2022’s most interesting health care research papers, according to the experts

Though the pandemic and all its attendant health care crises remained the major health care story of 2022, churning all the while in the background has been the critical work of academic scholars, operating on longer timelines, who are still trying to make sense of US health care and of medicine itself, to get a better idea of what’s wrong and how to make it better.

To wrap up this year, I asked a couple dozen health policy experts what research released this year (though, as one of them reminded me, these papers are often years in the making) had surprised them, changed their thinking, or struck them as especially notable.

Here are five particularly interesting papers, at least in my view. Because many more than that warrant mention, I have tried to cram in as many references to other work as I could. One of my lessons from this exercise was that there are noteworthy new studies being produced all the time. The US health system certainly merits such extensive investigation, given the number and diversity of its flaws.

These studies cover a broad range of subjects, from the intricacies of Medicaid provider networks to prescription uptake by Medicare beneficiaries to how bystanders react when a person experiences a cardiac episode in public. But first, on the topic of the pandemic…

1) Vaccination education campaigns in nursing homes didn’t make much difference

Several experts pointed me to data sets related to Covid-19 vaccination in nursing homes, the scenes of so much illness and death in that frightening first year of the pandemic. Larry Levitt, executive vice president of the Kaiser Family Foundation, flagged one recent KFF survey that found less than half of nursing-home residents are up to date on their vaccines.

That put into sharp relief the findings of a study that Harvard Medical School’s David Grabowski cited as one of his favorites of the year. The paper, published in JAMA Internal Medicine in January 2022, evaluated an effort to use educational campaigns and other incentives to improve vaccination rates among residents and staff in nursing homes.

They did not find a meaningful effect, despite three months of programming. There was plenty of room to grow, particularly among the staff, roughly half of whom were unvaccinated during the study period. (Vaccination rates among residents were already high at the time, though the experiment still did not find

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New poll demonstrates jump in grownups who fee the good quality of US wellness care as ‘poor’



CNN
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Most adults in the US look at the high quality of the country’s health and fitness care to be unfavorable, according to a new study. This is the initial time in a 20-yr development from Gallup polls that the share of adults who rated the high-quality of the nation’s health and fitness treatment to be “excellent” or “good” dipped under 50%. The share of adults who rated it as “poor” jumped earlier mentioned 20%, also for the initially time.

Practically half of older people claimed that the program has “major troubles.” A different a person in 5 adults said that US well being treatment is in a “state of disaster,” the premier share in about a ten years.

Rankings of wellness treatment cost and coverage ended up minimal – fewer than a quarter of adults say they are satisfied with the charge of health treatment in the country and less than a third of grown ups see wellness treatment coverage favorably – but all those sights have held fairly regular in excess of the decades.

For the past two decades, there has been a “clear distinction in between the substantial regard people today had for the top quality of care in the region as opposed to the complications they saw in health care administration, which includes protection and cost,” in accordance to the Gallup report, which revealed Thursday and is dependent on interviews collected in November.

But the declining sights on wellness care quality mark a obvious shift in this balance.

Partisan sights make clear some of this shift. Republicans’ perspective of wellbeing treatment high-quality dropped in 2014 soon after the implementation of the Reasonably priced Treatment Act and rebounded throughout Donald Trump’s presidency. But they dropped sharply once again in latest many years, down from 75% favorable in 2019 to 56% in the hottest poll. Democrats generally see health treatment top quality much less favorably than Republicans, but their ratings have stayed more consistent in excess of the years.

Also, fulfillment with health and fitness care has remained superior between more mature grownups ages 55 and up but declined between young and middle-age adults. The authors of Gallup report advise that some of this drop could reflect views on abortion obtain and other modifications that happened in the course of the Covid-19 pandemic.

In general, US grownups are significantly much more most likely to check out

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Sick Profit: Investigating Private Equity’s Stealthy Takeover of Health Care Across Cities and Specialties

Two-year-old Zion Gastelum died just days after dentists performed root canals and put crowns on six baby teeth at a clinic affiliated with a private equity firm.

