Association of Hospital Incentive Care Management Partnerships for Uninsured Patients With Emergency Department Utilization.

Importance: The South Carolina (SC) Healthy Outcomes Plan (HOP) program aimed to expand access to health care to individuals without insurance; it remains unknown whether there is an association between the SC HOP program and emergency department (ED) use among patients with high health care costs and needs.

Objectives: To determine whether participation in the SC HOP was associated with reduced ED utilization among uninsured participants.

Design, Setting, And Participants: This retrospective cohort study included 11 684 HOP participants (ages 18-64 years) with at least 18 months of continuous enrollment.

Community social determinants and health outcomes drive availability of patient-centered medical homes.

The collaborative design of America's patient-centered medical homes places these practices at the forefront of emerging efforts to address longstanding inequities in the quality of primary care experienced among socially and economically marginalized populations. We assessed the geographic distribution of the country's medical homes and assessed whether they are appearing within communities that face greater burdens of disease and social vulnerability. We assessed overlapping spatial clusters of mental and physical health surveys; health behaviors, including alcohol-impaired driving deaths and drug overdose deaths; as well as premature mortality with clusters of medical home saturation and community socioeconomic characteristics.

Association of Patient-Centered Medical Home designation and quality indicators within HRSA-funded community health center delivery sites.

Background: Patient-Centered Medical Home (PCMH) adoption is an important strategy to help improve primary care quality within Health Resources and Service Administration (HRSA) community health centers (CHC), but evidence of its effect thus far remains mixed. A limitation of previous evaluations has been the inability to account for the proportion of CHC delivery sites that are designated medical homes.

Methods: Retrospective cross-sectional study using HRSA Uniform Data System (UDS) and certification files from the National Committee for Quality Assurance (NCQA) and the Joint Commission (JC).

Precision of provider licensure data for mapping member accessibility to Medicaid managed care provider networks.

Background: In July 2018, the Centers for Medicare and Medicaid Services (CMS) updated its Medicaid Managed Care (MMC) regulations that govern network and access standards for enrollees. There have been few published studies of whether there is accurate geographic information on primary care providers to monitor network adequacy.

Methods: We analyzed a sample of nurse practitioner (NP) and physician address data registered in the state labor, licensing, and regulation (LLR) boards and the National Provider Index (NPI) using employment location data contained in the patient-centered medical home (PCMH) data file.

Comparison of small-area deprivation measures as predictors of chronic disease burden in a low-income population.

Background: Measures of small-area deprivation may be valuable in geographically targeting limited resources to prevent, diagnose, and effectively manage chronic conditions in vulnerable populations. We developed a census-based small-area socioeconomic deprivation index specifically to predict chronic disease burden among publically insured Medicaid recipients in South Carolina, a relatively poor state in the southern United States. We compared the predictive ability of the new index with that of four other small-area deprivation indicators.

Spatial visualization of multivariate datasets: an analysis of STD and HIV/AIDS diagnosis rates and socioeconomic context using ring maps.

Objectives: We used existing data systems to examine sexually transmitted disease (STD) and HIV/AIDS diagnosis rates and explore potential county-level associations between HIV/AIDS diagnosis rates and socioeconomic disadvantage.

Methods: Using South Carolina county data, we constructed multivariate ring maps to spatially visualize syphilis, gonorrhea, chlamydia, and HIV/AIDS diagnosis rates; gender- and race-specific HIV/AIDS diagnosis rates; and three measures of socioeconomic disadvantage-an unemployment index, a poverty index, and the Townsend index of social deprivation. Statistical analyses were performed to quantitatively assess potential county-level associations between HIV/AIDS diagnosis rates and each of the three indexes of socioeconomic disadvantage.

Diabetes and the socioeconomic and built environment: geovisualization of disease prevalence and potential contextual associations using ring maps.

Background: Efforts to stem the diabetes epidemic in the United States and other countries must take into account a complex array of individual, social, economic, and built environmental factors. Increasingly, scientists use information visualization tools to "make sense" of large multivariate data sets. Recently, ring map visualization has been explored as a means of depicting spatially referenced, multivariate data in a single information graphic.