Designing From the Margins to Advance Equity

By | May 2, 2023

“Access for the sake of access or inclusion is not necessarily liberatory, but access done in the service of love, justice, connection, and community is liberatory and has the power to transform.” – Mia Mingus, community organizer, disability and transformative justice advocate  Are you designing with equity and inclusion in mind? For public health and… Read More »

Using data-driven quality measurement and analytics to build health equity

By | April 27, 2023

The disproportionate impact of COVID-19 on underserved communities underscored the need for systemic change and renewed efforts to reduce health disparities in people with social risks.  This post describes a partnership between Inovalon and Humana to develop a new health equity composite quality measure to identify disadvantaged populations with the largest care disparities and determine… Read More »

Racial and ethnic segregation in primary care

By | April 20, 2023

Primary care in the US is segregated by racial/ethnic identification. What are the implications? Most people in the US are aware that our neighborhoods are often highly segregated by race and ethnicity. Racism — historical and current, structural and individual — plays a role in neighborhood demographics. The same forces also result in segregated workplaces,… Read More »

Healthy Intersections Podcast: April 2023

By | April 24, 2023

Originally published April 6, 2023; updated April 24, 2023 to add audio links. Welcome! April 2023 marks a new milestone for the Healthy Intersections Podcast (HIP), sponsored by the American Public Health Association’s Medical Care Section. I’m taking on the role of the main producer of HIP. We’re also moving to a video AND audio… Read More »

Pain: no longer a vital sign?

By | April 7, 2023

Pain was widely under-treated in the 1980s. Two decades ago, pain was recognized as an important problem that needed to be managed by healthcare providers. Today, the opioid crisis has led to under-treatment once again. Professional recognition of pain as a symptom that needs managing was the eventual outcome of several decades of research. Again… Read More »

Telemedicine and Depression

By | March 23, 2023

 The rapid transition from in-person to care to telemedicine visits at the start of the COVID‑19 pandemic did not adversely affect the quality of care – and even improved some aspects of care – for patients with major depression in a major integrated health system, according to a new report. The study appears as part of… Read More »

Why Does Insulin Cost So Much? Big Pharma Isn’t the Only Player Driving Prices

By | March 10, 2023

Eli Lilly & Co.’s announcement that it is slashing prices for its major insulin products could make life easier for some diabetes patients while easing pressure on Big Pharma. It also casts light on the profiteering methods of the drug industry’s price mediators — the pharmacy benefit managers, or PBMs — at a time when… Read More »

Medicare Advantage Should Be Making News

By | March 3, 2023

Medicare Advantage should be making news. It’s not because the Medicare trust fund continues to run on fumes, which it does. Nor is it because Medicare was taken “off the table” in recent debates about cutting the federal budget, which it was. Rather, it should be getting a lot of attention for new data about its… Read More »

Social Fitnessing as a Pandemic Health Strategy

By | February 23, 2023

Public health has preached a lot of things in the three years of the COVID-19 pandemic. It has promoted social distancing, masks, vaccines, and quarantine to help prevent the spread. And it has helped spread awareness about antivirals for people infected with COVID-19. But what about “social fitnessing”?   This is the premise that the… Read More »

Healthy Intersections Podcast: February 2023

By | February 10, 2023

This month’s podcast features a round-up of this month’s blog posts and a summary of three articles recently published in the journal Medical Care. Listen here or via your favorite podcast platform! Transcript Hello friends. Welcome to the Healthy Intersections Podcast for February 2023. This podcast is sponsored by the American Public Health Association’s Medical… Read More »

A Renewed Outlook on Substance Use Prevention

An Opportunity to Get Ahead of the Overdose Crisis For many Americans, drug use ‘prevention’ conjures memories of early public health campaigns using fearsome imagery and catchy slogans to deter substance use. Campaigns implored youth to “just say no” to drugs, and the public received stark warnings: “this is your brain on drugs.”

