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Health Equity and Access Weekly Roundup: May 11, 2024

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This week's topics include frameworks for improving health equity nationwide, addressing social determinants of health, discussing CMS's Medicare rules, investigating breast cancer treatment refusal, and exploring HIV and major depressive disorder in underrepresented groups.

Frameworks for Advancing Health Equity: Urban Health Outreach

In the newest episode of Managed Care Cast, the Center on Health Equity and Access kicks off a podcast series exploring programs dedicated to reducing health care disparities in the US by bridging care and accessibility gaps. The series, "Frameworks for Advancing Health Equity," will showcase innovative initiatives within health care centers. The inaugural episode highlights the Urban Health Outreach program by the Center for Inclusion Health at Allegheny Health Network (AHN). Mary Sligh, CRNP, and Chelsea Chappars, project manager, discuss their efforts in providing care for individuals experiencing homelessness and their program's comprehensive approach.

Addressing Whole Health Takes Rethinking Partnerships, Metrics, and Delivery

Denise Webb, a college sophomore, urges the involvement of youth in tackling health care disparities, drawing from her own experiences of low-income living, severe asthma, and homelessness. At the ISPOR: The International Society for Pharmacoeconomics and Outcomes Research conference moderated by Charlene Wong, MD, MSHP, Webb expressed the need for a holistic health care approach addressing social determinants. Panelists Seth Berkowitz, MD, MPH, and Eric Schneider, MD, MSc, advocate for recognizing and addressing health-related social needs, stressing person-centered care and system-level changes. They highlight the importance of investing in social needs like housing and food security, emphasizing collaboration and data generation for effective policy changes.

CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection

In this podcast episode of Managed Care Cast, Karen Iapoce, senior director of government products and programs at ZeOmega, delves into CMS's latest Medicare Part D and Medicare Advantage final rule and its implications for enrollees and health plans. The rule encompasses diverse measures, including mandates for health equity analysis and the inclusion of behavioral health providers. Additionally, it emphasizes access to reliable information for Medicare enrollees, enforces evidence-based supplemental benefits, and encourages biosimilar substitution.

Breast Cancer Treatment Disparities Impact Survival Based on Race, Age, Socioeconomics

Researchers investigated racial and ethnic disparities in breast cancer treatment refusal, linked to factors such as age, insurance status, income, comorbidities, and disease stage. The study, conducted between 2004 and 2020 using data from the National Cancer Database, reveals higher rates of treatment refusal among certain groups. Despite variations, patients who declined treatment generally had lower survival rates. The study highlights the need for further research to address disparities and improve health care outcomes for all breast cancer patients.

High Burden of Disease, Depressive Symptoms Found in Underrepresented Groups Living With HIV

A new investigation using the All of Us (AoU) database found significant links between HIV and major depressive disorder (MDD). Among the 5193 participants with HIV, 2238 also had MDD, with common comorbidities including hypertension and anxiety disorder. Black individuals and those identifying as gay or lesbian, gay, or bisexual had a higher burden of HIV. The study showed that MDD prevalence was notably higher among those with HIV compared to those without, and patients with both HIV and MDD reported poorer mental health. The study had limitations, such as sample size and lack of coverage for out-of-network care, which underscores the need for further research to better understand the relationship between HIV and MDD and improve clinical outcomes for affected individuals.

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