providers, public health professionals, and academic researchers who contribute to our dialogue most often. But they are frequently experts in… Read More »

Pediatric Payment Models for Child Health Services

By | December 11, 2020

How could alternative pediatric payment models help to address children’s broad health, social, and developmental needs? This post delves into funding and financing challenges and potential solutions. I recently collaborated on a report on alternative payment models for child health with colleagues from the Duke Margolis Center for Health Policy and Mental Health America. The… Read More »

Student Blog Contest!

Now more than ever, we need students engaged in improving healthcare access, delivery, and quality. The Medical Care Blog is committed to elevating student voices on these and other public health topics. To encourage excellent student blog posts, we are sponsoring a blogging competition with the Medical Care Section of the American Public Health Association.… Read More »

Pandemic Reminds Us to Pay Attention to Lack of Supplement Regulation in the U.S.

By | November 21, 2020

During the COVID-19 pandemic, health misinformation has been soaring across the internet and social media platforms. Despite a lack of supplement regulation, vitamin and supplement use have seen a sudden 28% increase in the US and a 25% increase globally during COVID-19. Vitamin C supplements have gained particular attention because of studies finding it might reduce… Read More »

Becoming dementia friendly: Less stigma, more inclusion, better care

By | November 11, 2020

With a growing recognition of the toll that dementia takes on individuals, families, and communities, there is a movement to prepare our society to better meet the needs of people living with dementia. This movement is referred to as becoming “dementia friendly,” and it can reduce stigma, increase inclusiveness, and improve care. A family example… Read More »

Using Digital Technologies for COVID-19 Exposure Notification and Tracking

By | November 8, 2020

Our data says a lot about us – where we go, who we see, and what we do. And since our smartphones come with us everywhere, they are almost always collecting our data. To improve my understanding of how our data and devices can be used to fight the COVID-19 pandemic, I sat down with (over… Read More »

On the Eve of a Public Health Election

By | November 2, 2020

Health care and public health loom large today, on the eve of the presidential election. From COVID-19 to the Affordable Care Act (ACA), this is now clearly a public health election. Let’s review what’s on people’s minds and what’s at stake. Where are voters on health issues? In February of this year, health care was… Read More »

Racism in Reproductive Care and Beyond

By | October 29, 2020

As I scrolled through Ms. Jones’ chart, I jotted down her chronic problems: hypertension, depression, and urinary incontinence. She was taking lisinopril and sertraline. She had seen gynecology back in February for surgical management of the incontinence. The chart said she wanted a hysterectomy as “definitive management.”  It seemed the surgery was canceled due to… Read More »

Is Sleep Driving Up Your Medical Costs?

By | October 22, 2020

  Millions are losing sleep due to anxiety, fear, and the difficulty of maintaining a schedule during this pandemic. Research suggests that those who get insufficient sleep may be at risk for health conditions such as obesity and heart disease. Yet, too much sleep may increase the risk of other health conditions such as diabetes and… Read More »

APHA 2020 Annual Meeting Preview

By | October 21, 2020

It’s that time again! The annual meeting for the American Public Health Association starts on October 24th with a twist–this year, the meeting is being held virtually. Everything from social events to scientific sessions will take place online. While I will miss seeing old and new friends in person, I am excited about the meeting.… Read More »

Addressing reproductive coercion during the COVID-19 pandemic

Historically, women are disproportionately impacted by pandemic illness and COVID-19 is no exception. Addressing domestic violence (DV) and access to reproductive healthcare may reduce the gendered impact of COVID-19. Before the COVID-19 pandemic, we piloted a program to enhance reproductive health literacy, Sexual Health Empowerment for Birth Control (SHE-BC). This program may offer insights to… Read More »

Health and Housing Equity: a new report released by the American Public Health Association

By | October 12, 2020

Earlier this fall the American Public Health Association (APHA) released a remarkable report on the relationship between Housing Equity and Health, “Creating The Healthiest Nation: Health and Housing Equity.” APHA’s Caucus on Homelessness is deeply appreciative of the report’s focus on US housing inequalities and the shortcomings of our current affordable housing programs to address… Read More »

Complementary and integrative health in the VA

By | October 8, 2020

The Veterans Health Administration (VA) has expanded research and education on complementary and integrative health (CIH) programs, focusing on pain, mental health, and chronic illness. CIH programs are a part of “Whole Health,” an approach to support veterans’ health and well-being. A recent Medical Care supplement contains several articles on the effectiveness and implementation of… Read More »

What’s next for virtual care after the pandemic?