Healthy Intersections Podcast: January 2023

By | January 26, 2023

This month’s podcast features a round-up of this month’s blog posts and an interview with Sungchul Park of Drexel University about his recent Medical Care paper on Medicare Advantage Star Ratings and disparities in ambulatory care sensitive hospitalizations. Listen here or via your favorite podcast platform! Transcript (partial): Hello listeners, and welcome to the Healthy… Read More »

Is It Time for Medicaid-For-All?

By | February 1, 2023

It isn’t what supporters of single-payer health care might prefer. But a Medicaid-for-all program, based on the already expansive safety-net program, might open new doors to universal coverage. And rising familiarity with the program is creating a window of opportunity. My realization began with several conversations First, it was a friend going through a divorce… Read More »

Using CLAS Standards to Advance Equity

To address calls for improving health equity, organizations could consider using CLAS Standards to advance diversity, equity, and inclusion (DEI). In recent years, health organization leaders have prioritized the need to address systemic inequities. A 2021 survey of health care organizations identified health equity as a top priority [pdf]. This focus has grown since the… Read More »

Reporting detention-related harms

Community-based clinicians sometimes see patients who have been recently released from immigration detention. Those encounters can be challenging, especially when patients reveal health harms experienced while in detention. It is obviously critical that clinicians provide high-quality medical care and address any health issues potentially brought about or exacerbated by their detention history. But do they… Read More »

Increasing Response Rates

Patient experience surveys are a cornerstone of public reporting and pay-for-performance initiatives. Some healthcare providers, payers, and other stakeholders have expressed concerns about declining response rates and representativeness of these surveys [pdf], especially for underserved groups. Increasing response rates is an important goal. Several strategies have been proposed to increase response rates, including administering surveys… Read More »

December 2022 Healthy Intersections Podcast

By | December 8, 2022

In this month’s podcast, co-editor Jess Williams recaps blog posts from November and talks about some December journal articles. Listen here or wherever you get your podcasts. Transcription Welcome back to Healthy Intersections, the podcast of themedicalcareblog.com. In this month’s episode, I’ll review some of our blog entries from November and give you a preview… Read More »

Limited Internet Access in Underserved Communities Could Drive Disparities in Telehealth Utilization

Telehealth–the ability for providers to care for patients using computers, tablets, or smartphones–has the potential to expand access to healthcare by allowing people to interact with providers remotely. However, there are disparities in access to the technology that makes it possible to use telehealth. For example, in analyzing Census data on availability of widely used… Read More »

Financial alignment of Medicare and Medicaid may improve access to primary care

By | November 21, 2022

Better care coordination may improve access to primary care for people who are dually eligible for Medicare and Medicaid. Recent evaluations of the Financial Alignment Initiative (FAI)–an initiative incentivizing the financial alignment of Medicare and Medicaid–suggests care coordination could improve access to primary care services for some dually eligible beneficiaries. Care coordination alone, however, may… Read More »

Long-acting reversible contraception in the era of abortion bans

It is more important than ever to expand access to a broad range of safe and effective contraceptives that includes long-acting reversible contraception (LARC) methods. We are living in a new era in the US. As of early November, 2022, abortions are banned from the point of conception in 12 states and severely restricted in… Read More »

November 2022 Healthy Intersections Podcast

In this month’s podcast, Dr. Samy Anand gives an overview of The Medical Care Blog posts published in October and a preview of the journal articles in the November issue of Medical Care. Then, co-editor of the blog, Dr. Gregory Stevens, discusses the results of the midterm election and the results of ballot measures relevant to… Read More »

APHA Annual Meeting 2022 Preview

By | November 4, 2022

It’s that time of year again–APHA’s Annual Meeting! This year we’ll be meeting in Boston Nov. 6-9 with a digital event Nov. 14-16. I’m looking forward to seeing colleagues this year and getting to catch up with so many interesting people. Of course, I’m also excited about the excellent Medical Care Section Program. Here’s a… Read More »

