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Health Equity and Access Weekly Roundup: February 17, 2024

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This week in health equity and access includes challenges for independent physicians due to Medicare cuts, inequities in access to State Health Insurance Assistance Program counseling, a study on patient experiences in national health plans, strategies for building trust in cancer care, and increasing breast cancer rates in young Black women.

Dr David Eagle: CMS Reimbursement Cuts Encourage Trend of Independent Physician Exodus

In an interview, David A. Eagle, MD, of New York Cancer & Blood Specialists, discusses the challenges independent physicians face in 2024, including Medicare reimbursement cuts and declining physician pay compared with rising hospital reimbursement. Eagle emphasizes the impact on patient access and quality of care, with many doctors leaving independent practice. He calls for legislative support, like the Strengthening Medicare for Patients and Providers Act, to address reimbursement discrepancies and sustain independent medicine.

Potential Inequities in Access to In-Person SHIP Counseling Services

A cross-sectional study examines the availability of in-person State Health Insurance Assistance Program (SHIP) counseling sites by ZIP code tabulation area (ZCTA) and assesses whether these sites are disproportionately located in higher-income communities. The analysis reveals that over half of the localities have a SHIP site within the ZCTA or county, while 24% lack a SHIP site within the county but have one in an adjacent county and 13% do not have a nearby SHIP site. Investigators found that areas without in-person SHIP sites tend to have a higher proportion of Medicare-eligible individuals, lower income, and less education.

Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans

In the latest episode of Managed Care Cast, J. Nwando Olayiwola, MD, MPH; Candy Magaña, MPA; and Bereket Kindo, PhD, discuss their recent study published in The American Journal of Managed Care® (AJMC®) titled "Screening for Health Literacy, Social Determinants, and Discrimination in Health Plans." Olayiwola serves as Humana's chief health equity officer and senior vice president, Magaña as the director of health equity innovation, and Kindo as a lead data scientist. Their study explores the experiences of patients within a national health plan, focusing on 2 structural determinants of health and their interaction with social determinants of health and patient demographics.

In Cancer Care, Building Trust Requires Understanding, Meeting Patients Where They Are

The panel at the Patient-Centered Oncology Care® 2023 conference discusses strategies for enhancing patient engagement and trust in health care, particularly in communities with a history of mistreatment. Led by Mary Caffrey, executive editor, AJMC® and Evidence-Based Oncology, experts emphasize the importance of validation, diversity, and inclusion in care delivery, suggesting approaches like technology utilization and community engagement. Overall, they highlight the vital role of ongoing human interaction in building trust in health care.

Breast Cancer Incidence Highest Among Young Black Women in the US

A recent study examined breast cancer rates among young women in the US over 20 years by race, hormone receptor status, and tumor stage. Findings show increasing rates, especially in non-Hispanic Black women aged 20 to 39 years, while rates decreased in non-Hispanic Black women aged 40 to 49 years compared with non-Hispanic White women. The rise is mainly in estrogen receptor–positive tumors. The study highlights the need for targeted prevention strategies and further research into risk factors among young women.

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