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Clinician Type and Care Setting for Treatment of Medicare Beneficiaries With Dementia
03-27-25
Standardizing and improving the treatment that Medicare beneficiaries living with dementia receive requires understanding the settings where they are receiving care, the types of clinicians providing that care, and whether clinicians recognize the diagnosis of dementia in their encounters with...
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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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Clinician Type and Setting of Care Delivered to Medicare Beneficiaries with Dementia in the US
12-31-24
Improving care coordination for people living with dementia (PLWD) requires understanding of the types of clinicians delivering care and the settings in which they practice.
We identified all beneficiaries with dementia in traditional Medicare in 2019. We used the Medicare Carrier file — i.e.,...
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Nurse Practitioner Race and Ethnicity and Interest in Independent Primary Care Practice and Serving Medicaid Enrollees
12-15-24
Nurse practitioners (NPs) are important providers of primary care to underserved populations, particularly in areas with lower physician supply. In 2023, California implemented new regulations aimed at improving access to care, especially primary care services, by providing a pathway for NPs to...
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Telehealth Outcomes and Impact on Care Delivery: A Review of Evidence
11-16-23
The COVID-19 pandemic rapidly reshaped health care delivery, notably with a surge in telehealth use driven by changes in Medicare and Medicaid reimbursement rates. The ensuing wave of research, spanning over 80 studies from 2021 to 2022, explored the impact of telehealth on health outcomes and care...
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Implementation of a Novel Program to Support Colorectal Cancer Screening in a Community Health Center Consortium Before and After Onset of COVID-19
05-22-23
In 2017, the San Francisco Cancer Initiative (SF CAN) established the Colorectal Cancer (CRC) Screening Program to provide technical assistance and financial support to improve CRC screening processes, and outcomes in a consortium of community health centers (CHCs) serving low-income communities in...
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Advanced Practice Clinician Care and End-of-life Outcomes for Community- and Nursing Home-dwelling Medicare Beneficiaries with Dementia
04-18-23
Older adults with Alzheimer's disease and related dementias (ADRD) often face burdensome end-of-life care transfers. Advanced practice clinicians (APCs), which include nurse practitioners and physician assistants, increasingly provide primary care to this population. To fill current gaps in the...
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Two Questions Before Health Care Organizations Plunge into Addressing Social Risk Factors
03-08-23
As experience with social risk interventions matures, and federal and state agencies consider ways to incentivize social risk interventions, this is an ideal time to pause and ask whether we are going in the right direction with this work.
In this perspective piece, the authors highlight that the...
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Understanding California’s Community Health Worker/Promotor Workforce: Four Reports
11-22-22
In California, one of the most culturally diverse states in the country, health care must bridge cultural and linguistic divides to serve all communities equitably. As trusted community members with lived experience, community health workers and promotores (CHW/Ps) have a long history of connecting...
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Teledentistry Trends in the United States During the COVID-19 Pandemic
10-24-22
This report reviews the use of teledentistry following the COVID-19 pandemic in 4 states—California, Maine, Pennsylvania, and Wisconsin—and the supports needed to enhance dental care in a post-COVID-19 world. States were selected for case studies based on the following parameters: existence of...
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Beyond Just a Supplement: Administrators' Visions for the Future of Virtual Primary Care Services
05-01-22
The COVID-19 pandemic resulted in unprecedented adoption and implementation of virtual primary care services, and little is known about whether and how virtual care services will be provided after the pandemic ends. We aim to identify how administrators at health care organizations perceive the...
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More Than Just Giving Them A Piece of Paper: Interviews with Primary Care on Social Needs Referrals to Community-Based Organizations
04-14-22
Primary care practices are responding to calls to incorporate patients' social risk factors, such as housing, food, and economic insecurity, into clinical care. Healthcare likely relies on the expertise and resources of community-based organizations to improve patients' social conditions, yet...
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Configuration and Delivery of Primary Care in Rural Settings
03-09-22
There are concerns about the capacity of rural primary care due to potential workforce shortages and patients with disproportionately more clinical and socioeconomic risks. Little research examines the configuration and delivery of primary care along the spectrum of rurality. We aimed to compare...
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Measuring the Financial Contribution of Peer Providers
03-01-22
Background
Peer support providers (peers) are increasingly delivering behavioral health treatment, but evaluation of their impact on client outcomes remains limited. Prior studies to determine the effectiveness of peers identify inconsistent training requirements and role definition as barriers to...
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A Dental Care Coordination System to Increase Access for Medicaid Dental Program Beneficiaries: Experiences in Alameda County, California
03-01-22
In 2016, the California Department of Health Care Services launched the Dental Transformation Initiative (DTI) to address statewide underperformance in providing dental services to Medicaid-eligible children and youth. The DTI allowed selected counties and other qualified organizations to create...
