Category Archives: All

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 »

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 »

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 »

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 »

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 »

April 2022 Podcast

By | April 7, 2022

In this episode of our podcast series, Greg Stevens discusses health care provider burnout with Cooper Couch, a practicing physician assistant at an FQHC in rural Colorado. Next, he recaps the blog posts published in February and previews an article published in the April issue of Medical Care. Authored by Jae Downing, Kendall Lawley and Alex McDowell,… Read More »

Social drivers of cancer mortality

By | March 28, 2022

In 1981, Doll and Peto published a well-known paper estimating that roughly 75-80% of cancer mortality was preventable. Forty years later, cancer mortality has declined some overall – but we still see vast disparities. Some of these disparities have gotten worse over time. With the Biden administration’s reignited Cancer Moonshot initiative, combined with a renewed… Read More »

The new landscape for community public health

By | March 10, 2022

We’re in a new landscape, where citizens sees themselves as agents for community public health and as part of the public health infrastructure. My patient began to talk about COVID in her community. She first told me the rates of infection from the previous weeks. Then she told me what COVID strains were dominant at… Read More »

March 2022 Podcast

By | March 2, 2022

In this episode of our podcast series, Samyuktha Anand, secretary-elect for the Medical Care section, recaps the blog posts we published in February. She also previews a few of the journal articles published in this month’s issue of Medical Care. Next, Lisa Lines, co-editor, discusses an article published ahead of print on March 1. The article is available here:… Read More »

Vaccination Choice: The Strongest Link in the Weakest Case

By | February 24, 2022

Almost 30 years ago I was working in the White House as part of a team working to win approval of President Bill Clinton’s proposal for universal health insurance. The effort was winding down. It was obvious it would fail. I was tired and depressed. One of my last appearances in support of the plan… Read More »

To Address Synthetic Opioids, These Public Health Strategies Must Play a Vital Role

By | February 14, 2022

The opioid epidemic and substance use disorders have garnered national attention as overdose deaths continue at an alarming rate. Synthetic opioids – chiefly fentanyl – are the culprit in many of those deaths. The Commission’s report Earlier this month, the bipartisan Congressional Commission on Combating Synthetic Opioid Trafficking, with representatives from many Federal agencies and… Read More »

February 2022 Podcast

By | February 10, 2022

In this episode of our podcast series, Samyuktha Anand, secretary-elect for the Medical Care section, recaps the blog posts we published in January. Next, Jess Williams, co-editor, interviews Nien Chen Li about her recently published paper — a winner of the APHA Medical Care Section’s Student Paper Award in 2020. Dr. Li’s paper is about… Read More »

Evaluating Community Health Worker Programs

By | February 3, 2022

Evaluating community health worker (CHW) programs can be difficult. Many of the outcomes that we care about, such as patients’ capacity to live healthier lives, can be difficult to measure and take time to manifest. I have been fortunate to be part of a five-year research partnership with the KC Care Health Center that was… Read More »

Is Something Going Wrong With the Patient Centered Medical Home?

By | January 27, 2022

Like others working at the intersection of public health and medicine, my faith in primary care has long been unshakeable. Increasingly actualized as the Patient-Centered Medical Home (PCMH), primary care has experienced a decade plus of attention thanks to efforts at retooling and rebranding the field. But in the last week, a tiny crack formed… Read More »

Lessons From Conducting the Path-4CNC Virtual Convenings

Last week, we detailed the findings of virtual convenings we held in North Carolina to improve care for children with complex health needs (CCHN). Here, we share our takeaways about the process of planning, holding and following-up on the convenings. We also outline the specific steps other leaders, innovators, and advocates can take to engage… Read More »

Engaging Communities to Improve Systems of Care for Children with Complex Health Needs

Children with complex health needs (CCHN) are a unique pediatric patient population. They have chronic medical and/or behavioral conditions that need ongoing health care. They use a disproportionate share of hospital resources. And they face greater social challenges when compared to other children. In North Carolina (where we work) and across the country, CCHN fail… Read More »

January 2022 Podcast

By | February 10, 2022

In this episode of our podcast series, Greg Stevens, co-editor, recaps the blog posts we published on The Medical Care Blog in November and previews the January issue of Medical Care. Greg also interviews Dr. Ben King from the University of Houston School of Medicine about their shared interest in health care for people experiencing homeless.… Read More »

How are CMMI health policy evaluations addressing non-parallel trends?

To help determine which health policy changes to the Medicare or Medicaid programs are desirable, the CMS Center for Medicare and Medicaid Innovation (CMMI) relies on formal evaluations, performed by outside contractors, of how smaller scale, typically voluntary, demonstrations and other initiatives impact outcomes of interest. However, determining causal impacts often relies on the key… Read More »

Category: All

“Carve In” Mental Health and Substance Use Treatment

By | December 21, 2021

More than 150,000 avoidable deaths occur each year due to mental, emotional, and behavioral health problems. This includes nearly 50,000 suicide deaths and 100,000 overdose deaths. People with chronic persistent mental illness suffer a 20-year shorter life expectancy. This country urgently needs to address how we pay for mental health services. Medicaid is a major… Read More »

The Power of Data – Takeaways from the 2021 All In National Meeting

By | December 10, 2021

“You can’t improve what you don’t measure” is a common phrase highlighting the importance and power of data. Indeed, the importance of data was the central theme of the 2021 All In National Meeting. In case you’re unfamiliar, the host of the national meeting is All In: Data for Community Health: a learning network of… Read More »

Nursing Home Characteristics and COVID-19 Outcomes: The Evidence is Mixed

By | December 17, 2021

COVID-19 has severely affected nursing homes. As of now, over 139,270 residents and 2,155 nursing home staff have died from COVID-19. This post provides insight on the questions researchers are asking to understand the impact of nursing facility factors on COVID-19. A Perfect Storm The combination of a frail, aging population, close living quarters, and… Read More »

Downstream Efforts to Address Social Determinants in the CMS Financial Alignment Initiative

In our last blog post, we discussed the Biden Administration’s infrastructure package as an example of an upstream policy effort that could promote equity and help address disparities. However, as we pointed out in the first in this series of blogs, stakeholders who interact with community members are best suited to identify social risk factors… Read More »