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Medicaid managed care network adequacy standards and mental health care access.
Am J Manag Care
January 2025
Department of Population Health Sciences, Weill Cornell Medicine, 575 Lexington Ave, 6th Floor, New York, NY 10022. Email:
Objectives: Medicaid is the largest payer of mental health (MH) services in the US, and more than 80% of its enrollees are covered by Medicaid managed care (MMC). States are required to establish quantitative network adequacy standards (NAS) to regulate MMC plans' MH care access. We examined the association between quantitative NAS and MH care access among Medicaid-enrolled adults and among those with MH conditions.
View Article and Find Full Text PDFIncreasing Access Through Integration: Behavioral Health Services and Beyond.
Am J Public Health
January 2025
Della Hughes Carter, Mary Claire Meimers, and Emily Fowler Bemben are with the Kirkhof College of Nursing, Grand Rapids, MI.
An academic health center (AHC) that provides primary care to an urban, underresourced population recognized the need for an integrated model of care to address behavioral health needs. The Ambulatory Integration of the Medical and Social (AIMS) Collaborative Care Model's five pillars provided the framework and enhanced outcomes through tailored initiatives at the AHC, expanding to onsite satellite locations in senior subsidized housing, and through telehealth services. The results showed increased access to behavioral health care and improved depression and anxiety symptoms.
View Article and Find Full Text PDFPurpose: In this study, we aimed to evaluate the association between the Extension for Community Healthcare Outcomes-Palliative Care (ECHO-PC; ECHO Model-Based comprehensive educational and telementoring intervention) for health care professionals (HCPs) and change in patient-reported quality-of-life (QOL; Functional Assessment of Cancer Therapy-General [FACT-G]) among patients with advanced cancer. We also examined the association between ECHO-PC and changes in symptom distress (Edmonton Symptom Assessment Scale [ESAS]), patient experience and satisfaction, and caregiver distress scores.
Methods: ECHO-PC Clinic sessions were conducted twice a month for 1 year by an interdisciplinary team of PC clinicians at the MD Anderson Cancer Center, with participation of experts in PC in sub-Saharan Africa, using standardized curriculum on the basis of PC needs in the region.
Principles for embedding learning and adaptation into New Zealand health system functioning: the example of the Viable System Model.
N Z Med J
January 2025
Executive Dean, Bond Business School, Bond University, Gold Coast, QLD, Australia; Harkness Senior Fellow, Commonwealth Fund of New York.
This article makes the case for taking a model-based management approach, specifically using the Viable System Model (VSM), to embed learning and adaptation into the New Zealand health system so it can function as a learning health system. We draw on a case study of a specialist clinical service where the VSM was used to guide semi-structured interviews and workshops with clinicians and managers and to guide analysis of the findings. The VSM analysis revealed a lack of clarity of organisational functioning, and of the systems, processes and integrated IT infrastructure necessary to support the fundamental requirements of a learning health system.
View Article and Find Full Text PDFThe prevalence of aortic stenosis in Māori undergoing clinically indicated echocardiography compared to New Zealand Europeans.
N Z Med J
January 2025
Department of Medicine, HeartOtago, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; Department of Cardiology, Dunedin Hospital, Southern District Health Board, Dunedin, New Zealand.
Aim: There are limited data on the prevalence of calcific aortic valve disease (CAVD) in Māori and known inequities in outcomes after aortic valve intervention. Our study aimed to investigate the prevalence of CAVD in Māori.
Methods: Data from initial clinically indicated echocardiograms performed between 2010 to 2018 in patients aged ≥18 years were linked to nationally collected outcome data.
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