Social Risks and Health Care Use in Medically Complex Patients.

Importance: Integrated health care systems have initiated major investments to identify and address social risks, particularly for patients with multiple medical conditions.

Objective: To evaluate the association of social risks with health care use among patients with complex multimorbidity.

Design, Setting, And Participants: This longitudinal cohort study assessed Kaiser Permanente Northern California (KPNC) patients with (1) moderate medical complexity (defined by high comorbidity score, high risk of hospitalization, and/or prior emergency department [ED] admissions) and (2) high medical complexity (eg, meeting additional criteria, such as ≥7 medications and laboratory evidence of poor disease control).

The Percentage of Patients Experiencing Financial Strain Depends on the Screening Measure: Evidence From a Cross-Sectional Survey of Adult Members of an Integrated Healthcare Delivery System.

Objectives: Financial strain has important consequences for patients, providers, and health care systems. However, there is currently no gold standard measure to screen for financial strain. This study compared the performance of 3 single-item screeners using a composite measure of financial strain as a "gold standard.

The impacts of supplemental benefits on Medicare Advantage plan composition.

Objectives: In 2019 and 2020, Medicare Advantage (MA) plans received historic flexibility to begin to address members' nonmedical and social needs through a set of primarily health-related benefits (PHRBs) and Special Supplemental Benefits for the Chronically Ill (SSBCIs). We aimed to evaluate the impact of adoption on the number and composition of new MA plan enrollees.

Study Design: A difference-in-differences design of retrospective Medicare enrollment data linked to publicly available plan and county-level data.

Rationale and design of the KP ENRICH trial: A food is medicine intervention in low-income high-risk adults with diabetes within Kaiser Permanente.

Background: Food insecurity is associated with poor glycemic control and increased risk for diabetes-related complications. The clinical benefit of addressing these challenges through a medically supportive grocery prescription (GRx) program in patients with type 2 diabetes mellitus (T2D) remains unclear. We report the aims and design of a randomized clinical trial to evaluate the effectiveness of a 6-month GRx intervention on hemoglobin A1c (HbA1c) levels among low-income adults with T2D.

New Supplemental Benefits and Plan Ratings Among Medicare Advantage Enrollees.

Importance: In 2018, the US Congress gave Medicare Advantage (MA) historic flexibility to address members' social needs with a set of Special Supplemental Benefits for the Chronically Ill (SSBCIs). In response, the Centers for Medicare & Medicaid Services expanded the definition of primarily health-related benefits (PHRBs) to include nonmedical services in 2019. Uptake has been modest; MA plans cited a lack of evidence as a limiting factor.

Evaluating a Care Management Program for Dual-Eligible Beneficiaries: Evidence from Rhode Island.

As health systems attempt to contain utilization and costs, care management programs are proliferating. However, there are mixed findings on their impact. In 2018, Rhode Island initiated a care management program for dually eligible Medicare and Medicaid beneficiaries at high risk of hospitalization or institutionalization.

Leveraging survey and claims data to identify high-need Medicare beneficiaries in the National Health and Aging Trends Study.

Background: Multiple algorithms have been developed to identify and characterize the high-need (HN) Medicare population. However, they vary in components and yield different populations, and were developed for varying purposes. We compared the performance of existing survey and claims-based definitions in identifying HN beneficiaries and predicting poor outcomes among a community-dwelling population.

An Exploratory Framework to Interpret County-Level Indicators of Food Insecurity.

In 2017, 12.5% of the population was estimated to be food insecure (FI) with wide regional variation. County-level FI is closely associated with, but likely more complex, than the county-level poverty rates.

Conceptualizing Food Insecurity Among Older Adults: Development of a Summary Indicator in the National Health and Aging Trends Study.

Objectives: Measurement of food insecurity in older adults is focused on financial barriers to food access. Given that older adults are particularly susceptible to additional access-related barriers including functional limitations and lack of social support, the objective of this study was to construct a summary indicator of food insecurity incorporating these domains.

Methods: We used nationally representative survey data from Round 5 of the National Health and Aging Trends Study (NHATS; n = 7,070).

Medicare Plans' Adoption of Special Supplemental Benefits for the Chronically Ill for Enrollees With Social Needs.

This cross-sectional study assesses the extent to which Medicare plans have offered Special Supplemental Benefits for the Chronically Ill for enrollees with social needs.