Valerie A. Lewis

@valeriealewis

Associate Prof, Health Policy and Mgmt . Tweeting health policy, disparities, sociology, academic life. Tweets=own; RT≠endorse

Chapel Hill, NC
Vrijeme pridruživanja: lipanj 2009.

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  1. Prikvačeni tweet
    25. lip 2018.

    My goal: hire and train people who are smarter than I am, so that their careers surpass my own in impact. They may start off more junior, but their slope is steeper! I can't wait to see the amazing things some of these amazing rising colleagues will do in their careers!

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  2. proslijedio/la je Tweet
    prije 12 sati

    Fascinating summary by of her team’s new paper. Effective partnerships between health care systems and community-based organizations are critical to addressing social determinants of health, but there is still a lot to learn about how to do this well.

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  3. I also love sending these notes— it is such a joyful and gratifying activity to tell others how much you enjoy their work! I don’t do it nearly enough though. I love the idea of making it a weekly practice!

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  4. I made a single slide from this work for a series of talks in 2018, and everyone was really engaged. So we decided to try the paper, realizing our null results actually had important contribution. Here’s to all your unwritten papers that have a contribution you don’t see yet!

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  5. Addendum 2: We started this work studying how ACOs actually address social needs. We felt defeated at how nascent the field was—not ideal for observational work. And null results qualitative work (no one is doing much because it’s hard!) seemed unlikely to get published.

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  6. proslijedio/la je Tweet
    prije 21 sat

    A micro-level complement to the macro-level constraints I lay out in Regimes of Inequality. No matter how you slice it, trying to reduce inequality by focusing on is rowing with a small paddle against a big tide.

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  7. proslijedio/la je Tweet
    prije 21 sat

    Read the entire thread for a summary of the issues and potential solutions. (Or you could always read the full article!) In some cases, initiatives such as NCCARE360 already are being implemented to try to address some of these identified issues.

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  8. proslijedio/la je Tweet

    Super important. There's an active, ongoing debate regarding the extent to which "clinical" entities should really be in the vanguard of collective action on . Some public health leaders are skeptical ...

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  9. proslijedio/la je Tweet
    prije 22 sata

    Terrific work on barriers to integrating social services into healthcare among ACOs prioritizing . Need: - sustainable funding - local & regional networking initiatives to facilitate partnership development - standardized data on CBO services and quality

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  10. proslijedio/la je Tweet
    prije 24 sata

    Fantastic new paper out by Murray, Rodriguez, & that assesses how ACOs are addressing patients' social needs, and the challenges in doing so: lack of data and financial support, low screening rates, partnerships difficult to establish, uncertain ROI

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  11. proslijedio/la je Tweet
    4. velj

    Such a good paper by et al about why some organization even when committed to addressing have difficulty (1) Lack data on patients’ social needs & capabilities of community partners (2) partnerships w/ community still in early stages Solutions in paper 👇🏾!!

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  12. 3. velj

    Addendum: tweeting careful qualitative analysis (led by a medical anthropologist!) is horribly hard. Read the paper for much more nuance, careful analysis, sharp examples, and clear evidence.

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  13. 3. velj

    tl;dr Even committed health care providers face massive barriers to addressing patients' social needs. -little data to guide decisions -want to partner with local social services.. but few existing paths to do so -$ and regulations always a problem

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  14. 3. velj

    A recent RCT showed that networking/connecting health care and social services providers didn't alone change patient outcomes, but did improve knowledge. This is exactly the kind of effort that may meaningfully improve ACO efforts to address social needs.

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  15. 3. velj

    So... what might help? (1) funding mechanisms and incentives to create a funding model and business case (2) initiatives aimed at bridging health care and social services providers together. On this one for example...

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  16. 3. velj

    Finally, of course fiscal challenges. These include gross levels of funding, challenges with regulations on medical dollar spending, and how to think about sustainability and ROI (especially across short time horizons of ACO funding and longer time horizons of social services).

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  17. 3. velj

    Drawing on personal ties is a very rational approach given the lack of existing formal and professional ties between health care and social service sectors. It makes clear just how hard it is bridge sectors long silo-ed and establish meaningful working relationships.

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  18. 3. velj

    As a result of limited professional ties, it was common that ACOs relied on personal ties to initiate these partnerships. e.g. ACO leaders draw on personal friends from religious or recreational activities who work at community organizations to develop new partnerships.

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  19. 3. velj

    Medical providers that partner with one another under ACOs usually had some history of collaborating together, e.g. through regional quality initiatives. But health care providers have much less prior collaboration with social service or community based organizations to draw on.

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  20. 3. velj

    Second bit problem: ACO medical providers usually looked to partner with local social service agencies rather than provide services directly. This makes sense and is probably in most cases the right way to do it. However, these partnerships are quite hard to put together.

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  21. 3. velj

    Providers also lack data on their own programs developed with community based organizations. For example, providers often had no way to track even how many of their patients used a new service or completed a referral to a social service provider.

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