Impact of New York State’s Health Home program on access to care among patients with diabetes

IntroductionAccess to care is essential for patients with diabetes to maintain health and prevent complications, and is important for health equity. New York State’s Health Homes (HHs) provide care management services to Medicaid-insured patients with chronic conditions, including diabetes, and aim to improve quality of care and outcomes. There is inconsistent evidence on the impact of HHs, and care management programs more broadly, on access to care.Research design and methodsUsing a cohort of patients with diabetes derived from electronic health records from the INSIGHT Clinical Research Network, we analyzed Medicaid data for HH enrollees and a matched comparison group of HH non-enrollees. We estimated HH impacts on several access measures using natural experiment methods.ResultsWe identified and matched 11 646 HH enrollees; patients were largely non-Hispanic Black (29.9%) and Hispanic (48.7%), and had high rates of dual eligibility (33.0%), Supplemental Security Income disability enrollment (49.1%), and multiple comorbidities. In the 12 months following HH enrollment, HH enrollees had one more month of Medicaid coverage (p<0.001) and 4.6 more outpatient visits than expected (p<0.001, evenly distributed between primary and specialty care). There were also positive impacts on the proportions of patients with follow-up visits within 7 days (4 percentage points (pp), p<0.001) and 30 days (6pp, p<0.001) after inpatient care, and on the proportion of patients with follow-up visits within 30 days after emergency department (ED) care (4pp, p<0.001). We did not find meaningful differences in continuity of care. We found small positive impacts on the proportion of patients with an inpatient visit and the proportion with an ED visit.ConclusionsNew York State’s HH program improved access to care for Medicaid recipients with diabetes. These findings have implications for New York State Medicaid as well as other providers and care management programs.

From Research to Practice: Toward the Examination of Combined Interventions for Autism Spectrum Disorders

The use of biological (i.e., medications) in conjunction with applied behavior analysis is relatively common among people with ASD, yet research examining its benefit is scarce. This paper provides a brief overview of the existing literature on the combined interventions, including promising developments, and examines the existing barriers that hinder research in this area, including the heavy reliance on RCTs. Recommendations for possible solutions, including the creation of health homes, are provided in order to move toward a more integrated approach.

HYPER-ELLIPTIC CURVE BASED SIGNCRYPTION SCHEMES FOR RESOURCE CONSTRAINT DEVICES IN IOT

The Internet of things has become part of our day to day life as many more devices are connecting to the internet, the number is increasing rapidly. IoT devices have become the element in our day to day life. Such as many tiny devices are continuously monitoring our health homes and providing sensitive information which can be analyzed and help for decision making. This important data must have enough security. Hence, the security and efficiency of these IoT devices play an important role therefore various efforts are made to make these resource constraint devices highly secure and efficient. Signcryption is one of the techniques to increase efficiency as compare to traditional signature then encryption schemes. Signcryption along with the hyper-elliptic curve (HECC) can reduce the computational cost of the encryption schemes along with the provision of higher security.