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A Missed Opportunity? How Health Care Organizations Engage Primary Care Clinicians in Formal Social Care Efforts
02-21-22
Health care organizations increasingly recognize the impact of social needs on health outcomes. As organizations develop and scale efforts to address social needs, little is known about the optimal role for clinicians in providing social care. In this study, the authors aimed to understand how...
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Utilization of Community Paramedics to Respond to the COVID-19 Pandemic
02-01-22
Objective
Some health systems and emergency medical services agencies in the United States are leveraging the versatility and experience of community paramedics to meet needs for COVID-19 testing, care, and vaccination. This report describes models of community paramedic practice that communities...
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Psychometric Properties of the Perinatal Missed Care Survey and Missed Care During Labor and Birth
02-01-22
Kalisch and colleagues developed one of the reliable and valid measures of missed nursing care, the MISSCARE survey, which has been used extensively in medical surgical care and has been adapted to pediatric and neonatal intensive care. Our team previously adapted the MISSCARE Survey for the labor...
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It’s Not Just the Right Thing...It’s a Survival Tactic: Disentangling Leaders’ Motivations and Worries on Social Care
12-14-21
Health care organizations face growing pressure to improve their patients’ social conditions, such as housing, food, and economic insecurity. Little is known about the motivations and concerns of health care organizations when implementing activities aimed at improving patients’ social conditions....
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Dental Therapists in the United States: Health Equity, Advancing
10-01-21
Dental therapists (DTs) are primary care dental providers, used globally, and were introduced in the United States (US) in 2005. DTs have now been adopted in 13 states and several Tribal nations. This study aimed to qualitatively examine the drivers and outcomes of the US dental therapy movement...
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Development of the California Oral Health Literacy Toolkit
09-01-21
Although many factors contribute to the high prevalence of oral health problems and widening disparities in the U.S., limited oral health literacy has emerged as a major contributor. Oral health literacy (OHL) refers to people’s abilities to access, understand and use oral health information to...
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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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A Systematic Review of the Roles and Contributions of Peer Providers in the Behavioral Health Workforce
06-24-21
Approximately 1 in 5 U.S. adults experienced a mental illness in the past year, a number that is expected to rise amid a shortage of mental health and substance use disorder (SUD) providers. One way to address this growing need for behavioral health services is through the use of peer providers, or...
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Implementation of Care Coordination and Technology in the Dental Setting to Address High-Risk Patient Needs
05-01-21
Poor oral health, and biological impact of oral disease, affects a person's general health and well-being. Using electronic dental health record data to identify high-risk dental caries patients coupled with a new oral health team member, the dental care advocate (DCA) facilitated the dental...
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Implementing Care Coordination in a Large Dental Care Organization in the United States by Upskilling Front Office Personnel
04-07-21
Care coordination is a key strategy used to improve health outcomes and efficiency, yet there are limited examples in dentistry. A large dental accountable care organization piloted care coordination by retraining existing administrative staff to coordinate the care of high-risk patients. Following...
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The Association Between Scope of Practice Regulations and Nurse Practitioner Prescribing of Buprenorphine After the 2016 Opioid Bill
04-01-21
This article examines the relationship between federal regulations, state scope-of-practice regulations on nurse practitioners (NPs), and buprenorphine prescribing patterns using pharmacy claims data from Optum’s deidentified Clinformatics Data Mart between January 2015 and September 2018. The...
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Dental Health Aides: Adapting a Community Health Worker Program to Preventive Dental Care
02-18-21
Community health workers (CHWs) are an increasingly important member of the healthcare and public health professions who help build primary care capacity. Yet, in spite of the exponential growth of CHW interventions, CHW training programs, and CHW certification and credentialing by state agencies,...
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Translating Evidence into Practice: ACOs’ Use of Care Plans for Patients with Complex Health Needs
01-01-21
Care plans are an evidence-based strategy, encouraged by the Centers for Medicare and Medicaid Services, and are used to manage the care of patients with complex health needs that have been shown to lead to lower hospital costs and improved patient outcomes. Providers participating in payment...
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Conceptualizing Performance Measurement for Social Care Interventions: An Issue Brief for State Medicaid Agencies
01-01-21
Growing recognition that socioeconomic adversity impacts health outcomes has led the healthcare sector to support initiatives that address social determinants of health (SDOH). There is an opportunity to leverage performance measures to further incentivize these interventions and track adoption....
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Barriers and Facilitators to Promoting Oral Health Literacy and Patient Communication Among Dental Providers in California
12-30-20
Care coordination is a key strategy used to improve health outcomes and efficiency, yet there are limited examples in dentistry. A large dental accountable care organization piloted care coordination by retraining existing administrative staff to coordinate the care of high-risk patients. Following...