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Optimal Staffing Models to Care for Frail Older Adults in Primary Care And Geriatrics Practices in the U.S.
09-01-21
Different staffing configurations in primary and geriatric care practices could have implications for how best to deliver services that are essential for a growing population of older adults. Using data from a 2018 survey of physicians (MDs) and nurse practitioners (NPs) working in primary and...
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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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Evaluation of California’s Community Paramedicine Pilot Program
02-19-21
Community paramedicine, also known as mobile integrated health, is an innovative model of care that is being implemented throughout the United States. From 2014 to 2020, the California Emergency Medical Services Authority sponsored a Health Workforce Pilot Project under which specially trained...
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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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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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Developing and Testing Electronic Health Record-Derived Caries Indices
11-01-19
Caries indices, the basis of epidemiologic caries measures, are not easily obtained in clinical settings. This study’s objective was to design, test, and validate an automated program (Valid Electronic Health Record Dental Caries Indices Calculator Tool [VERDICT]) to calculate caries indices from...
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Supporting the Integration of Community Health Workers in Whole Person Care Pilots
10-11-19
Community health workers (CHWs) are vital contributors to high quality and equitable health services, particularly to vulnerable populations. CHWs provide a key link between community resources and the clinical team as well as advocate on behalf of communities regarding social determinants of...
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CIN Toolkit: Three Strategies to Help Primary Care Teams Treat Substance Use Disorders
01-31-19
This document is a guide for primary care organizations and care teams working to integrate substance use disorder (SUD) treatment services. It provides proven strategies, best practices, and tools used by organizations within California to expand the capability of primary care teams in commercial...
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The Impact of Federal and State Policy on Oral Health Care Delivery in Long-Term Care Settings
11-21-18
Residents of long-term care (LTC) facilities have a significantly higher risk of poor oral health status compared with those living independently; moreover, the provision of oral health services to LTC residents is often limited. This study identifies and classifies state-level policies and funding...
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CIN Connections, Fall 2018: Integrating Primary Care and Substance Use Disorder Treatment
10-18-18
Ensuring that Californians have timely access to substance use disorder (SUD) treatment that is appropriately linked to their physical health care represents a huge challenge and opportunity for health leaders, providers, and care teams throughout the state. This issue of CIN Connections features...
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Medication Adherence, Costs, and ER Visits of Nurse Practitioner and Primary Care Physician Patients
10-03-18
Objective
To compare medication adherence, cost, and utilization in Medicare beneficiaries attributed to nurse practitioners (NP) and primary care physicians (PCP).
Data
Medicare Part A, B, and D claims and beneficiary summary file data, years 2009‐2013.
Study Design
We used propensity score‐...
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California Nurse Practitioners Are Positioned To Fill The Primary Care Gap, But They Face Barriers To Practice
09-03-18
Nurse practitioners are well prepared to help fill care gaps arising from shortages of primary care physicians in California. This article reports findings from a survey of California nurse practitioners that examined their employment and practice barriers. The number of nurse practitioners per...
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More Nurses with Bachelor's Degrees Required to Meet Future Health Care Needs
05-03-18
In 2011, the Institute of Medicine (IOM, now part of the National Academy of Science, Engineering, and Medicine) released a report, “The Future of Nursing: Leading Change, Advancing Health,” which contained eight recommendations regarding how the nursing workforce can best meet health-care needs in...
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2017 Survey of Nurse Practitioners and Certified Nurse Midwives
04-11-18
This study of California nurse practitioners (NPs) and certified nurse-midwives (CNMs) was conducted in early 2017. In November 2016, there were 20,337 NPs living in California, of whom 569 also were CNMs (“dual certified”). Another 582 people had CNM-only certification. Surveys were mailed to 2,...
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Community-Based Palliative Care Leader Perspectives on Staffing, Recruitment, and Training
04-01-18
This qualitative descriptive study assesses perspectives of US community-based palliative care program leaders on staffing, recruitment, and training. Leaders from academic medical centers, large integrated and community health systems, home health and hospice organizations, and the Veterans...
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Federally Qualified Health Centers Reduce the Primary Care Provider Gap in Health Professional Shortage Counties
02-13-18
Federally qualified health centers (FQHCs) were designed to provide care in medically underserved areas and substantial and sustained federal funding has accelerated FQHC growth. This report examines changes over time in primary care provider supply and whether FQHCs have been successful in...