By | October 6, 2020

In March, CMS and other Federal agencies announced temporary telehealth policy changes in response to the COVID-19 public health emergency.  These changes promoted continued access to care while allowing for physical distancing.  Virtual care encounters have increased since March.  However, as the public health emergency has continued, there are questions about the future of virtual… Read More »

Maintaining healthcare access during outbreaks

By | October 6, 2020

Preserving access to care is a high priority, even in a pandemic. We need to strengthen the existing coordinated regional treatment network for better preparedness. One consequence of the COVID-19 pandemic has been that people are scared to seek health care because they fear getting infected in clinics and hospitals. Although in many cases it… Read More »

Rebuilding the Foundation of Rural Community Health after COVID-19

COVID-19 has exposed the cracks in the foundation of America’s rural community health system. These cracks include increased risk of facility closures, loss of services, low investment in public health, maldistribution of health professionals, and payment policies ill-suited to low-volume rural providers. As a result, short-term relief to stabilize rural health systems and long-term strategies… Read More »

Health Equity: Lessons from AcademyHealth 2020

By | September 21, 2020

Health equity and the disparities within our health care system were the predominant themes at AcademyHealth’s 2020 Annual Research Meeting (ARM), which concluded on August 6th. As usual, health services researchers gathered to disseminate the latest evidence across a broad range of health care topics and discuss the most pressing issues in health services research… Read More »

Potential effects of COVID-19 on health care utilization and quality measures

What are the potential impacts of COVID-19 on health care utilization? How will changes in healthcare use impact quality measures? Researchers are asking many key questions to understand the impacts of COVID-19. It is clear that trends in healthcare use are changing. These changes will likely affect quality measure scores in the future. This is… Read More »

A Revisionist History of COVID-19

Note from the Editors: Last week capped two jam-packed weeks of political nominating convention activities. COVID-19 was discussed at both conventions. The Washington Post fact-checked some of the health care claims at the Democratic convention. Here, with the permission of Kaiser Health News and Politifact, we are republishing their recent fact-checking of the COVID-19 content from the Republican… Read More »

Wildfires: Effects on Health and Care Delivery

By | August 27, 2020

Climate change is a contributory factor to wildfires in California this year that have engulfed 1.4 million acres of land.  Most recently, lightning strikes sparked new fires in Northern California, including the L.N.U. Lightning Complex (currently the third largest fire in California history).  Wildfires contribute to poor health outcomes and disrupt care delivery.  In addition, the… Read More »

Surprise Billing: Why Provider Contracting May Matter to You

By | August 27, 2020

Provider contracting may sound dull, but it can have big impact on patients. Contracting may not be the first thing you think of when choosing a provider or facility. It may also not be something you have a lot of control over. But because of surprise billing, provider contracting can have a big effect on… Read More »

After COVID-19, We Must Build Back Better

By | August 17, 2020

The COVID-19 pandemic has brought to light the gross underinvestment in public health, primary care, and the social determinants of health in the United States. Yet, this experience gives us a chance to rethink our health and social service systems, as these are often siloed. We see education, employment, healthcare, housing, and other social services… Read More »

Using Technology to Improve Community Health After COVID-19

By | August 12, 2020

To be at the intersection of technology and product development in a field as ripe for disruption as healthcare couldn’t be more opportune. But how can we use technology to improve community health, especially after COVID-19? Technology and Health: A Budding Relationship On April 10th 2020 the Apple-Google partnership announced a notification tool for contact tracing to support… Read More »

