Resource Library

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The John T. Gorman Foundation strives to be data-driven and results based and seeks to promote information and ideas that advance greater understanding of issues related to our mission and priorities. In our effort to promote these values, we offer these research and best practice resources collected from reputable sources across the country. The library also includes briefs and reports the Foundation has commissioned or supported, a listing of which can be found here.


Telemedicine use among Medicare beneficiaries has decreased in 2021 following May 2020 spike

August 30, 2021 – SeniorsHealth

The use of telemedicine among Medicare beneficiaries exploded at the beginning of the pandemic, particularly following the mid-March 2020 announcement that the Centers for Medicare and Medicaid Services would reimburse providers for telemedicine services. Interested in understanding older adults’ use of telehealth during the pandemic, researchers from the Health Data Analytics Institute and Harvard Medical School analyzed medical claims for 30 million Medicare beneficiaries from January 2020 through May 2021. They find that although Medicare beneficiaries’ telemedicine use spiked in March 2020 and peaked in May 2020 (at over 2 million visits per week), the number of weekly telemedicine visits has since fallen considerably, down to 800,000 by May 2021. This is still considerably more than pre-pandemic—around 125,000-200,000 per week in early 2020—though not quite the sustained ‘boom’ that some anticipated. Importantly, around 10 percent of Medicare beneficiaries received telehealth care only via telephone. Additional research is needed to explore who does and does not have access to video visits as well as patient preferences regarding visit type. While researchers have been concerned about disparities in telemedicine, authors found no substantial variation in use by race-ethnicity in 2020.

COVID-era remote patient monitoring supports at-home care for rural residents

July 14, 2021 – SeniorsCOVID-19, Health, Mental Health, Rural

In response to the pandemic, a Midwestern health system created a remote patient monitoring program that allows health care providers to monitor and advise patients without requiring an emergency room visit. The program includes vital-sign-monitoring equipment and a tablet equipped with video communication software, which only requires a cell signal and not internet access. Although the program was created to reduce hospital crowding and in-person exposures in the pandemic, providers find that not only do patients appreciate home-based care, providers are also able to more quickly identify changes in patient status given the ongoing monitoring. The additional benefit of easy check-ins also eases anxiety and loneliness among older adults living alone. #covid-19 #rural #mentalhealth #health

Evidence-based program strengthens multiple dimensions of senior wellbeing

July 8, 2021 – SeniorsHealth, Rural

The Rural Health Information Hub presents a summary of the StrongPeople™ programs, which have been under evaluation since 1994. The affiliated programs equip community-based health educators to lead classes on exercise, dietary skills, and civic activity to expand options for healthy living activities among older adults, particularly in rural places. Each element of the program has a substantial evidence base, with measurable improvements in physical activity, weight, strength, physical function, pain, depression, and other indicators among older adult participants. Companionship among group members is cited as a particularly favored element among participants. Interested community leaders can purchase training materials, then offer the programming to community members at typically low costs. #health #rural

COVID further strains rural health safety net amid growing rural health and resource risks

July 7, 2021 – FamiliesCOVID-19, Health, Racial Equity, Rural

A healthcare analytics firm, the Chartis Group, has released a paper reporting on its ongoing data collection on rural health conditions and health care resources in light of the pandemic. The work identifies a pre-existing fragility in rural health care resources, with 138 rural hospital closures in the past decade, and 453 more vulnerable to closure. The authors note that rural places at risk of prolonged pandemic effects and those at risk of high hospital closures share key characteristics, including high rates of uninsurance and greater shares of residents with chronic illness. #covid-19 #rural #racialequity #health

Nurse home visiting program reduces child maltreatment and emergency care usage

July 7, 2021 – Families, Young ChildrenChild Welfare, Health

Newly published results from a randomized clinical trial find that participation in a postpartum nurse home visiting program reduces child maltreatment investigations and child emergency medical care usage each by one-third by age five. For 18 months beginning in July 2009, all children born in Durham County, North Carolina were randomly assigned to participate in the Family Connects program (2,327 children) or to receive treatment as usual (2,440 children). Program participation included 1-3 visits in children’s first month of life to identify family service needs, followed by connection to an “aligned” set of community services specific to their identified needs. Program duration was short, concluding by four weeks postpartum. A subset of 531 families were selected for evaluation purposes at five years out, with outcomes determined via state administrative child welfare records and hospital billing data. The reduction in child maltreatment investigations and child emergency medical care usage persisted across all study subgroups, regardless of presence of infant medical risks at birth, insurance status, single parent household status, parent race ethnicity, birthweight, and child sex. The authors conclude that the high-quality delivery and broad reach drove effectiveness, while the brevity of the program supports its efficiency and replicability. #childwelfare #health

