Medicaid billing for community health worker services growing, but remains low, 2016-2020.

Despite the recognized value of Community Health Workers (CHWs) in improving health outcomes, the integration of CHWs into Medicaid continues to be a challenge. This study examines the trends in CHW billing for Medicaid services across states from 2016 to 2020. We conducted an exploratory descriptive analysis of the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) 2016-2020 to identify trends in direct billing for CHW services, including beneficiaries served, total services rendered, payment type, place of service, and procedure codes used for services billed by CHWs.

Obstetrician-Gynecologists' Telehealth Provision at the Beginning, During, and Latter Stages of the COVID-19 Pandemic.

: This study aims to determine how obstetrician-gynecologists provided telehealth from January 2020 to December 2022 in the United States, using de-identified commercial insurance data from FAIR Health. It also explores the trends in telehealth provision by physicians' age, gender, and by state policies on telehealth payment parity. : Aggregated, de-identified data derived from medical claims containing 450,588 physician-quarter observations during 2020 to 2022 were analyzed using descriptive methods to examine the total number of telehealth services to pregnant individuals provided, the number of obstetrician-gynecologists that provided telehealth, and the mean number of telehealth services provided per quarter.

Kappa-opioid receptor antagonism in the nucleus accumbens shell distinguishes escalated alcohol consumption and negative affective-like behavior from physiological withdrawal in alcohol-dependence.

Alcohol use disorder (AUD) is a chronic relapsing disease that is deleterious at individual, familial, and societal levels. Although AUD is one of the highest preventable causes of death in the USA, therapies for the treatment of AUD are not sufficient given the heterogeneity of the disorder and the limited number of approved medications. To provide better pharmacological strategies, it is important to understand the neurological underpinnings of AUD.

A Rare Case Report of Hypoketotic Hypoglycemia Induced Seizures Due to Secondary Carnitine Deficiency in a 44-year-old Female.

Carnitine deficiency is a rare metabolic condition that can result in fasting hypoglycemia. Carnitine deficiency could be primary or secondary to other conditions. Among secondary causes, antiepileptics such as valproic acid have been incriminated.

Tracking 5-Year Trends in the Workforce Prescribing Psychotropics and Medications for Opioid Use Disorder: A Cross-Sectional Study.

Background: Although there is increased demand for behavioral health services, there is limited national data on the workforce prescribing psychotropics and/or medications for opioid use disorder (MOUD), and many current estimates are based on self-reported data or clinician rosters.

Objective: To describe trends in the workforce prescribing psychotropics (i.e.

Functional and morphological adaptation of medial prefrontal corticotropin releasing factor receptor 1-expressing neurons in male mice following chronic ethanol exposure.

Chronic ethanol dependence and withdrawal activate corticotropin releasing factor (CRF)-containing GABAergic neurons in the medial prefrontal cortex (mPFC), which tightly regulate glutamatergic pyramidal neurons. Using male CRF1:GFP reporter mice, we recently reported that CRF1-expressing (mPFC) neurons predominantly comprise mPFC prelimbic layer 2/3 pyramidal neurons, undergo profound adaptations following chronic ethanol exposure, and regulate anxiety and conditioned rewarding effects of ethanol. To explore the effects of acute and chronic ethanol exposure on glutamate transmission, the impact of chronic alcohol on spine density and morphology, as well as persistent changes in dendritic-related gene expression, we employed whole-cell patch-clamp electrophysiology, diOlistic labeling for dendritic spine analysis, and dendritic gene expression analysis to further characterize mPFC and mPFC prelimbic layer 2/3 pyramidal neurons.

Grazing exclusion-induced changes in soil fungal communities in a highly desertified Brazilian dryland.

Soil desertification poses a critical ecological challenge in arid and semiarid climates worldwide, leading to decreased soil productivity due to the disruption of essential microbial community processes. Fungi, as one of the most important soil microbial communities, play a crucial role in enhancing nutrient and water uptake by plants through mycorrhizal associations. However, the impact of overgrazing-induced desertification on fungal community structure, particularly in the Caatinga biome of semiarid regions, remains unclear.

Advanced practice providers in hematology: actionable findings from national paired APP and physician surveys.

Advanced practice providers (APPs) are critical to the hematology workforce. However, there is limited knowledge about APPs in hematology regarding specialty-specific training, scope of practice, challenges and opportunities in APP-physician interactions, and involvement with the American Society of Hematology (ASH). We conducted APP and physician focus groups to elucidate major themes in these areas and used results to inform development of 2 national surveys, 1 for APPs and 1 for physicians who work with APPs.

Molecular and Dual-Isotopic Profiling of the Microbial Controls on Nitrogen Leaching in Agricultural Soils under Managed Aquifer Recharge.

Nitrate (NO) leaching is a serious health and ecological concern in global agroecosystems, particularly those under the application of agricultural-managed aquifer recharge (Ag-MAR); however, there is an absence of information on microbial controls affecting NO leaching outcomes. We combine natural dual isotopes of NO (N/N and O/O) with metagenomics, quantitative polymerase chain reaction (PCR), and a threshold indicator taxa analysis (TITAN) to investigate the activities, taxon profiles, and environmental controls of soil microbiome associated with NO leaching at different depths from Californian vineyards under Ag-MAR application. The isotopic signatures demonstrated a significant priming effect ( < 0.

