Health Equity and Access Weekly Brief: February 10, 2024

Health Equity and Access Weekly Brief: February 10, 2024

Examining health education, social determinants, and discrimination in health plans

A new study aimed to evaluate the feasibility of telephone screening for health education (HL) and perceived healthcare discrimination (PHD) among managed care patients, focusing on social determinants of health (SDOH). While the HL screen was well received, the PHD screen had a lower response rate, possibly due to discomfort. Low HL was associated with being black, having a low income, and experiencing loneliness or food insecurity. According to the authors, this suggests the potential for health plans to use such examinations to understand patient barriers and tailor interventions for health equity, despite limitations such as sample size and implications of causality.

Medicare’s value-based purchasing program yields comparable 30-day mortality rates across hospitals

Researchers investigated the effect of the Medicare hospital value-based purchasing program on mortality rates in hospitals with a high percentage of black patients. Despite concerns about the quality of care in these hospitals, no significant differences in mortality rates were found compared to other hospitals after the implementation of the program. However, the program was associated with widening disparities in pneumonia mortality rates for adults of color, highlighting the need for continued evaluation of initiatives to address outcomes of care, particularly for minority populations.


Carrie Kozlowski discusses the impacts of the Medicaid disenrollment crisis

Carrie Kozlowski, COO and co-founder of Upfront Healthcare, discussed the ramifications of increased Medicaid disenrollment in the US healthcare system. She highlighted the financial strain, noting the increase in uncompensated care rates from 6.4% to 8.7%, and predicted long-term impacts such as patients avoiding care due to financial constraints leading to advanced disease. She noted the challenges hospitals face in managing uninsured patients, affecting turnover and delaying care for others. Kozlowski also cited the broader community impact, particularly on vulnerable populations, with 37% of children disenrolled from Medicaid last year exacerbating existing racial disparities.


Non-white patients with CRC have an increased chance of urgent resection

The study in Surgery Open Science found that nonwhite patients, including black, Hispanic, and other ethnicities, faced higher odds of emergency colorectal cancer (CRC) resection and major adverse events compared with white patients for nearly a decade, despite from a decline in general emergency operations. Emergency admissions were associated with Medicaid or uninsured status, indicating financial barriers, and were associated with increased mortality and complications. This underscores the importance of timely CRC screening and oncologic evaluation to reduce the need for emergency surgery in nonwhite populations, although limitations such as lack of data on cancer staging and complexity of surgery suggest that further research is needed to address these inequalities effectively.


New Mexico implements mobile crisis intervention teams with HHS approval

HHS approved New Mexico’s plan for mobile crisis intervention teams, a crucial step in President Biden’s mental health agenda under the American Rescue Plan. These teams will provide 24/7 crisis services to Medicaid beneficiaries, providing rapid response and connecting individuals with behavioral health providers. This aligns with efforts in other states to expand community-based crisis care and the statewide launch of the 988 Suicide and Crisis Line. In New Jersey, mobile crisis response teams are being established to provide timely intervention without involving enforcement of the law, ensuring equal access to mental health services.

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