Closing the Medicaid coverage gap would narrow racial disparities

June 14, 2021 – FamiliesHealth, Racial Equity

Researchers at the Center on Budget and Policy Priorities (CBPP) analyzed the potential impact of closing the Medicaid coverage gap for the 2.2 million uninsured adults living in one of the 12 states that have not adopted Medicaid expansion. Those caught in the coverage gap have incomes that, despite being below the poverty line, are both too low for subsidized coverage in Affordable Care Act (ACA) marketplaces and yet too high to qualify for Medicaid in their state. The authors estimate that in 2019, more than half (around 60 percent) of the adults in the coverage gap were people of color and one third were parents with children at home. Creating a federal fallback to expand Medicaid coverage to those in this gap would improve financial security and the health of adults and children. Given the disproportionate share of people of color in the coverage gap, this represents an opportunity to begin to narrow long-standing racial disparities. #racialequity #health

20 years of data reveal little improvement in narrowing racial health disparities in rural places

March 15, 2021 – FamiliesHealth, Racial Equity, Rural

A study published in the Journal of the American College of Cardiology examines diabetes, hypertension, heart disease, and stroke mortality among rural and urban Black and white adults ages 25 and older. The study used de-identified data spanning 1999-2018 from the Centers for Disease Control and Prevention (CDC). The authors found mortality rates for these conditions were high among Black rural adults compared to white rural adults. For example, diabetes and hypertension mortality is 2 to 3 times higher among Black rural adults than among their white rural peers. Their analysis also found greater urban improvements in racial disparities and minimal progress in rural areas. These findings highlight the need for targeted public health efforts in rural areas that seek to better address the specific structural inequities that present barriers for Black rural residents. #health #rural #racialequity

Delayed and Forgone Health Care for Children during the COVID-19 Pandemic

February 16, 2021 – General – COVID-19, Education, Health

Drawing on the Urban Institute’s September 2020 Coronavirus Tracking Survey, a nationally representative survey of adults ages 18 to 64, UI examined delayed and forgone health care for children under 19 during the pandemic because of parents’ concerns about exposure to the coronavirus or limits on providers’ services due to the pandemic. They find that 28.8 percent of parents delayed or did not get one or more types of care for their children for these reasons. Parents with lower incomes were more likely than those with higher incomes to report their children delayed or missed out on multiple types of care. Among parents whose children delayed or did not get care, more than one in four reported negative effects on their children’s health, schooling, and other daily activities. #covid-19 #education #health

Delayed and Forgone Health Care for Nonelderly Adults during the COVID-19 Pandemic

February 16, 2021 – General – COVID-19, Health, Mental Health, Racial Equity

Using data from the Urban Institute’s September 2020 Coronavirus Tracking Survey, a nationally representative survey of adults ages 18 to 64, we examine delayed or forgone care during the pandemic for nine types of health care services and assess patterns by race/ethnicity, income, and the presence of physical and mental health conditions. We find that more than one-third (36 percent) of nonelderly adults delayed or did not get care because they were worried about exposure to the coronavirus or because a health care provider limited services because of the pandemic. Black adults and adults with chronic health conditions were among those most likely to report delaying or not getting needed care. Rates of delayed or forgone care were particularly high among adults with mental health conditions. Nearly one-third of adults who delayed or went without care because of the pandemic reported doing so negatively affected their health, ability to work, or ability to perform other daily activities. These findings underscore the importance of steps to address health issues that have not been attended to during the pandemic, including assuaging fears about exposure to the coronavirus in health care settings, strengthening efforts to reduce coronavirus transmission and promote vaccination, and ensuring equitable access to telehealth services. #covid-19 #mentalhealth #racialequity #health