His parents sued the Kool Smiles dental clinic in Yuma, Arizona, and its private equity investor, FFL Partners. They argued the procedures were done needlessly, in keeping with a corporate strategy to maximize profits by overtreating kids from lower-income families enrolled in Medicaid. Zion died after being diagnosed with “brain damage caused by a lack of oxygen,” according to the lawsuit.

Kool Smiles “overtreats, underperforms and overbills,” the family alleged in the suit, which was settled last year under confidential terms. FFL Partners and Kool Smiles had no comment but denied liability in court filings.

Private equity is rapidly moving to reshape health care in America, coming off a banner year in 2021, when the deep-pocketed firms plowed $206 billion into more than 1,400 health care acquisitions, according to industry tracker PitchBook.

Seeking quick returns, these investors are buying into eye care clinics, dental management chains, physician practices, hospices, pet care providers, and thousands of other companies that render medical care nearly from cradle to grave. Private equity-backed groups have even set up special “obstetric emergency departments” at some hospitals, which can charge expectant mothers hundreds of dollars extra for routine perinatal care.

As private equity extends its reach into health care, evidence is mounting that the penetration has led to higher prices and diminished quality of care, a KHN investigation has found. KHN found that companies owned or managed by private equity firms have agreed to pay fines of more than $500 million since 2014 to settle at least 34 lawsuits filed under the False Claims Act, a federal law that punishes false billing submissions to the federal government with fines. Most of the time, the private equity owners have avoided liability.

New research by the University of California-Berkeley has identified “hot spots” where private equity firms have quietly moved from having a small foothold to controlling more than two-thirds of the market for physician services such as anesthesiology and gastroenterology in 2021. And KHN found that in San Antonio, more than two dozen gastroenterology offices are controlled by a private equity-backed group that billed a patient $1,100 for her share of a colonoscopy charge — about three times what she paid in another state.

It’s not

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Homeless health care crisis: Will street teams remedy?

In summary

Homeless people often have sporadic or no access to health care, resulting in costly, chronic conditions. A new statewide effort encourages Medi-Cal insurers to partner with street teams to improve care.

Lea este artículo en español.

Living on the streets of California is a deadly affair. The life expectancy of an unsheltered person is 50, according to national estimates, nearly 30 years less than that of the average Californian. As homelessness spirals out of control throughout the state, so too do deaths on the street, but it’s those whose lives are the most fragile who are least likely to get medical care.

Now, the state Medi-Cal agency is endeavoring to improve health care access for people experiencing homelessness. Through a series of incentives and regulatory changes, the Health Care Services Department is encouraging Medi-Cal insurers to fund and partner with organizations that bring primary care into encampments.

They’re known as street medicine teams. There are at least 25 in California.

“Oh crap. This is where she was, and they just swept that,” said Brett Feldman on a Friday morning in November, looking at a green tent, crumpled and abandoned on Skid Row in Los Angeles. Feldman, a physician assistant, is searching for a female patient in her 40s with severe and unmanaged asthma. She cycles predictably in and out of the hospital, and Feldman knows she’s due for another hospitalization soon.

Physician’s assistant Brett Feldman asks a man in his encampment if he has seen a patient along Skid Row on Nov. 18, 2022. The patient was likely pushed out of the area as the Los Angeles sanitation department cleared the unhoused to clean the street near Skid Row. Photo by Larry Valenzuela for CalMatters

The road is streaked with water from a cleaning truck, and sanitation workers in fluorescent vests sweep up debris. Parking enforcement and police cruisers line the section of road where a homeless encampment once stood. Nearly 5,000 people live in the half-mile block infamous for the hypervisibility it affords the state’s unrelenting homeless crisis.

Burdened by disproportionate rates of addiction, mental health disorders and chronic disease, people experiencing homelessness are some of the state’s neediest patients, but few receive anything more than emergency services. Barriers like lack of transportation and cumbersome insurance rules keep most from getting regular health care. Instead, they drift through the emergency room during a crisis,

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Medicare Pay Cuts Will Hurt Seniors’ Care, Doctors Argue

[UPDATED at 11 a.m. ET for news developments.]

