I am a health economist, trained to make sense of messy data. I generally work amidst a sea of numbers. But I’ve found that seeking out stories in health services research–those of doctors and patients–can help me anchor what’s truly important in research. These stories may also help researchers communicate the value of their work to others. For the past seven years, I’ve worked on several of Medicare’s primary care models. First, I worked on the Comprehensive Primary Care Plus Initiative (CPC+) and more recently on the Primary Care First and Making Care Primary models. These models all seek t ..read more

Suicide prevention and intervention programs and services are vital. Mental health services are essential to support individuals, families, and communities struggling with mental health, suicide, and after suicide loss. But we must also recognize that preventing suicide requires a larger collective, systemic response.  Suicide deaths are rising steadily every year, with a record high of nearly 50,000 people who took their own lives in the U.S. in 2022. This urgent public health issue requires us to examine and address the social determinants of health of poor mental health. We must a ..read more

How patients are seeing their doctor is changing, and that could shape access to and quality of care for decades to come. More than 100 million Americans don’t have regular access to primary care, a number that has nearly doubled since 2014. Yet demand for primary care is up, spurred partly by record enrollment in Affordable Care Act plans. Under pressure from increased demand, consolidation, and changing patient expectations, the model of care no longer means visiting the same doctor for decades. KFF Health News senior correspondent Julie Appleby breaks down what is happening— and what it me ..read more

It’s been 4 years this month since the World Health Organization declared COVID-19 to be a global pandemic. Where are we now? It’s time to take stock of the real impact of the pandemic. Aside from the burden of illness and mortality, the mental health toll, and the strains on the healthcare system, COVID even affected climate change. Elsewhere, we have noted the burden on the environment from the pandemic (single-use masks, single-use plastics, and overall intense resource use), along with disproportionate harms to vulnerable communities. We’ve published a large collection of posts on COVID-19 ..read more

Patient-provider racial/ethnic concordance (i.e., physician and patient identify as the same race/ethnicity) has emerged as one key suggestion for mitigating healthcare disparities. Past research has underlined its benefits, including improved infant mortality and more appropriate prescription regimens. However, the sum of the evidence remains unclear and many facets of the patient-provider relationship have yet to be examined. From historical and practical perspectives, shared decision-making and doctors communicating treatment options are critical in improving healthcare trust and experience ..read more

Competition between hospitals in a given market should provide incentives to ensure quality while also lowering costs. Over the past two decades, hospital markets have increasingly consolidated. This consolidation reduces competition and increases the comparative leverage that hospitals and associated health systems have. While there are some theoretical advantages of increased consolidation such as potential for economies of scale, prior research has shown that consolidation has been associated with higher costs, in addition to worse quality. In response, regulatory agencies at both the state ..read more

If the US healthcare industry were its own country, it would be in the top 10% of all countries in greenhouse gas emissions. Welcome to the February, 2024 edition of the Healthy Intersections Podcast! This month, we sit down with David Introcaso, PhD, to discuss the healthcare industry’s carbon footprint. Dr. Introcaso is the host and producer of the Healthcare Policy Podcast as well as an experienced researcher. He talks us through understanding the scope of the problem and makes excellent points about the role of policies in addressing the climate crisis. Why not require healthcare organizat ..read more

In January, the Medical Care Blog’s editors published a consensus statement on climate policy and health. This statement was co-signed by many of our authors, editors, and editorial board members of the Medical Care journal. As we look ahead to our focus theme for 2024, we want to begin with a look backward as well. The American Public Health Association (APHA) has a legacy of adopting position statements that acknowledge and propose responses to environmental health hazards, including the changing climate. APHA has a long history of member-driven scientific policies to address environmental ..read more

A special supplemental issue of Medical Care supports the growing recognition that patient economic outcomes matter in health care. Sponsored by the Assistant Secretary for Planning and Evaluation (ASPE) in the U.S. Department of Health and Human Services, the issue highlights studies that explore the relationship between economic outcomes, patient care, health outcomes and equity. Patient-centered outcomes research (PCOR) includes economic outcomes In 2019, reauthorization of the Patient-Centered Outcomes Research Trust Fund involved an expansion of PCOR to focus on economic outcomes.&n ..read more

The social determinants of health (SDOH), the conditions in which we are born, live, learn, work, play, worship, and age, have a significant impact on health outcomes. Research shows that a whopping 80-90% of health outcomes are dependent on SDOH factors, while medical care only accounts for about 10-20%. New clinical-community partnerships designed to address SDOH, however, are showing promise in improving patient outcomes. Adverse SDOH make patients sicker The burden of disease is greater among those living with adverse SDOH. A study of primary care patients with a chronic medical and behavi ..read more