In COVID-19 Response, ICE May Be Misusing a Common Disinfectant in Detention Facilities

The U.S. government is reportedly harming people held in immigration detention centers with its excessive use of a common disinfectant. According to reports by immigrant advocacy groups, HDQ Neutral disinfectant is being sprayed dozens of times per day in enclosed environments. This is resulting in concerning health symptoms among detained people. This potentially egregious practice further… Read More »

Rural Postpartum Mental Health: the Challenge to Improve

Postpartum depression is common, preventable, and treatable. The Agency for Healthcare Research and Quality (AHRQ) challenge competition, “Cross-Sectional Innovation to Improve Rural Postpartum Mental Health,” identifies what communities are doing to improve access to mental healthcare for rural women. Furthermore, the challenge seeks new solutions to ensure that more women and families receive the help… Read More »

COVID-19 & Violence Against Healthcare Workers

By | July 13, 2020

As COVID-19 cases continue to rise, the pandemic has spotlighted the heroic efforts of our nation’s healthcare workers. Healthcare workers are providing much needed front-line patient care. However, in doing so, they also place themselves at risk of exposure to infectious disease, psychological distress, and burnout. But as the COVID-19 pandemic continues, another concern for… Read More »

A story of primary care: neighborhood deprivation and health spending

By | July 2, 2020

A new study out this month in Medical Care by Yongkang Zhang and colleagues finds that people in struggling neighborhoods have considerably higher spending on potentially preventable health care. While overall health care spending was similar between the most deprived areas and average communities, the finding about spending on potentially preventable health care tells an… Read More »

Options for Universal Coverage: Part 2 – Eligibility and Enrollment

In this series on options for universal coverage, we explore elements of various reform proposals and evaluate their potential impact. Rather than examining complete proposals, we highlight specific policy elements that appear in one or more such proposals. The three we focus on in this series are: Part 1 – Eliminating Medicare Advantage (May 14,… Read More »

Medicare Advantage and Reimbursement to Address Social Risk Factors

By | June 22, 2020

We don’t always think of health insurers as communicators. However, when insurers set reimbursement rates, they provide information that directly influences service delivery. When payors reimburse for certain services, they are informing providers these services are valued and providing these services is encouraged. When payors do not reimburse for services, or reimburse at lower rates,… Read More »

The Challenge of Change: Tracking COVID-19 Policy Updates for Nursing Facilities

Nursing facilities have been in the center of the COVID-19 pandemic and experienced sweeping policy changes. The pace of change has made it difficult to keep track of each new policy, so this post summarizes the key shifts from January through May. Nursing facilities are attempting to protect residents by ramping up existing infection control… Read More »

Framing Success for Supportive Housing Services

By | June 11, 2020

In this post we reflect on the definition of success in a study measuring the value of peer support services administered through the HUD VASH program and discuss client-centered definitions of value. We propose designing and understanding programmatic success goals tailored to unique need categories within veteran participant groups. With stay-at-home orders lifting all across… Read More »

Natural Experiments for Diabetes

Over the past two decades, research has helped identify ways to reduce complications among people with diabetes and laid the foundation for primary prevention. However, prevention and treatments are still unequally applied, and social, economic, and age-related disparities persist. The June 2020 supplement issue of Medical Care argues for and presents the results of natural… Read More »

Born in a Crisis: How COVID-19 May Change the US Health Insurance System

By | June 4, 2020

Like the rest of society, the US health insurance system is going to change in the wake of the COVID-19 pandemic. The question is whether changes will be made deliberately, through policy actions, or reactively, through the markets. The American health care system has been at the forefront of the COVID-19 crisis in more ways… Read More »

#SexEdForAll: What We Need to Prevent Intimate Partner Violence

By | June 1, 2020

We just wrapped up #SexEdForAll month in May, yet most people still believe sex education is just about sex. But it’s so much more than that! That’s why I created the Sexuality Education Legislation and Policy: A State-by-State Comparison of Health Indicators story map, in conjunction with the Robert Graham Center for Policy Studies in… Read More »