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Impact of COVID-19 on Trends in Physician Payments from Traditional Medicare from 2017-2021
03-11-25
Physicians, especially in primary care, likely faced substantial revenue loss during the COVID-19 pandemic due to decreases in patient volume and deferred healthcare utilization. While studies have focused on projections and limited surveys, the impact of the pandemic on physician revenue is...
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An Unclear Partnership: Key Questions about Physician and Advanced Practice Provider Collaboration in Primary Care
01-17-25
More than 83 million people in the United States live in primary care shortage areas. As the US healthcare system faces a contracting primary care physician workforce, advanced practice providers are playing an increasingly important role in the delivery of primary care services. In parallel,...
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Physicians’ Perspectives on Using Direct Observation to Assess Non-English Language Proficiency for Clinical Practice: A Qualitative Study
11-20-24
Communication barriers are known to adversely affect patient safety. Yet few health systems assess and track physician non-English language proficiency for use in clinical settings. Barriers to current assessments (usually simulated clinician oral proficiency interviews) include time constraints...
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Nurse Practitioner Care, Scope of Practice, and End-of-Life Outcomes for Nursing Home Residents with Dementia
05-10-24
Is nurse practitioner (NP) care associated with end-of-life outcomes for nursing home residents with Alzheimer disease and related dementias (ADRD), and do these associations differ between states with full versus restrictive NP scope of practice regulations?
The results of this cohort study...
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Language-Concordant Care: A Qualitative Study Examining Implementation of Physician Non-English Language Proficiency Assessment
08-24-23
Clinicians who speak the language of the patients they care for can help increase access to care and improve patient health outcomes. Researchers, including Healthforce Center’s Director Sunita Mutha, looked at the barriers and facilitators to primary care physicians’ willingness to have their...
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"Long Overdue": Nurse and Resident Physician Perspectives on Implementation of Dual-Handset Interpreter Phones in the Inpatient Setting
02-16-23
Patients with language barriers suffer significant health disparities, including adverse events and poor health outcomes. While remote language services can help improve language access, these modalities remain persistently underused. The objective of this study was to understand clinician...
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Rural-Urban Prescribing Patterns by Primary Care and Behavioral Health Providers in Older Adults with Serious Mental Illness
11-30-22
Older adults with serious mental illness (SMI) often have multiple comorbidities and complex medication schedules. Shortages of behavioral health specialists (BHSs), especially in rural areas, frequently make primary care providers (PCPs) the only clinician managing this complex population. The aim...
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Physician and Nurse Practitioner Teamwork and Job Satisfaction: Gender and Profession
09-08-22
Designing interprofessional primary care teams composed of physicians and nurse practitioners (NPs) is a national priority. We assessed how profession and gender affect teamwork and job satisfaction among primary care physicians and NPs by using survey data from 186 physicians and 398 NPs...
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A Toolkit to Advance Racial Health Equity in Primary Care Improvement
04-21-22
The California Improvement Network (CIN) is focused on effectively integrating equity into health care improvement projects. Informed by its Racial Health Equity Workgroup and developed in partnership with HealthBegins, this practical toolkit is designed to help health care organizations —...
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Prescribing Patterns in Nursing Home Residents Living with Dementia by Specialty and Provider Type
04-04-22
Objective/Issue
Little is known about the contributions of different provider specialties in prescribing medications for nursing home residents living with dementia. In this study, we examine prescribing patterns for common psychiatric medications and for opioid and non-opioid analgesics in long-...
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Lack of Racial and Ethnic Diversity Among Addiction Physicians
01-31-22
Compared to white individuals, Black, Indigenous, and Latinx individuals have decreased access to addiction care, lower rates of addiction treatment, and higher rates of incarceration, non-fatal overdose, and death. Racial/ethnic concordance between patients and clinicians has been associated with...
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CIN Connections, Winter 2022 — Centering Equity in Health Care Improvement
01-11-22
The California Improvement Network (CIN) is a community of health care professionals committed to identifying and spreading ideas for better primary care delivery. This issue of CIN Connections offers ways to implement quality improvement efforts that intentionally advance health equity in primary...
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The CMS State Innovation Model Initiative and Improved Health Information Technology and Care Management Capabilities of Physician Practices
08-01-21
The Centers for Medicare and Medicaid Services’ (CMS) State Innovation Models (SIMs) initiative funded 17 states to implement health care payment and delivery system reforms to improve health system performance. This study aimed to evaluate SIMs role in improved health information technology (HIT)...
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Health Professionals and Patients in California: Speaking the Same Language
06-21-21
California is facing a shortage of health professionals to meet the needs of its large, diverse, and aging population, and the situation is worsening. Shortages exist across professions and geographies, with sizeable urban and rural underserved populations. Despite increasing population diversity,...
