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Awaiting insurance coverage: Medicaid enrollment and post-acute care use after traumatic injury.
J Trauma Acute Care Surg
January 2025
From the Section of Trauma and Acute Care Surgery, Department of Surgery (D.N.H., J.S.H.), University of Chicago, Chicago, Illinois; Perelman School of Medicine (E.C.E., A.T.C., O.I.R., A.U.M., M.K.D., N.D.M., M.J.S., E.J.K.), Division of Trauma, Surgical Critical Care and Emergency Surgery (K.M.C., N.D.M., M.J.S., E.J.K.), University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Surgery (L.M.K.), Stanford University, Stanford, California.
Background: Lack of insurance after traumatic injury is associated with decreased use of postacute care and poor outcomes. Insurance linkage programs enroll eligible patients in Medicaid at the time of an unplanned admission. We hypothesized that Medicaid enrollment would be associated with increased use of postacute care, but also with prolonged hospital length of stay (LOS) while awaiting insurance authorization.
View Article and Find Full Text PDFTen-Year Trends in Last Known Well to Arrival Time in Acute Ischemic Stroke Patients: 2014 to 2023.
Stroke
January 2025
Northwell Health, New Hyde Park, NY (N.G.F., M.X.S., J.O.H., S.R.F., J.J.W., J.M.K., P.C.S.).
Background: Many national initiatives focus on promoting early hospital arrival of patients with acute ischemic stroke (AIS) because treatment effectiveness is time-dependent. However, several studies reported time-delays in hospital arrival, especially during the COVID-19 pandemic. Our purpose was to evaluate the 10-year trends in last known well to arrival (LKWA) time and assess disparities in patients with AIS.
View Article and Find Full Text PDFTrends in Formulary Restrictions for Long-Acting Injectable Antipsychotic Medications Among Medicare Drug Plans, 2019-2023.
Psychiatr Serv
January 2025
Department of Psychiatry and Behavioral Neuroscience (Bunting, Gray), Department of Pharmacy (Gray), and Pritzker School of Medicine (Chalmers), University of Chicago, Chicago; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Cotes); Department of Psychiatry, University of Washington, Seattle (Chalmers); Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor (Nguyen).
Objective: Long-acting injectable antipsychotics (LAIAPs) enable safe and effective long-term management of chronic psychotic disorders but are underused in clinical practice. The authors examined whether Medicare formulary restrictions (prior authorization [PA] or step therapy) impose barriers to LAIAP uptake.
Methods: The authors analyzed formulary restrictions and patient cost-sharing for several LAIAPs and estimated the percentage of plans (N=2,494 were available per year) applying formulary restrictions.
Achievement of guideline-based lipid goals among very-high-risk patients with atherosclerotic cardiovascular disease and type 2 diabetes: results in 213,380 individuals from the cvMOBIUS2 registry.
Am J Prev Cardiol
March 2025
UT Southwestern Medical Center, Department of Medicine, Division of Cardiology, TX, USA.
Objective: Lowering lipid to reach guideline-indicated goals significantly reduces cardiovascular outcomes in very-high-risk (VHR) patients with atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes (DM2). How well VHR patients currently achieve these goals in community practice is unknown.
Methods: VHR patients with ASCVD and DM2 were identified across 14 US healthcare systems using electronic health records between 1/1/2021-12/31/2022.
The importance of Ombudsman programs in supporting the transition from medicare-medicaid plans to dual special needs plans.
Disabil Health J
January 2025
Disability Policy Consortium, 25 Kingston St, 4th Floor, Boston, MA, 02111, USA. Electronic address:
In this paper, we examine the critical role of Ombudsman programs in facilitating the transition from Medicare-Medicaid Plans (MMPs) to Dual Special Needs Plans (D-SNPS) for dual-eligible members. As states implement this federally mandated transition, Ombudsman programs serve as essential supports for the dual-eligible population who are navigating complex healthcare changes. Through analysis of Ombudsman programs in California, Massachusetts, Rhode Island, and Michigan, we highlight how these services address beneficiary concerns, resolve access issues, and provide valuable insights to policymakers.
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