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The Roles and Value of Geriatricians in Healthcare Teams: A Landscape Analysis
12-21-17
While it is difficult to know the true number of practicing geriatricians, the supply has been negatively affected by tightening certification requirements, relatively low income and negative return on investment. There appears to be consensus that clinical care by geriatricians should be reserved...
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Alternative Payment Models Lead to Strategic Care Coordination Workforce Investments
12-21-17
Highlights
Value-based payment is leading to enhanced care coordination staffing.
Sites are task shifting low-complexity care coordination to unlicensed staff.
Important care coordination education gaps necessitate in-depth on-the-job training.
Demonstrating the return on investment of care...
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Employer Demand for Physician Assistants and Nurse Practitioners to Care for Older People and People with Disabilities
12-18-17
Demand for health care professionals with expertise in long-term care (LTC) and older populations is rising, due to projected growth in the older population and the increasing burden of chronic disease. One way to meet this growing LTC workforce demand may be to employ more nurse practitioners (NPs...
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The Male-female Earnings Gap for Nurses in Germany: A Pooled Cross-sectional Study of the Years 2006 and 2012
07-14-17
The aim of this study is to examine male-female earnings of nurses in Germany. Understanding and addressing differences in earnings by gender is important because differences in pay accumulate over a nurse’s career and can lead to substantial disparities between genders, especially if they...
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Supporting the Integration of Community Health Workers into Health Care Teams in California
07-06-17
Community health workers (CHWs) and promotores de salud are playing an increasingly important role in the delivery of high quality and equitable health related services, particularly to vulnerable populations. Using a Theory of Change framework, this report connects intervention and support...
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The Pediatric Dental Workforce is Changing: What Does it Mean for Patient Outcomes?
06-02-17
Research examining productivity, quality and outcomes of traditional pediatric dental care are generally lacking. The literature shows that education, qualifications, and roles are changing with case examples of success, but what these changes portend for patient care remains an open question. New...
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Dementia-Capable Care Coordination
05-25-17
This study describes the program requirements, workforce competencies, and barriers for dementia capable care coordination within health plans from seven states participating in the Center for Medicare and Medicaid Services demonstration programs for dually-eligible Medicare and Medicaid...
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How do Stakeholders Perceive Labor Nurses' Influence on Birth Outcomes?
04-21-17
Background
Childbirth is a leading reason for hospital admission in the USA, and most labor care is provided by registered nurses under physician or midwife supervision in a nurse-managed care model. Yet, there are no validated quality measures for maternity care that are thoughtful about the role...
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Review of Recent Literature on Peer Support Providers
03-23-17
This report updates a literature review on peer support providers prepared in 2015. Peer support workers fulfill a broad range of tasks ad job titles, in a broad range of mental health and substance use disorders recovery settings, and in various service models, although there is a lack of...
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California's Primary Care Workforce: Supply, Characteristics and Pipeline
02-16-17
Is California prepared to meet growing demand for primary care?
This report is the first in a series of three Healthforce Center at UCSF reports that will provide information to help policymakers, consumers and leaders of health care delivery organizations and educational institutions understand...
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Utilization of Community Health Workers in Emerging Care Coordination Models in California
01-24-17
Community health workers (CHWs) and promotores de salud are playing an increasingly important role in community-based and clinical care settings. This research, supported by the Blue Shield of California Foundation, represents the culmination of the first phase of a two-part project aimed at...
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New Model of Paramedicine Could Reduce Demand for Long-Term Care
11-17-16
Mobile integrated healthcare – community paramedicine (MIH-CP) is a new model of care that trains paramedics to deliver a broader range of services than traditional emergency response and transport of people to emergency departments (ED). By 2014, more than 100 emergency medical services (EMS)...
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Exploring Explanations for the Female-Male Earnings Difference Among Registered Nurses in the United States
09-01-16
A 2015 study published in JAMA found that the wage gap persists in nursing, with male nurses making $5,100 more on average per year than female colleagues in similar positions. This latest study aims to uncover the root causes of the gender pay discrepancy in nursing. Specifically, the study set...
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Evolving Delivery Models for Dental Care Services in Long-Term Care Settings: 4 State Case Studies
02-05-16
As the Baby Boomer Generation ages into long-term care (LTC) facilities, the number of individuals requiring dental care will rise, but these systems are not set up to adequately meet their needs. The supply of dentists is projected to increase; however, enormous barriers to dental care continue to...