Primary Care Provider Medicaid Participation Across the United States, 2016.

Purpose: To understand primary care provider participation in Medicaid programs across states and provider specialties and professions.

Methods: We examined the 2016 Medicaid claims data across 45 states and territories from the Transformed Medicaid Statistical Information System (T-MSIS).

Results: Of the 616,182 primary care providers we identified, 111,152 (18.

Telehealth Use and Access to Care for Underserved Populations Before and During the COVID-19 Pandemic.

While several studies have documented the rapid growth in telehealth visits during the pandemic, none have examined its relationship with greater overall access to care among vulnerable populations. We use Association of American Medical Colleges' Consumer Survey data to examine the relationship between access to care and telehealth use before and during the pandemic. The proportion of survey respondents who were always able to get medical care when needed was slightly lower in 2020 compared with prior years while telehealth use rose dramatically.

Interaction between age and gender on survival outcomes in extramedullary multiple myeloma over the past two decades.

Background: Extramedullary multiple myeloma (MM) (EMM) is a rare and aggressive subentity of MM that can be present at diagnosis or develop anytime during the disease course. There is a paucity of data on the clinical characteristics and overall epidemiology of EMM. Furthermore, there is a scarcity of data on how the interaction of age and gender influences the survival of EMM.

Documenting a Decade of Exponential Growth in Employer Demand for Peer Support Providers.

The past decade has seen peer support providers increasingly incorporated as part of a recovery-oriented approach to behavioral health (BH) services for mental illness and substance use disorder. Despite this, there are few data sources to track this sector of the BH workforce, and understanding of peer support provider supply, demand, distribution, and associated factors is limited. In this retrospective, observational study, the authors analyzed job postings from 2010 to 2020 to assess employer demand for peer support providers and the factors associated with its growth, using a labor market data set from Emsi Burning Glass.

Association between state payment parity policies and telehealth usage at community health centers during COVID-19.

Objective: We study the association between payment parity policies and telehealth utilization at community health centers (CHCs) before, during, and after the onset of the pandemic.

Materials And Methods: We use aggregated, de-identified data from FAIR Health for privately insured patients at CHC sites. Descriptive statistics and time trends are calculated.

Historic Redlining and Contemporary Behavioral Health Workforce Disparities.

This cross-sectional study investigates the association between redlining and behavioral health specialist supply in 2 mental health professional shortage areas.

Burnout in US hematologists and oncologists: impact of compensation models and advanced practice provider support.

Burnout is prevalent throughout medicine. Few large-scale studies have examined the impact of physician compensation or clinical support staff on burnout among hematologists and oncologists. In 2019, the American Society of Hematology conducted a practice survey of hematologists and oncologists in the AMA (American Medical Association) Masterfile; burnout was measured using a validated, single-item burnout instrument from the Physician Work-Life Study, while satisfaction was assessed in several domains using a 5-point Likert scale.

A Mixed-Methods Study of Teaching Health Center Residents' Experiences of Mentorship, Career Planning, and Postresidency Practice Environments.

Purpose: The Teaching Health Center (THC) Graduate Medical Education program enables primary care physicians to train in community-based, underserved settings by shifting the payment structure and training environment for graduate medical education. To understand how THCs have successfully trained primary care physicians who practice in community-based settings, the authors conducted a mixed-methods exploratory study to examine THC residency graduates' experiences of mentorship and career planning during their residencies, perceptions of preparation for postresidency practice, and how these experiences were related to postresidency practice environments.

Method: Surveys were conducted for all 804 graduating THC residents nationally, 2014-2017 (533 respondents, 66% response rate).

Advancing Social Mission Research: A Call to Action.

Social mission efforts in health professions education are designed to advance health equity and address the health disparities of the society in which they exist. While there is growing evidence that social mission-related interventions are associated with intended outcomes such as practice in underserved communities, student diversity, and students graduating with skills and knowledge that prepare them to address societal needs, critical evidence gaps remain that limit the possibility of generalizing findings and using social mission strategically to advance health equity. At a time when COVID-19 has been laying bare health disparities related to systemic racism and maldistribution of resources, understanding how health professions training can produce the workforce needed to advance health equity becomes even more imperative.

The Use of Medical Scribes in Primary Care Settings: A Literature Synthesis.

Background: Clerical burdens have strained primary care providers already facing a shifting health care landscape and workforce shortages. These pressures may cause burnout and job dissatisfaction, with negative implications for patient care. Medical scribes, who perform real-time electronic health record documentation, have been posited as a solution to relieve clerical burdens, thus improving provider satisfaction and other outcomes.

Coronavirus Disease 2019 Planning and Response: A Tale of 2 Health Workforce Estimator Tools.

Background: As coronavirus disease 2019 (COVID-19) rapidly progressed throughout the United States, increased demand for health workers required health workforce data and tools to aid planning and response at local, state, and national levels.

Objective: We describe the development of 2 estimator tools designed to inform health workforce planning for COVID-19.

Research Design: We estimated supply and demand for intensivists, critical care nurses, hospitalists, respiratory therapists, and pharmacists, using Institute for Health Metrics and Evaluation projections for COVID-19 hospital care and National Plan and Provider Enumeration System, Provider Enrollment Chain and Ownership System, American Hospital Association, and Bureau of Labor Statistics Occupation Employment Statistics for workforce supply.