Mathematica

Everyone with a serious cancer diagnosis stays with Medicare Fee-For-Service (FFS), right? Well, not everyone. The Sankey below shows how the incident lung cancer population in Medicare FFS in 2017 moves between plans. The source here is again 100% Medicare enrollment files at the beneficiary level from Mathematica’s Health Data Innovation Lab. Of course, the largest movement is from enrolled to deceased, but there is a non-trivial amount of movement to Medicare Advantage at 3 years (2020) and 5 years (2022) after incident diagnosis. Also, if you squint, some people do move back to Medicare FFS from Medicare Advantage. The challenge here is for those doing cancer outcomes research over a longer time period that involves the Medicare population. It's very difficult to stitch together all required claims and other real-world data to follow cohorts across plans. Credit to Jelena Zurovac and Mike Barna for pulling together the data and visuals.

#EvidenceOnAdaptation Let's start with the big picture: What do recent evidence reviews and analyses tell us about overall global #ClimateAdaptation progress? The bad news ?: Progress has been incremental and fragmented. ?? Researchers at the Stanford King Center on Global Development found limited evidence that ‘sensitivities’ to climate change have declined in a way consistent with adaptation. Of the 21 outcomes they studied (yields, mortality, damages, etc.), only six showed significant declines in their sensitivity to climate change (five became more sensitive). They stress this doesn’t mean no adaptation is occurring, but their approach finds only a weak signal overall. ??https://bit.ly/40wCIrm ?? Similarly, an exhaustive systematic review by Berrang-Ford et al found only “… minor adjustments to business as usual rather than transformation, and short-term responses to extreme weather rather than long-term proactive change”. They also note several shortcomings in the adaptation evidence base that hamper understanding overall progress, including less than 5% of the c. 50K papers they sifted through (!) attempting to measure outcomes from adaptation interventions. ??https://bit.ly/40wRoGU The good news ?: There are a growing number of success stories that are a source of both encouragement and learning: ?? For example, a new report by the The World Bank generally agrees with this overall diagnosis but emphasizes that “there are strong examples of effective adaptation practices in all sectors, regions, and income levels”. One of their recommendations: despite measurement challenges, invest in more robust monitoring, evaluation, and learning systems to address the current evidence shortfalls and get a firmer handle on adaptation progress. ?? https://bit.ly/48ypeNK We'll be digging deeper into specific geographies, sectors, and issues to get clearer signals on adaptation progress, challenges, and evidence gaps in the weeks ahead! Mathematica, Tulika Narayan, Dheeya Rizmie, PhD, Johanna Choumert-Nkolo, Veronica Barger, MPA, Colleen Psomas