Health affairs
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Review
Children's Health Insurance Coverage: Progress, Problems, And Priorities For 2021 And Beyond.
Expansion of Medicaid and establishment of the Children's Health Insurance Program (CHIP) represent a significant success story in the national effort to guarantee health insurance for children. That success is reflected in the high rates of coverage and health care access achieved for children, including those in low-income families. ⋯ Children continue to face coverage interruptions, and Latino, adolescent, and noncitizen children continue to face elevated risks of being uninsured. Although we note the benefits of a universal, federally financed, single-payer approach to coverage, we also offer two possible reform pathways that can take place within the current multipayer system, aimed at ensuring coverage, access, continuity, and comprehensiveness to move the nation closer to the goal of providing the health care that children need to reach their full potential and to reduce racial and economic inequalities.
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As the coronavirus disease 2019 (COVID-19) pandemic surged in New York City, the city's public hospital system, New York City Health + Hospitals, recognized that innovative technological solutions were needed to respond to the crisis. Our health system recently transitioned to a unified enterprisewide electronic medical record across all of our hospitals. This accelerated our ability to implement a series of technological solutions to the crisis. ⋯ We standardized patient workup using specialty-specific order sets, created dashboards to give insight into enterprisewide bed availability and facilitate transfers from the hardest-hit hospitals, and improved the patient experience by using tablets to connect patients with loved ones. The technology bridged divides between different hospital systems across New York City to encourage the sharing of data and improve patient care. By rapidly expanding its use of information technology, NYC Health + Hospitals was able to respond to the COVID-19 surge and is now better positioned to work in a more integrated fashion in the future.
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Most states enacted shelter-in-place orders when mitigating the coronavirus disease 2019 (COVID-19) pandemic. Emerging evidence indicates that these orders have reduced COVID-19 cases. Using data starting at different dates in March and going through May 15, 2020, we examined the effects of shelter-in-place orders on daily growth rates of both COVID-19 deaths and hospitalizations, using event study models. ⋯ C., that had statewide shelter-in-place orders. The daily hospitalization growth rate examined in nineteen states with shelter-in-place orders and three states without them that had data on hospitalizations declined by up to 8.4 percentage points after forty-two days. This evidence suggests that shelter-in-place orders have been effective in reducing the daily growth rates of COVID-19 deaths and hospitalizations.
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As a result of the coronavirus disease 2019 (COVID-19) pandemic, virtually all in-person outpatient visits were canceled in many parts of the country between March and May 2020. We sought to estimate the potential impact of COVID-19 on the operating expenses and revenues of primary care practices. ⋯ We further estimated that the cost at a national level to neutralize the revenue losses caused by COVID-19 among primary care practices would be $15.1 billion. This could more than double if COVID-19 telemedicine payment policies are not sustained.