Strengthening Integration of Health Services and Systems

A new University of Michigan analysis reviews 46 studies evaluating interventions for "super-utilizers" of emergency department and prehospital care in the U.S. Here, the authors share their thoughts on the importance of their findings.

In June 2018, Arkansas became the first state to implement work requirements in Medicaid. Benjamin D. Sommers, Anna L. Goldman, Robert J. Blendon, E. John Orav, and Arnold M. Epstein of Harvard University provide the first independent assessment of early changes in beneficiary coverage and employment after the work requirements went into effect.

The rising rate of non-medical exemptions is a driving force behind our nationwide measles crisis. Chelsea J. Richwine, Avi Dor, and Ali Moghtaderi of George Washington University examine the effect of California’s 2016 decision to repeal all non-medical exemptions on immunization coverage in a new working paper.

“Super-utilizers” have been the subject of much attention as health care systems work to reduce costs and provide better care. As part of their work to understand best practices for addressing the medical and social needs of high-need/high-cost patients, Samantha Iovan, Paula Lantz, Katie Allan, and Mahshid Abir published a systematic review examining interventions that are being implemented to address super-utilizers in prehospital and emergency care settings in the U.S.

Across the country, changes to Medicaid policy are under way. They hold the potential to dramatically alter the landscape of health care for millions of low-income individuals. Meanwhile, the 2018 midterm election results may lead to further Medicaid expansion in five states, three through ballot initiatives (Idaho, Nebraska, and Utah) and two with the election of new governors supportive of expansion, who replace outgoing governors who opposed it (Kansas and Maine). If all five states expand Medicaid, an estimated 500,000 people are expected to gain coverage.

In a recent opinion in The Milbank Quarterly, Dr. Lantz builds on insights from her P4A research portfolio to articulate concerns about the recent "medicalization" of population health within the health care system and its limits in making substantial improvements in population health.

If you’re one of the millions of Americans who tuned in to some Thanksgiving TV programming last week, you probably caught at least a few pharmaceutical ads for drugs to help manage diabetes and its side effects.

Steven H. Goldberg, Paula M. Lantz, and Samantha Iovan from the University of Michigan P4A Research Hub examine the use of federal Medicaid dollars as a payout source for non-medical services aimed at addressing social determinants of health under the 2016 Medicaid Managed Care Final Rule.

The Pay for Success model may prove to be a valuable tool for increasing critical investments in effective health and wellness interventions. The public-private nature of the approach can encourage important ties between the business community, investment groups, philanthropy, and public agencies and service systems; and stimulate innovative changes in the financing and delivery of sustainable, community-driven solutions.

Proposed budget cuts to the Department of Housing and Urban Development (HUD) would likely result in a loss of federal housing assistance--and potential rent hikes--for thousands of low-income families. Our forthcoming study will test whether differences in the monetary value of housing assistance received by households translates into meaningful differences in health outcomes.

Five years ago, a groundbreaking report showed people in the US in worse health and dying younger than those in other rich nations. Today, despite the alarm the report generated, we learned that life expectancy in the country declined for a second year in a row – astonishing by any standard.

Manmeet Kaur, executive director and founder of the Harlem-based community health organization City Health Works, is the inaugural recipient of the Janice Nittoli Practitioner Fellowship. Funded by the Rockefeller Foundation, the Nittoli Fellowship is awarded to innovative, entrepreneurial practitioners working in communities to address inequalities and is open to applications.