Comparative Effectiveness of Buprenorphine Adherence with Telemedicine versus In-person for Rural and Urban Patients.

Background: Policy changes during the COVID-19 pandemic allowed buprenorphine to be prescribed for opioid use disorder (OUD) via telemedicine without an in-person visit. A recently proposed change will limit buprenorphine access to 30 days without an in-person visit. Given that people living in rural areas may be disproportionally impacted by this change, we sought to better understand how buprenorphine adherence may be impacted by requiring in-person visits.

Trends in U.S. self-reported health and self-care behaviors during the COVID-19 pandemic.

Importance: The COVID-19 pandemic represents a unique stressor in Americans' daily lives and access to health services. However, it remains unclear how the pandemic impacted perceived health status and engagement in health-related behaviors.

Objective: To assess changes in self-reported health outcomes during the COVID-19 pandemic, and to explore trends in health-related behaviors that may underlie the observed health changes.

Impact of notification policy on patient-before-clinician review of immediately released test results.

The 21st Century Cures Act mandates immediate availability of test results upon request. The Cures Act does not require that patients be informed of results, but many organizations send notifications when results become available. Our medical center implemented 2 sequential policies: immediate notifications for all results, and notifications only to patients who opt in.

Excess Mortality at Veterans Health Administration Facilities During the COVID-19 Pandemic.

Importance: The COVID-19 pandemic resulted in excess mortality among the general US population and at Veterans Health Administration (VHA) facilities. It is critical to understand the characteristics of facilities that experienced the highest and lowest pandemic-related mortality to inform future mitigation efforts.

Objective: To identify facility-level excess mortality during the pandemic and to correlate these estimates with facility characteristics and community-wide rates of COVID-19 burden.

Plan Selection, Enrollee Risk, and Health Spending on the Patient Protection and Affordable Care Act Individual Marketplaces, 2019.

Importance: The Patient Protection and Affordable Care Act (ACA) individual marketplaces are a source of insurance for millions of residents in the US. However, the association between enrollee risk, health spending, and metal tier selection remains unclear.

Objectives: To describe individual marketplace enrollees' metal tier selections by risk score and assess enrollees' health spending by metal tier, risk score, and spending type.

Validation of the Clinicians' Cultural Sensitivity Survey for Use in Pediatric Primary Care Settings.

Incorporating cultural sensitivity into healthcare settings is important to deliver high-quality and equitable care, particularly for marginalized communities who are non-White, non-English speaking, or immigrants. The Clinicians' Cultural Sensitivity Survey (CCSS) was developed as a patient-reported survey assessing clinicians' recognition of cultural factors affecting care quality for older Latino patients; however, this instrument has not been adapted for use in pediatric primary care. Our objective was to examine the validity and reliability of a modified CCSS that was adapted for use with parents of pediatric patients.

Changes in Health Care Access by Race, Income, and Medicaid Expansion During the COVID-19 Pandemic.

Background: The intersecting crises of the COVID-19 pandemic, job losses, and concomitant loss of employer-sponsored health insurance may have disproportionately affected health care access within minorized and lower-socioeconomic status communities.

Objective: To describe changes in access to care during the COVID-19 pandemic, stratified by race/ethnicity, household income, and state Medicaid expansion status.

Research Design: We used interrupted time series and difference-in-differences regression models, controlling for respondent characteristics and preexisting trends.

Changes in US Veterans' Access to Specialty Care During the COVID-19 Pandemic.

This cross-sectional study identifies changes in referral volume and wait times for veterans seeking care from the specialists in the Veterans Health Administration or the community.

Geographic Variation in Appointment Wait Times for US Military Veterans.

Importance: Timely access to medical care is an important determinant of health and well-being. The US Congress passed the Veterans Access, Choice, and Accountability Act in 2014 and the VA MISSION (Maintaining Systems and Strengthening Integrated Outside Networks) Act in 2018, both of which allow veterans to access care from community-based clinicians, but geographic variation in appointment wait times after the passage of these acts have not been studied.

Objective: To describe geographic variation in wait times experienced by veterans for primary care, mental health, and other specialties.

Association of Medicaid Managed Care Drug Carve Outs With Hepatitis C Virus Prescription Use.