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California Healthcare Almanac: Physicians
03-05-21
Although the number of active physicians increased by 21% between 2006 and 2018, and exceeded the 10% population growth, many areas in California face substantial shortages of primary care providers and specialists. California Physicians: A Portrait of Practice presents detailed information about...
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The State of California's Physician Workforce
01-01-21
This report provides California policymakers with up-to-date information about the state’s physician workforce and the pipeline of trainees in the state’s medical schools and graduate medical education (GME) programs, often referred to as residency programs.
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Recovery with Limited Progress: Impact of California Proposition 209 on Racial/Ethnic Diversity of California Medical School Matriculants, 1990 to 2019
12-09-20
Proposition 209 prohibits the use of affirmative action – the practice of considering an individuals’ race, sex, color, ethnicity or national origin – in public education, employment and contracting. This brief expands on previous studies that analyzed the impact of Proposition 209 on the racial/...
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The Role of Value-Based Payment in Promoting Innovation to Address Social Risks: A Cross-Sectional Study of Social Risk Screening by U.S. Physicians
12-01-20
One of the most important possibilities of value-based payment is its potential to spur innovation in upstream prevention, such as attention to social needs that lead to poor health. However, there is uncertainty about the conditions under which value-based payment will encourage health care...
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Medical Staffing Organization and Quality of Care Outcomes in Post-acute Care Settings
11-04-20
Medical providers are significant drivers of care in post-acute long-term care (PALTC) settings, yet little research has examined the medical provider workforce and its role in ensuring quality of care. This study examined the impact of nursing home medical staffing organization (NHMSO) dimensions...
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Practicing Holistic Review in Medical Education
10-23-20
Holistic review is a conceptual framework that encourages medical schools to consider a wide range of criteria in deciding which applicants to admit. It promotes a balanced approach to the admissions process, taking into account both the need to admit students whose Medical College Admissions Test...
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Time Trends in the Regional Distribution of Physicians, Nurses and Midwives in Europe
10-12-20
Country-level data suggest large differences in the supply of health professionals among European countries. However, little is know about the regional supply of health professionals taking a cross-country comparative perspective. The aim of the study was to analyse the regional distribution of...
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Medical Care Delivery in US Nursing Homes: Current and Future Practice
09-22-20
The delivery of medical care services in US nursing homes (NH) is dependent on a workforce comprised of physicians, nurse practitioners (NP), and physician assistants (PA). Each of these disciplines operate under a unique regulatory framework while adhering to common standards of care. NH provider...
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Physician Workforce and Medical Education in California
07-31-20
This report presents an overview of California’s allopathic (MD) and osteopathic (DO) physicians.
Allopathic medical schools grant the Doctor of Medicine (MD) degree, while osteopathic medical schools grant the Doctor of Osteopathic Medicine (DO) degree. Graduates earning an MD typically complete...
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CIN Connections, Spring 2020: Foundations for Health
04-08-20
The California Improvement Network’s (CIN) latest report, CIN Connections: Foundations for Health, features tips for resilient leadership and building partnerships between health providers and community-based organizations from Access Community Health Network’s chief operating officer, Donna...
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Modernizing Scope-of-Practice Regulations — Time to Prioritize Patients
02-13-20
Ongoing payment reforms are pressing health systems to reorganize delivery of care to achieve greater value, improve access, integrate patient care among settings, advance population health, and address social determinants of health. Many organizations are experimenting with new ways of unleashing...
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Reducing Educational Debt Among Underrepresented Physicians and Dentists
08-27-19
The rising cost of higher education raises concerns about equitable access to professional education for underrepresented minorities (URMs). This is problematic since URMs play critical roles in the health care field. They often speak patients’ languages and/or relate to them on both cultural and...
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Geriatrician Roles and the Value of Geriatrics in an Evolving Healthcare System
07-08-19
There are insufficient numbers of practicing geriatricians to meet current demand for their services, and the shortage is projected to worsen in the coming decades as the number of older Americans rapidly increases. Understanding how to best leverage geriatricians as members of an overall care team...
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Consensus-Based Recommendations for an Adequate Workforce to Care for People with Serious Illness
05-10-19
The lack of an adequately prepared workforce is a critical barrier to delivering high-quality community-based care for individuals living with serious illness. This article presents 16 consensus-based recommendations to improve the capacity of the workforce in this area within the next 5 years,...
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Fundamental Concepts for Managing Risk and Understanding the Total Cost of Care
04-23-19
This resource is designed to serve as a primer for anyone interested in gaining a better understanding of health payment models in California and nationally. It focuses on concepts and terminology related to value-based payment models and to health care delivery models and systems.
The publication...
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CIN Connections, Spring 2019: Managing Financial Risk and Total Cost of Care
04-18-19
This issue of CIN Connections includes strategies to manage total cost of care. It features Mitch Katz, MD, head of the largest public health care system in the country, and other health care leaders across the state who share their experiences managing risk and total cost of care. Included in this...