The Affordable Care Act provides new Medicaid coverage to an estimated 12 million low-income adults. Barriers access or quality could hamper the program's success. One of these barriers might be stigma associated with poverty.Our mixed-methods study involved 574 adults and included data from in-person survey follow-up interviews. Our analysis interviews showed that many participants who were on uninsured described a perception fear being treated poorly in health care setting. We defined this...

Objective To identify factors that promote the effective performance of accountable care organizations ( ACO s) in Medicare Shared Savings Program. Data Sources/Study Setting come from a convenience sample 16 s were organized around large physician groups. We use claims data Center for Medicaid and Services 60 interviews at three high‐performing low‐performing s. Study Design Explanatory sequential design, using qualitative to account patterns observed quantitative assessment performance....

Background: This study sought to examine the complex relationship between individual and environmental characteristics, broadband access, device type (computer or smartphone), telehealth utilization as it relates digital divide. Methods: We analyzed a combination of electronic health record publicly available zip code-level data for 2,770 men seeking treatment on large, nationally available, direct-to-consumer platform. Using logistic regression, we determined likelihood accessing platform...

More than 25% of US adults experience mental health or substance use conditions annually, yet less half receive treatment. This study explored how rural participants with behavioral pursue and care, it examined these factors differed across American Indian (AI) geographic subpopulations.We undertook a qualitative follow-up from statewide survey unmet needs in South Dakota. We conducted semistructured phone interviews purposive sample key informants varying perceptions need for treatment.We...

Background: Efforts to improve outcomes for the 10% of patients using two thirds health care expenditures increasingly include addressing social determinants. Empiric evidence is needed identify highest impact nonmedical drivers medical complexity and cost. Objectives: This study examines whether complex, cost have different patterns critical life adversity than those with better lower utilization. Research Design: Using a validated algorithm we constructed complexity/cost risk patient...

Medicaid expansions through the Affordable Care Act began in January 2014, but we have little information about what is happening rural areas where provider access and patient resources might be more limited. In 2008, Oregon held a lottery for restricted to its program uninsured low-income adults not otherwise eligible public coverage. The Health Insurance Experiment used this opportunity conduct first randomized controlled study of insurance expansion. This analysis builds off previous work...

In 2012, Oregon embarked on an ambitious plan to redesign financing and care delivery for Medicaid. Oregon's Coordinated Care Organizations (CCOs) are the first statewide effort use accountable principles pay Medicaid benefits. We surveyed 8,864 Medicaid-eligible participants approximately 1 year before 12 months after CCO implementation assess impact of CCOs member-reported outcomes. compared changes in outcomes over time between members, fee-for-service (FFS) those who were uninsured....

Asynchronous health care encounters are becoming an increasingly mainstream form of telehealth. While synchronous phone or video visits have become more widely accepted, US policymakers and other key stakeholders been hesitant to fully embrace asynchronous diagnosis treatment. This is particularly true in the context direct-to-consumer (DTC) platforms, where patient-initiated there no preestablished relationship with a provider. hesitation compounded by limited research comparing outcomes...

Behavioral health integration (BHI) models seek to improve patient experience and outcomes by bridging physical behavioral services. Past BHI research has not focused on stigma in these settings, which been previously found impact engagement outcomes. We surveyed patients over a two year period at 12 integrated clinics Oregon using measures developed Patient Advisory Team. Over quarter of respondents reported stigmatization (26.81%). Compared non-stigmatized patients, those who had five...

Oregon's coordinated care organizations (CCOs) are an integral part of a massive statewide reform that brings accountable to Medicaid. CCOs regional collaboratives among health plans, providers, county public health, and communitybased administer single global budget covering physical, mental, dental healthcare for low-income Oregonians. have been given freedom within the implement reforms might capture efficiencies in cost quality. For this study-fielded between 2012 2015-we traced path...

Introduction & Objective: A third of the U.S. population has prediabetes but most are unaware. Knowing one’s status can reduce risk future Type II Diabetes (T2D); current demand for anti-obesity medication is an opportunity to screen prediabetes, offer counseling, and, when appropriate, initiate weight loss treatment prevent T2D. We explored characteristics and outcomes individuals with prediabetic HbA1C values no prior diagnosis who sought management care on a direct-to-patient (DTP)...

Background Despite the increasing prevalence of obesity, use pharmacotherapy treatment remains low. Telehealth platforms have potential to facilitate access interventions, but little is known about telehealth patients. Objective This study describes a large patient population taking Plenity, an oral superabsorbent hydrogel (OSH) used in excess weight or obesity (BMI 25-40 kg/m2). The analysis compared differences loss practices and in-person care among patients with preobesity obesity....

Incorporating patient-reported outcome measures into routine clinical care can improve the patient experience, increase engagement, and establish a structured method for gathering adverse event (AE) data. Systematically collecting this information on large scale also inform new solutions removing treatment barriers like medication nonadherence. This study evaluated whether implementing data collection surveillance tool would result in greater continuation patients receiving telehealth...

The continued emergence of new COVID-19 variants highlights the importance vaccination in effort to reduce disease transmission and burden. objective this study is evaluate processes outcomes associated with a novel in-home program aimed at vaccinating high-risk populations New York, USA.To processes, we described itself reflected on some key lessons learned. To outcomes, analyzed data reported by vaccine recipients. These included percentage recipients that successfully received full course...

Background and Objective: Plenity is a non-systemic oral superabsorbent hydrogel which promotes fullness by increasing the volume elasticity of ingested food in stomach small intestine. The efficacy safety have been demonstrated clinical trials. This study evaluated weight change people with overweight or obesity following treatment real-world setting. Research Design Methods: Data was analyzed using chart records from national telehealth platform. Demographic health information...

<sec> <title>BACKGROUND</title> Asynchronous health care encounters are becoming an increasingly mainstream form of telehealth. While synchronous phone or video visits have become more widely accepted, US policymakers and other key stakeholders been hesitant to fully embrace asynchronous diagnosis treatment. This is particularly true in the context direct-to-consumer (DTC) platforms, where patient-initiated there no preestablished relationship with a provider. hesitation compounded by...