Importance: Medicaid enrolls a disproportionate share of US adults with hepatitis C virus (HCV), and most receive Medicaid benefits through managed care organizations (MCOs). Medicaid MCOs often impose stricter requirements to access HCV medications than traditional fee-for-service Medicaid, which may inhibit use. Though Medicaid MCOs generally cover prescription drugs, several states have carved out direct-acting antiviral HCV medications from MCO coverage and opted to cover them under fee-for-service.

Medicaid Subscription-Based Payment Models and Implications for Access to Hepatitis C Medications.

Importance: Hepatitis C virus (HCV) can be cured with direct-acting antiviral medications, but state Medicaid programs often restrict access to these lifesaving medications owing to their high costs. Subscription-based payment models (SBPMs), wherein states contract with a single manufacturer to supply prescriptions at a reduced price, may offer a solution that increases access. Whether SBPMs are associated with changes in HCV medication use is unknown.

Improving Access to High-Value, High-Cost Medicines: The Use of Subscription Models to Treat Hepatitis C Using Direct-Acting Antivirals in the United States.

State payers may face financial incentives to restrict use of high-cost medications. Yet, restrictions on access to high-value medications may have deleterious effects on population health. Direct-acting antivirals (DAAs), available since 2013, can cure chronic infection with hepatitis C virus (HCV).

Local Supply Of Postdischarge Care Options Tied To Hospital Readmission Rates.

The extent to which patients' risk for readmission after a hospitalization is influenced by local availability of postdischarge care options is not currently known. We used national, hospital-level data to assess whether the supply of postdischarge care options in hospitals' catchment areas was associated with readmission rates for Medicare patients after hospitalizations for acute myocardial infarction, heart failure, or pneumonia. Overall, readmission rates were negatively associated with per capita supply of primary care physicians (-0.

A novel dataset of predictors of mortality for older Veterans living with type II diabetes.

The dataset summarized in this article includes a nationwide prevalence sample of U.S. military Veterans who were aged 65 years or older, dually enrolled in the Veterans Health Administration and traditional Medicare and had a previous diagnosis of diabetes (diabetes mellitus) as of December 2005 ( = 275,190) [1].

Medicaid expansion and drug overdose mortality during the COVID-19 pandemic in the United States.

Background: The COVID-19 pandemic caused disruptions in the delivery of health services, which may have adversely affected access to substance use disorder (SUD) treatment services. Medicaid expansion has been previously associated with increased access to SUD services for low-income adults. Thus, the pandemic may have differentially impacted overdose mortality depending on expansion status.

Cost Analysis of an Annual School-Based Pediatric Hearing Screening Program in Semi-Rural Kenya.

Introduction: Approximately 8.9 million children in Sub-Saharan Africa have disabling hearing loss, accounting for 11% of the global child healthcare hearing costs. For children living in Low- and Middle-Income Countries (LMICs), 75% of hearing loss is preventable.

County-Level Impact of the COVID-19 Pandemic on Excess Mortality Among U.S. Veterans: A Population-Based Study.

Background: As the novel coronavirus (COVID-19) continues to impact the world at large, Veterans of the US Armed Forces are experiencing increases in both COVID-19 and non-COVID-19 mortality. Veterans may be more susceptible to the pandemic than the general population due to their higher comorbidity burdens and older age, but no research has examined if trends in excess mortality differ between these groups. Additionally, individual-level data on demographics, comorbidities, and deaths are provided in near-real time for all enrolees of the Veterans Health Administration (VHA).

Increasing Insurance Choices In The Affordable Care Act Marketplaces, 2018-21.

The Affordable Care Act (ACA) relies on insurers to offer health plans in the individual health insurance Marketplaces. Since the ACA's implementation, levels of Marketplace competition have varied, reaching a nadir in 2018. We examined the characteristics of counties that experienced changes in insurers' participation in the ACA Marketplaces from 2016 to 2021.

Association of Childcare Facility Closures With Employment Status of US Women vs Men During the COVID-19 Pandemic.

This cross-sectional study assesses the association of closures of childcare facilities with the employment status of women and men with children in the US during the COVID-19 pandemic.

Appointment wait time data for primary & specialty care in veterans health administration facilities vs. community medical centers.

The datasets summarized in this article include more than 38 million appointment wait times that U.S. military veterans experienced when seeking medical care since January 2014.

County-level data on U.S. opioid distributions, demographics, healthcare supply, and healthcare access.

The dataset summarized in this article is a combination of several of U.S. federal data resources for the years 2006-2013, containing county-level variables for opioid pill volumes, demographics (e.