Public health is (once again) on the ballot

By | November 29, 2022

The 2022 midterm elections are upon us. And public health is once again prominent on the ballot. Think back to the 2020 presidential election and just how stark a contrast Joe Biden and Donald Trump presented on COVID-19, climate change, and the Affordable Care Act. This year is no different. Voters across the country are choosing… Read More »

Early Access vs. Proven Efficacy: FDA’s Accelerated Approval Process

By | October 24, 2022

A recent JAMA article noted that only one-third of new drug approvals through the accelerated approval process by the FDA in the US or the conditional marketing authorization in the EU have shown therapeutic value.  Many of these drugs are high cost, and this begs the question if we are spending our health care dollars appropriately. … Read More »

Improving treatment adherence with evidence-based approaches

Over the last 25 years, researchers have documented the broad impact of behavioral interventions on a range of psychological and physical health outcomes. Despite the promise of evidence-based treatments, a common challenge for practitioners is ensuring treatment adherence to maximize benefits. This is especially challenging for most chronic conditions. Integrating research and recommendations from medication… Read More »

October 2022 Healthy Intersections Podcast

By | November 9, 2022

In this month’s podcast, Dr. Samy Anand gives an overview of the Medical Care Blog posts published in September and a preview of the journal articles in the October issue of Medical Care. Then, co-editor of the blog, Dr. Lisa Lines, discusses an article in the October issue in more detail. Below is a transcript… Read More »

COVID Still Kills, but the Demographics of Its Victims Are Shifting

As California settles into a third year of pandemic, covid-19 continues to pose a serious threat of death. But the number of people dying — and the demographics of those falling victim — has shifted notably from the first two years. Given the collective immunity people have garnered through a combination of mass vaccination and… Read More »

The Medicaid Outcomes Distributed Research Network MODRN [Podcast]

By | October 10, 2022

The Medicaid Outcomes Distributed Research Network (MODRN) was started by AcademyHealth and is a collaborative research network of state Medicaid agencies and university partners. The goal of the network is to allow analysis and learning about Medicaid by facilitating comparison across states and aggregate data with a shorter lag time than other available sources.  This… Read More »

Healthy Intersections Podcast: September 2022

By | October 10, 2022

On this month’s episode of the Health Intersections Podcast, Samy Anand from the Medical Care Section recaps last month’s blog posts and previews September’s issue of the Medical Care journal. Check out these great reads. Next, Jess Williams, co-editor of the blog and podcast, interviews Dr. Cheryl Conner who is a Clinical Associate Professor at… Read More »

Becoming Adept at Policy in Health Advocacy

The pursuit of health equity requires public health and medical professionals to become adept at policy in their health advocacy work. The American Public Health Association (APHA), in fact, defines policy work as one of its 10 essential public health services. APHA says professionals should be capable of “creating, championing and implementing policies, plans and laws”.… Read More »

Medicare Will Negotiate Prescription Drug Prices…In Four Years

By | August 25, 2022

In 2026, Medicare will negotiate prescription drug prices with manufacturers. It is a dramatic reversal of a stranglehold placed on Medicare back in 2003. And it may be one of the most impactful policy changes to the government program since its creation. But there is a catch…we have to wait. President Biden signed the Inflation Reduction… Read More »

Retrospective: On Prescription Drugs

By | August 22, 2022

The Medical Care Blog is preparing for its full return later this month. Until then, we are continuing to highlight articles published by our contributors on timely topics. A federal bill is pending that would allow Medicare to begin negotiating drug prices for the very first time. Even though it would begin with only 10… Read More »

Retrospective: On Reproductive Health Care

By | August 4, 2022

The Medical Care Blog is returning from its summer break this month. We hope you are feeling recharged and ready to dig deep again into health care and public health. We’re beginning with a series of retrospective posts to highlight the work of our contributors on prominent topics. This week, we focus on a collection… Read More »

Summer Break at The Medical Care Blog

By | July 8, 2022

The Medical Care Blog is taking a short summer break from publishing new articles. In the meantime, catch up with the latest posts on the blog: Healthy Intersections Podcast, June 2022 featuring MC Governing Councilor Samy with a wrap-up and co-editor Lisa Lines interviewing noted infectious disease epidemiologist Pia MacDonald about COVID-19 – looking back and looking… Read More »

