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.

State-Level Community Benefit Regulation and Nonprofit Hospitals' Provision of Community Benefits.

Do nonprofit hospitals provide enough community benefits to justify their tax exemptions? States have sought to enhance nonprofit hospitals' accountability and oversight through regulation, including requirements to report community benefits, conduct community health needs assessments, provide minimum levels of community benefits, and adhere to minimum income eligibility standards for charity care. However, little research has assessed these regulations' impact on community benefits. Using 2009-11 Internal Revenue Service data on community benefit spending for more than eighteen hundred hospitals and the Hilltop Institute's data on community benefit regulation, we investigated the relationship between these four types of regulation and the level and types of hospital-provided community benefits.

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.

Using reporting requirements to improve employer wellness incentives and their regulation.

Employer interest in offering financial incentives for healthy behaviors has been increasing. Some employers have begun to tie health plan-based rewards or penalties to standards involving tobacco use or biometric measures such as body mass index. The Patient Protection and Affordable Care Act attempts to strike a balance between the potential benefits and risks of wellness incentive programs by permitting these incentives but simultaneously limiting their use.

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.

Written informed-consent statutes and HIV testing.

Background: Almost 1 million Americans are infected with HIV, yet it is estimated that as many as 250,000 of them do not know their serostatus. This study examined whether people residing in states with statutes requiring written informed consent prior to HIV testing were less likely to report a recent HIV test.

Methods: The study is based on survey data from the 2004 Behavioral Risk Factor Surveillance System.

Multihospital system membership and patient treatments, expenditures, and outcomes.

Objective: To determine the relationship between hospital membership in systems and the treatments, expenditures, and outcomes of patients.

Data Sources: The Medicare Provider Analysis and Review dataset, for data on Medicare patients admitted to general medical-surgical hospitals between 1985 and 1998 with a diagnosis of acute myocardial infarction (AMI); the American Hospital Association Annual Survey, for data on hospitals.

Study Design: A multivariate regression analysis.

Hospital-physician affiliations and patient treatments, expenditures, and outcomes.

Objective: To determine the relationship between hospital-physician affiliations and the treatments, expenditures, and outcomes of patients.

Data Sources: Sources include the Medicare Provider Analysis and Review dataset, the American Hospital Association (AHA) Annual Survey, and the Area Resource File (ARF).

Study Design: A multivariate regression analysis of the relationship between hospital-physician affiliations (such as physician-hospital organizations [PHOs] or salaried employment) and the treatment of Medicare patients with a diagnosis of acute myocardial infarction admitted to general medical-surgical hospitals between 1994 and 1998.