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Increasing Medicaid enrollment among formerly incarcerated adults

Increasing Medicaid enrollment among formerly incarcerated adults

Formerly incarcerated adults bear a disproportionate burden of disease, including substance use disorders, mental illness, and HIV, conditions that require timely and ongoing medical care. However, as they reenter the community from correctional facilities, the likelihood of receiving treatment for many chronic conditions declines relative to the incarceration period, and they experience high rates of emergency department use, substance use, and elevated rates of mortality particularly due to drug overdose.

Improved access to health care in the reentry period has the potential to mitigate these relatively high rates of morbidity and mortality. However, historically a key component of access, health insurance coverage, has been largely unavailable to this population. In this publication, HIP Investigator, Dr. Marguerite Burns et al. aimed to estimate the incremental associations between the implementation of expanded Medicaid eligibility and prerelease Medicaid enrollment assistance on Medicaid enrollment for recently incarcerated adults.

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Quit smoking

Impact of a Rheumatology Clinic Protocol on Tobacco Cessation Quit Line Referrals

Impact of a Rheumatology Clinic Protocol on Tobacco Cessation Quit Line Referrals

Although smoking is a risk factor for patients with rheumatic conditions and contributes to greater symptom severity and cardiovascular disease risk, standard smoking cessation intervention is rare in rheumatology clinics. Primary care uses brief staff protocols to connect patients to free, state-run tobacco cessation quit line resources, but this approach had not been previously tested in rheumatology.

In this article, authors including HIP Investigators Dr. Christie Bartels and Dr. Edmond Ramly implemented a rheumatology staff-driven protocol, Quit Connect, to increase the rate of electronic referrals (e-referrals) to free, state-run tobacco quit lines (TQL). The group found that implementing Quit Connect in rheumatology clinics was feasible and improved referrals to a state-run TQL.

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WMJ: Impact of Race and Racism on Health

Identifying Substantial Racial and Ethnic Disparities in Health Outcomes and Care in Wisconsin Using Electronic Health Record Data

Identifying Substantial Racial and Ethnic Disparities in Health Outcomes and Care in Wisconsin Using Electronic Health Record Data

Although Wisconsin ranks highly in overall health care quality, the state performs poorly with respect to health disparities. To eliminate health disparities in Wisconsin, it is critical to understand where disparities exist.

Measuring disparities in health outcomes and care allows for benchmarking of current performance and monitoring changes over time. Measurement also allows stakeholders to prioritize efforts and develop and implement programs for the populations that are most impacted by disparities. Authors including HIP Investigator, Dr. Maureen Smith identified racial and ethnic disparities in health outcome and care measures in Wisconsin.

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Co-designing to advance community health and health equity in Wisconsin: Building the Neighborhood Health Partnerships Program

Co-designing to advance community health and health equity in Wisconsin: Building the Neighborhood Health Partnerships Program

Engaging communities can increase the speed of translating health and health equity research into practice. Effective engagement requires a shared understanding of neighborhood health care quality and outcomes. Creating this shared understanding can be challenging without timely and accurate local health data, or ways to provide the data that are directly applicable to improving community health.

In this publication, authors including HIP Investigator, Dr. Maureen Smith discuss how an effective co-design strategy can lead to increased usability and adoption of CTSA resources, enabling a shared understanding of community health and ultimately leading to the successful translation of research into practice.

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Effect of Resident Physicians in a Supervisory Role on Efficiency in the Emergency Department

Effect of Resident Physicians in a Supervisory Role on Efficiency in the Emergency Department

Patient throughput and emergency department (ED) length of stay (LOS) are recognized as important metrics in the delivery of efficient care in emergency medicine. However, academic centers must balance expeditious care delivery with the educational mission of training the next generation of emergency physicians.

In this article, HIP Investigator, Dr. Brian Patterson et al. sought to examine the impact of a staffing model involving a supervisory resident “pre-attending” (PAT) on ED throughput and LOS, as this model offers a valuable educational experience for residents, but may do so at the expense of operational efficiency.

