Author Interviews, Cost of Health Care, COVID -19 Coronavirus, JAMA / 26.09.2022

MedicalResearch.com Interview with:

Allison Witman PhD Assistant Professor of Economics Economics & Finance Cameron School of Business University of North Carolina, Wilmington

Yu Wang PhD Assistant Professor Congdon School of Supply Chain, Business Analytics, & Information Systems Cameron School of Business University of North Carolina Wilmington David Cho PhD Assistant Professor of Management California State University, Fullerton

MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic placed tremendous financial pressure on hospitals. Beginning in March of 2020, hospitals cancelled outpatient and elective procedures to accommodate surges in demand from COVID-19 patients. As these procedures account for more than 60% of an average hospital’s revenue, cancellation posed serious challenges to the financial health of hospitals. Revenue from COVID-19 patients may have partially offset these effects, but the American Hospital Association estimated a total loss of $202.6 billion by American hospitals between March and June 2020. In response, the U.S. government created large federal assistance programs aimed to stabilize hospitals’ financial situation as their ability to maintain operations was critical to the health of the nation. Due to differences in hospital characteristics, certain hospitals such as rural hospitals and those serving a higher share of Medicaid and uninsured patients (e.g., safety net hospitals) may have been more financially susceptible to the effects of the pandemic. These hospitals that serve vulnerable patient populations historically have had lower profit margins and were candidates for targeted COVID relief funding (e.g., Safety Net Hospitals Payments, a $10 billion component of the Provider Relief Fund). (more…)
Author Interviews, Cost of Health Care, Dermatology, JAMA / 08.09.2022

MedicalResearch.com Interview with: Jane M. Zhu, M.D., M.P.P., M.S.H.P. Assistant Professor of Medicine Division of General Internal Medicine and Geriatrics School of Medicine Oregon Health & Science University Portland, Oregon MedicalResearch.com: What is the background for this study? Response: Private equity (PE) acquisitions of physician practices are accelerating across many specialties, but there is still little robust evidence on the effects of these acquisitions. Concerns about PE involvement is predicated on the fact that these firms expect high annual returns, which require either reducing costs or increasing revenue, or both. Using PE acquisition data from 2016-2020, linked to commercial claims data, we sought to understand what common mechanisms of revenue generation were being adopted after private equity acquisition of physician practices. (more…)
Author Interviews, Health Care Systems, JAMA / 12.07.2022

MedicalResearch.com Interview with: Dr. Joanna JiangJoanna Jiang, PhD Agency for Healthcare Research and Quality Rockville, Maryland MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Over the last decade we have seen two trends occurring to rural hospitals – closures and mergers. A hospital in financial distress could likely face closure. But if the hospital affiliates with a multihospital system, it may have access to resources from the system that help shelter the hospital from closure. That is exactly what we found in this study. System affiliation was associated with a lower risk of closure for financially distressed hospitals. However, among hospitals that were financially stable, system affiliation was associated with a higher risk of closure. This is somewhat puzzling and needs further study to better understand the reason for closure. (more…)
Author Interviews, Diabetes, JAMA, Race/Ethnic Diversity, University of Pennsylvania / 20.12.2021

MedicalResearch.com Interview with: Lauren A. Eberly, MD, MPH Clinical Fellow, Cardiovascular Medicine Perelman School of Medicine Cardiovascular Division, Perelman School of Medicine Center for Cardiovascular Outcomes, Quality, and Evaluative Research, Cardiovascular Center for Health Equity and Social Justice, Leonard Davis Institute of Health Economics University of Pennsylvania, Philadelphia MedicalResearch.com: What is the background for this study? Response: Racial inequities are pervasive in our country, and cardiovascular therapeutics with proven benefit have been shown to be underutilized among Black and Latinx patients. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a recommended treatment option for glycemic control in patients with diabetes, have recently emerged as a cardioprotective therapy as multiple large randomized clinical trials have shown they prevent cardiovascular events among patients with Type 2 Diabetes (T2D), particularly patients with established atherosclerotic cardiovascular disease (ASCVD). Given this, they are now recommended therapy for patients with diabetes and established or high risk of ASCVD. Given the known inequitable utilization of other therapies, along with the known higher burden of diabetes and cardiovascular disease among Black patients, the aim of this study was to evaluate the uptake of GLP-1 RA as well as for inequities in utilization. (more…)
Author Interviews, Cost of Health Care, JAMA, Medicare / 12.12.2021

MedicalResearch.com Interview with: Jeanne Madden, PhD Associate Professor Department of Pharmacy and Health Systems Sciences School of Pharmacy and Pharmaceutical Sciences Bouvé College of Health Science Northeastern University MedicalResearch.com: What is the background for this study? Response: Medicare is the US public insurance program mainly serving people 65 years and older, but also some younger adults who have long-term disabling conditions. As such, on average, the Medicare population bears a heavy burden of illness and has high health care needs, compared to the general US population. The under-65 group for the most part has quite low incomes, while the older group represents a wide spectrum, from poor to well-off. Medicare beneficiaries also differ a great deal in terms of whether they have access to supplemental insurance that can help with patient cost-sharing requirements. I’m referring to Medicaid assistance, or a self-purchased Medigap plan, or retiree health benefits, etc. The cost-sharing requirements in traditional Medicare are substantial — e.g., 20% for doctor visits — and there is no annual cap on patient out-of-pocket spending. That’s in contrast to commercial insurance and Medicare Advantage managed care plans — all of those have an annual cap on patient out-of-pocket costs. There’s a good amount of existing research on whether people in Medicare can afford their drugs, and on the affordability of medical care among younger groups such as working-aged uninsured people and those in ACA exchange plans. But there hasn’t been much research into medical care affordability among older Americans. (more…)
Author Interviews, Columbia, JAMA, Race/Ethnic Diversity, Telemedicine / 29.07.2021

MedicalResearch.com Interview with: Steffie Woolhandler MD MPH, FACP Professor of Public health and Health Policy CUNY School of Public Health at Hunter College Co-founder and board member Physicians for a National Health Program MedicalResearch.com: What is the background for this study? What are the main findings? Response:   We analzyed a national database of healthcare utilization. We found racial disparities exist in use of specialist MD services by Black- and Native-Americans relative to White-Americans, despite their greater needs.  Hispanic- and Asian-Americans also receive specialist care at low rates.   (more…)