Doctors are urging Congress to call off cuts scheduled to take effect on Jan. 1 in the reimbursements they receive from Medicare.

In what has become an almost yearly ritual, physician groups are arguing that patients will have greater difficulty finding doctors who accept Medicare if lawmakers allow the pay cuts to happen.

A more than 4,000-page draft government spending bill released by lawmakers early Tuesday morning proposed much smaller-than-planned cuts to Medicare payments. But the bill, which Congress hoped to pass by the weekend to keep the government funded and avert a shutdown, would not go as far as doctors wanted.

“Despite overwhelming bipartisan, bicameral support to stop the full Medicare physician payment cut, Congress failed once again to end the cycle of harmful Medicare cuts, showing a disregard for vulnerable seniors,” the Surgical Care Coalition, an organization representing surgeons and anesthesiologists, said in a statement.

The doctors’ lobbying campaign had gained traction on Capitol Hill. A bipartisan group of 115 House lawmakers rallied behind doctors in a letter to congressional leaders and President Joe Biden last week, urging them to prevent cuts that they argued would “only make a bad situation far worse” for Medicare patients.

In recent years, the Centers for Medicare & Medicaid Services scheduled the pay cuts to offset the cost of increasing payments for underpaid services, like primary care. Physicians also stand to see reductions tied to broad cuts implemented by Congress in recent decades to try to control government spending.

Some Republicans have pushed to wait on passing the spending package until their party controls the House of Representatives next year and can have a greater say over what they call out-of-control spending. One priority of the incoming House Republican majority is curbing Social Security and Medicare, a federal health insurance program for people age 65 and older, among others.

“We’re mortgaging our kids’ futures,” Sen. Ron Johnson of Wisconsin, a Republican on the Senate Budget Committee, told reporters, referring to overall spending. “This is killing us from a financial standpoint. It’s got to stop.”

Despite concerns about ballooning government spending, for years doctors have been successful in delaying or softening proposed pay cuts, arguing that there would be dire consequences if the cuts kicked in.

Physicians carry a lot of political weight in Washington. The American Medical Association, the professional organization that represents and

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Health Care Shouldn’t Be This Expensive: How to Find Answers and Low-Cost Options

This story is part of Priced Out, CNET’s coverage of how real people are coping with the high cost of living in the US.

Evan Stewart has epilepsy, so going a day without health insurance isn’t an option. When he left his job in the medical field to tour with his musical band, he was able to keep his benefits through COBRA. That meant a large part of his income — $800 a month — went toward keeping that coverage until he qualified for another insurance plan with his new employer. 


Brandon Douglas/CNET

The cost wasn’t bad considering the alternative. “If a seizure lasts me more than five minutes, an ambulance has to come to my house, and then I’ll probably go to the emergency room,” said Stewart, who lives in Seattle. “Without insurance, the ambulance ride would bankrupt me, and the hospital stay would keep me in medical debt for the rest of my life.” 

Stewart was nervous about switching his job because he didn’t want to give up his health care benefits. That’s fairly common in the US: One out of every six adult workers who get medical insurance through an employer stay in their jobs out of fear of losing coverage, according to a recent Gallup poll. While the majority of larger employers offer health benefits, annual premiums have soared in the last decade, reaching a yearly average of $7,911 for single coverage and $22,463 for family coverage. Many of these plans also have costly copays and high deductibles, requiring employees to pay even more. 

Even with a good insurance policy like Stewart’s, Americans often find themselves paying insurmountable out-of-pocket medical expenses. 

“We have an incredibly complex health care system,” said Amy Niles of the PAN Foundation, a nonprofit that helps underinsured patients in need. “And unfortunately, at the end of the day, a lot of the cost gets shifted onto the patients.” 

That’s why, according to Niles, it’s important to understand the price tag when considering your own health needs. Getting affordable medical care isn’t impossible, but it means sifting through an array of options: from private short-term plans to the Affordable Care Act’s marketplace tiers to government- or state-based insurance, all with different rules, requirements, enrollment dates, premiums and deductibles. It also means becoming a strong self-advocate. If a household can’t afford health insurance, there are other resources that provide

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