Health Services Research

New study in #HSR Wiley from Evan Michael Shannon MD MPH et al evaluates racial and ethnic differences in patient experience among VA primary care users at the Veterans Integrated Service Network (VISN) level. FULL ARTICLE: https://lnkd.in/dFRzQ6u9 WHAT IS KNOWN: There are documented racial and ethnic disparities in patient experience, including in the Veterans Health Administration (VA). WHAT THIS STUDY ADDS: This study identified regional variation in racial and ethnic disparities in patient experience among VA users across the United States. CONCLUSION: In our study, we found VISN-level variation in racial and ethnic differences in patient experience, with unique patterns for minoritized groups, including groups with lower representation in the VA.

New study in #HSR Wiley from Laura J. Damschroder MS, MPH et al describes the impacts of four Veterans Health Administration (VA) Quality Enhancement Research Initiative (QUERI) projects implementing an evidence-based lifestyle intervention known as the Diabetes Prevention Program (DPP). FULL ARTICLE: https://lnkd.in/dmrUbSuc WHAT IS KNOWN: The VHA has prioritized the management and prevention of diabetes and obesity for over two decades, including the delivery of the VA MOVE! Weight Management Program for Veterans across 150+ VA sites. WHAT THIS STUDY ADDS: Four QUERI effectiveness-implementation studies have advanced the reach of and engagement in diabetes prevention services among 963 Veterans across 16 VA sites. CONCLUSION: Four QUERI DPP-related projects conducted between 2012 and 2024 helped redesign MOVE! programming across the national VA healthcare system, enhance the evidence base for online DPP delivery within and outside VA, and demonstrate the importance of tailoring preventive care services by and for women Veterans.

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New study in #HSR Wiley from Monica M. Matthieu PhD, LCSW et al describes a process model for assisting partners in addressing requirements of legislation and review policy analysis, planning, and evaluation design processes and tools. FULL ARTICLE: https://lnkd.in/det_yedW WHAT IS KNOWN: Congress holds the power and the purse strings for the entire federal government; legislation also drives which policies, programs, and practices federal agencies must implement, evaluate, and report to Congress. (2/4) WHAT THIS STUDY ADDS: Preparation of Congressionally Mandated Reports is best done in active, engaged collaboration between scientists and executive leadership. (3/4) CONCLUSION: Lessons learned may help other scientists partnering in VA or other federal agencies to plan, conduct, and report on congressionally mandated projects. (4/4)

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For HSR peer reviewers: We have new guidelines for writing your review. We're grateful for your work and hope our questions-based guide makes it easier. https://lnkd.in/guHaWzja?

HSR appreciates our peer reviewers! We've developed reviewer guidelines that we hope will make your work easier. Please give them a try. We welcome your feedback to improve them. https://lnkd.in/guHaWzja?

New study in #HSR from Joanne Constantin PhD, MPH and George L. Wehby PhD, MPH et al evaluate the effects of Medicaid Accountable Care Organizations (ACOs) on children's access to and utilization of health services. WHAT IS KNOWN?Prior evidence points to improvement in some children's healthcare access and utilization measures with Medicaid Accountable Care Organizations (ACOs). WHAT THIS STUDY ADDS?Findings suggest an increase in having a personal doctor/nurse and in specialist care use and decline in emergency department use, but no discernable or robust associations with other outcomes. CONCLUSION There is mixed evidence on the associations of Medicaid ACOs with pediatric access and utilization outcomes. Examining effects over longer periods post-ACO implementation is important. FULL ARTICLE:?https://lnkd.in/gt5jzT-T #HealthServicesResearch Wiley AcademyHealth ?

New study in #HSR from Youngmin Kwon PhD et al examine changes in late- versus early-stage diagnosis of cancer associated with the introduction of mandatory Medicaid managed care (MMC) in Pennsylvania. WHAT IS KNOWN?Medicaid covers a growing population of individuals with cancer but Medicaid beneficiaries with cancer often experience poor survival due to late-stage diagnosis. WHAT THIS STUDY ADDS?Using a difference-in-differences design, we examined the effects of mandatory Medicaid managed care in Pennsylvania on early versus late-stage diagnosis of incident cancer cases among adult patients aged 21–64 covered by Medicaid. CONCLUSION In Pennsylvania, the implementation of mandatory MMC for adult Medicaid beneficiaries was associated with earlier stage of diagnosis among newly diagnosed cancer patients with Medicaid, especially those diagnosed with screening-amenable cancers. Considering that over half of the sample was diagnosed with late-stage cancer even after the transition to mandatory MMC, Medicaid programs and managed care organizations should continue to carefully monitor receipt of cancer screening and design strategies to reduce barriers to guideline-concordant screening or diagnostic procedures. FULL ARTICLE:?https://lnkd.in/gn85k8Cz #HealthServicesResearch Wiley AcademyHealth

New study in #HSR from Jenny Markell BA and Mark Katz Meiselbach PhD investigate the impact of Medicaid expansion on state expenditures through the end of 2022. WHAT IS KNOWN?COVID-19 policies led to increased Medicaid enrollment across states, with Medicaid enrollment rising approximately 29% in expansion states from 2020 to 2022. WHAT THIS STUDY ADDS?The impact of Medicaid expansion on Medicaid spending was substantially greater in the post-COVID era (2020–2022) compared with the pre-COVID era following Medicaid expansion (2015–2019). CONCLUSION There was no evidence of crowding out of other state expenditure categories or a substantial impact on total state spending, even in the COVID-19 era. Increased federal expenditures may have shielded states from substantial budgetary impacts. FULL ARTICLE:?https://lnkd.in/guXeJzzt #HealthServicesResearch Wiley AcademyHealth ?