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A prioritization algorithm for healthcare personnel for the CDC’s COVID-19 Phase 1a vaccine distribution plan

A prioritization algorithm for healthcare personnel for the CDC’s COVID-19 Phase 1a vaccine distribution plan

The National Academies of Sciences, Engineering, and Medicine, in its Framework for Equitable Allocation of COVID-19 Vaccine, suggests using an index such as the Social Vulnerability Index (SVI) to prioritize individuals living in locations identified as vulnerable in order to incorporate variables that are most linked to the disproportionate impact of COVID-19 on people of color.

In this paper, authors including HIP Investigator Dr. Maureen Smith, developed an algorithm that can be used to equitably distribute COVID-19 vaccinations to healthcare personnel (HCP) during Phase 1a of the Center for Disease Control and Prevention’s (CDC) coronavirus vaccine distribution plan, if not enough vaccine is available to immunize an entire group of employees with similar job-related risk exposure. The algorithm prioritizes individuals with the highest risk of mortality using Social Vulnerability Index (SVI) and age.

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Novel Decision Support Interventions for Low-risk Thyroid Cancer

Novel Decision Support Interventions for Low-risk Thyroid Cancer

The treatment paradigm for low-risk thyroid cancer increased in complexity following release of the 2015 American Thyroid Association Guidelines for Adults with Differentiated Thyroid Cancer. Although the intention of the guidelines were to “complement informed, shared patient-healthcare provider deliberation” when making treatment decisions, patient-clinician deliberation can fail to meet patients’ needs and may exclude available treatment.

In this research letter, Dr. Susan Pitt and Megan Saucke examined a patient-oriented intervention to support decision-making about low-risk thyroid cancer treatment. The duo held 16 stakeholder meetings between July 2016 and December 2017 to develop a 1-page treatment comparison chart and a trifold pamphlet containing a question prompt list (available at https://www.hipxchange.org/ThyroidCancerTreatmentChoice).

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Implementing parity for mental health and substance use treatment in Medicaid

Implementing parity for mental health and substance use treatment in Medicaid

Rates of mental health and substance use disorders (MHSUDs) in the adult Medicaid population are higher than for adults with Medicare or private health insurance. In this publication, HIP Investigator, Dr. Marguerite Burns et al. estimates the association between the implementation of parity in coverage for mental health and substance use disorder (MHSUD) services within the Medicaid program and MHSUD service use.

The authors' findings suggest that parity implementation in Medicaid could increase access to effective MHSUD services in a high‐need population.

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Bandaging amputee

Expect Delays: Poor Connections Between Rural and Urban Health Systems Challenge Multidisciplinary Care for Rural Americans With Diabetic Foot Ulcers

Expect Delays: Poor Connections Between Rural and Urban Health Systems Challenge Multidisciplinary Care for Rural Americans With Diabetic Foot Ulcers

Over 30 million people in the United States have diabetes, and up to 25% of them will develop a diabetic foot ulcer (DFU). Specific to DFUs, rural patients face 50% higher odds of major (above-ankle) amputation and 40% higher odds of death compared to their urban counterparts. A group of authors including HIP Investigators, Dr. Meghan Brennan and Dr. Christie Bartels sought to understand what health system factors contribute to the rural disparity in diabetic foot ulcer outcomes.

The authors concluded that future interventions focusing on mitigating the poor connections across rural and urban healthcare systems could reduce the rural disparity in major amputations.

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Telemedicine for Glaucoma: Guidelines and Recommendations

Telemedicine for Glaucoma: Guidelines and Recommendations

Glaucoma is the leading cause of irreversible blindness worldwide, estimated to affect >60 million people. Access to glaucoma specialists is challenging and likely to become more difficult as the population ages. Glaucoma care guidelines are not as standardized as those for diabetic retinopathy, which allow for significant regional and provider variability in glaucoma diagnosis and management.

In these guidelines, co-authored by HIP Investigator Dr. Yao Liu, authors reviewed considerations and practice recommendations for teleglaucoma programs.

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