Background: Physician shortage and healthcare access is a serious issue in rural America with reports estimating a shortage of more than 45,000 physicians by 2025. The rural and the underserved communities are predominantly served by International Medical Graduates (IMGs). Majority of the IMG physicians work are on a J1 waiver, National Interest Waiver (NIW) program [...]

Background: Physician shortage and healthcare access is a serious issue in rural America with reports estimating a shortage of more than 45,000 physicians by 2025. The rural and the underserved communities are predominantly served by International Medical Graduates (IMGs). Majority of the IMG physicians work are on a J1 waiver, National Interest Waiver (NIW) program [...]

Background: Recognizing the significant effect that social factors have on health outcomes, national stakeholders have developed policies requiring healthcare organizations to identify and address health-related social needs (HRSN). However, the effectiveness of HRSN screening strategies remains unclear. Notably, policymakers provide minimal guidance on how screening should be conducted and allow hospitals to use self-selected screening [...]

Background: Physician advocacy and knowledge of healthcare policy are vital elements of medical education and included within the ACGME Core Competency of Systems-Based Practice. The ability to advocate effectively has potential to impact healthcare regulations for both inpatient and outpatient practice. However, many GME programs do not incorporate these topics into their trainee education. To [...]

Background: Medicare Advantage (MA) plans have strong incentives to reduce potentially wasteful healthcare, including costly acute care visits for ambulatory care-sensitive conditions (ACSC) [1-4]. It is unknown, however, whether MA plans lower acute care use relative to Traditional Medicare (TM) or instead shift patients from hospitalizations towards observation stays and emergency department (ED) direct discharges. [...]

Background: Medicare observation stays are increasing nationally. Beneficiaries frequently hospitalized under observation, as well as those needing post-acute care skilled nursing facility coverage, may face increased financial burdens from these services. Patients living in the most disadvantaged neighborhoods have increased risk of inpatient 30-day re-admissions. It is not known whether neighborhood socioeconomic disadvantage increases 30-day [...]

Background: Eviction represents a traumatic form of housing instability and is an important social determinant of health. Growing wealth inequality and a housing crisis have resulted in high rates of eviction since 2000, with women renters and those of Black race disproportionately affected. Prior studies demonstrate the negative impact of eviction on self-reported mental and [...]

Background: While improving the American healthcare system has been a top focus of the domestic policy agenda for decades, health reform debates since early 2020 have taken place against the backdrop of a global pandemic that has highlighted key challenges in public health infrastructure and healthcare access. U.S. physicians are at the forefront of this [...]

Background: Prescription opioids have come under increasing scrutiny in recent years due to the rise in use and misuse which has resulted in significant morbidity and mortality. There have been several efforts by government agencies to address this such as the FDA issuing a Risk Evaluation Mitigation Strategy (REMS) for extended release/long acting (ERLAs) opioids [...]

Background: Physician shortage and healthcare access is a serious issue especially in a rural state like Arkansas and the dearth of physicians has further worsened during the COVID-19 pandemic. Many US trained International Medical Graduates (IMGs) serve the underserved communities of Arkansas to fill in the physician gap. However, the uncertainties surrounding immigration policies, especially [...]