Health Equity and Access Weekly Roundup: February 10, 2024

Screening for Health Literacy, Social Determinants, and Discrimination in Health Plans

A new study aimed to assess the feasibility of telephonic screening for health literacy (HL) and perceived health care discrimination (PHD) among managed care patients, focusing on social determinants of health (SDOH). While the HL screen was well-received, the PHD screen had a lower response rate, possibly due to discomfort. Low HL was associated with being Black, low-income, and experiencing loneliness or food insecurity. According to the authors, this suggests the potential for health plans to use such screenings to understand patient barriers and tailor interventions for health equity, despite limitations such as sample size and causality implications.

Medicare Value-Based Purchasing Program Yields Comparable 30-Day Mortality Rates Across Hospitals

Researchers investigated the effect of the Medicare Hospital Value-Based Purchasing program on mortality rates in hospitals with high proportions of Black patients. Despite concerns about care quality in these hospitals, no significant differences in mortality rates were found compared with other hospitals after the program's implementation. However, the program was associated with widening disparities in pneumonia mortality rates for Black adults, highlighting the need for ongoing evaluation of initiatives to address care outcomes, especially for minority populations.

Carrie Kozlowski Discusses the Impacts of the Medicaid Disenrollment Crisis

Carrie Kozlowski, COO and co-founder of Upfront Healthcare, discussed the ramifications of increasing Medicaid disenrollment in the US health system. She highlighted the financial strain, noting the rise in uncompensated care rates from 6.4% to 8.7%, and anticipated long-term impacts such as patients avoiding care due to financial constraints leading to advanced diseases. She pointed out the challenges faced by hospitals in managing uninsured patients, affecting throughput and delaying care for others. Kozlowski also stated the broader community impact, particularly on vulnerable populations, with 37% of kids disenrolled from Medicaid in the past year exacerbating existing racial inequities.

Non-White Patients With CRC Have Increased Odds of Emergent Resection

The study in Surgery Open Science found that non-White patients, including Black, Hispanic, and other ethnicities, faced higher odds of emergent colorectal cancer (CRC) resection and major adverse events compared with White patients over nearly a decade, despite a decline in overall emergent surgeries. Emergent admissions were linked to Medicaid or uninsured status, indicating financial barriers, and were associated with increased mortality and complications. This underscores the importance of timely CRC screening and oncologic assessment to reduce the need for emergent surgeries in non-White populations, although limitations such as the lack of data on cancer staging and surgery complexity suggest further research is needed to address these disparities effectively.

New Mexico Implements Mobile Crisis Intervention Teams With HHS Approval

HHS approved New Mexico's plan for mobile crisis intervention teams, a crucial step in President Biden's mental health agenda under the American Rescue Plan. These teams will provide 24/7 crisis services to Medicaid beneficiaries, offering rapid response and connecting individuals to behavioral health providers. This aligns with efforts in other states to expand community-based crisis care and the nationwide launch of the 988 Suicide & Crisis Lifeline. In New Jersey, Mobile Crisis Outreach Response Teams are being established to provide timely intervention without involving law enforcement, ensuring equitable access to mental health services.