Regional Economic Conditions and Preventable Hospitalization Among Older Patients With Diabetes.

Objective: The aim was to explore the relationship between changes in regional economic conditions and quality of care-preventable hospitalization or death among older patients with diabetes at Veterans Health Administration (VHA), safety-net system for veterans.

Subjects: VHA patients aged 65 years and older with a diabetes diagnosis between July 2012 and June 2014, who had at least 1 primary care visit in the past year.

Measures: County-level and state-level public data were used to characterize regional health insurance coverage and affluence surrounding the VHA facilities.

Regional market factors and patient experience in primary care.

Objectives: To evaluate the association between regional market factors and experience with patient-provider communication in primary care services of safety net hospitals.

Study Design: A retrospective cohort study with 933,407 patient experience survey respondents from 128 Veterans Health Administration (VHA) hospitals between fiscal years 2013 and 2016.

Methods: Patient responses on 5 patient-provider communication questions were used to evaluate quality of care.

The Risks Of Using Workplace Wellness Programs To Foster A Culture Of Health.

In many respects, employers are well positioned to take a leading role in helping create a culture of health. Employers have access to many programs that could be beneficial to their employees' health. The potential for financial gains related to health improvement may motivate employers to offer these programs, and if the gains are realized, they may help finance the programs.

The law, policy, and ethics of employers' use of financial incentives to improve health.

The Patient Protection and Affordable Care Act (ACA) turns to a nontraditional mechanism to improve public health: employer-provided financial incentives for healthy behaviors. Critics raise questions about incentive programs' effectiveness, employer involvement, and potential discrimination. We support incentive program development despite these concerns.