Category: All

Social Drivers of Cancer Mortality: Part 2

By | September 1, 2022

Measuring and addressing social drivers of health are important in cancer research. Part 1 of this series, published in March 2022, described three commonly used area-level SDoH indices. None are not able to explain much variation in cancer mortality rates. In this post, I share results from a new model that shows promise. Methods in… Read More »

APHA Calls for Single-Payer Health Reform

By | July 6, 2022

It is not too late to fix the US healthcare system. But every day spent in this folly, the problem gets worse. It is time to move this conversation forward. We are excited to share that in November 2021, the American Public Health Association (APHA) formally adopted a policy statement titled “Adopting a Single-Payer Health… Read More »

Ethical research using government administrative data

By | June 16, 2022

As a public health researcher, I love data, the more the better. I held this belief until I found that I myself had become the “subject” of research without my consent. This experience made me rethink ethical research. The more data, the better? In 2017, I encountered a state-level bill that required all the government… Read More »

SDoH in Same-Sex Couple Hotspots and Coldspots

By | June 24, 2022

Happy Pride month! In this post, I’d like to share about a research project in progress that is relevant to the LGTBQIA+ community. This post may also be interesting to those of you who care ok about health equity and the social determinants of health (SDoH). I am a member of the queer community myself.… Read More »

Healthy Intersections Podcast: June 2022

By | June 2, 2022

On this month’s episode of the Healthy Intersections Podcast, Samy Anand from the Medical Care Section recaps last month’s blog posts and preview’s June’s issue of the Medical Care journal. Some great articles to check out for your summer reading list. Next, Lisa Lines, co-editor of the blog and podcast, interviews Dr. Pia MacDonald, an… Read More »

Diabetes Cure or Diabetes Management?

By | May 26, 2022

Reuter’s announced in January that diabetes deaths in the United States continue to surge well above pre-pandemic levels with over 100,000 Americans dying from diabetes in 2021. Given COVID-19’s relationship to diabetes, we may see this trend continue. Increasing deaths from diabetes is a clear call to action for new solutions. Historically, diabetes has been… Read More »

May 2022 Podcast

By | May 13, 2022

In this episode of our podcast series, Jess Williams discusses COVID-19 case and hospitalizations with Tami Gurley, an Associate Professor at the University of Kansas Medical Center. Jess also recaps the blog posts published in April and previews some articles published in the May issue of Medical Care. Listen here or wherever you get your fine audio content.… Read More »

Fixing Health Care: A Health Care Revolt Begs Five Big Questions

In a previous post, we shared highlights from an event about fixing health care featuring Dr. Michael Fine, a family medicine physician, former public health official, and the author of Health Care Revolt. The faculty of the Department of Public Health at California State University Los Angeles led the event as part of a department-wide book read.… Read More »

A Health Care Revolt Begins with Us

Readers of this blog know the problems of U.S. health care well. Principally, it is absurdly expensive, deeply inequitable, and contributes relatively little to overall public health. Yet, most people aware of these problems have been sidelined, feeling incapable of changing things and left hoping for reform to come from within. But health care providers… Read More »

Category: All

Broadband is a human right: the right to information and COVID-19 disparities

Understanding internet access through a human rights framework has been a goal of human rights advocates for years. But COVID-19 has brought the idea of “broadband as a human right” to the forefront as a necessary and urgent human need. A recent study exploring the Social Determinants of Health and COVID-19 mortality, found that individuals without… Read More »

Centering measurement on patients and family caregivers while developing two novel quality measures

In healthcare, what gets measured gets done. This is particularly true as the use of value-based purchasing, alternative payment models, and consumer tools to compare quality expand in the U.S. Centering measurement on patients, and focusing on their needs, preferences, and values, ensures that what we measure really matters, not only to patients and their… Read More »