Healthcare Provider Referrals for Financial Support in Low-Income Families
Palo Alto (17 mi)Age: 18+
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: N/A
Recruiting
Sponsor: University of California, Los Angeles
No Placebo Group
Trial Summary
What is the purpose of this trial?The purpose of this study is to pilot test the feasibility, acceptability, and preliminary efficacy of healthcare provider referrals to a tax filing app within parent-child health programs to test whether such referrals can increase receipt of tax credits among low-income parents. The study will use a single-group, pre/post test design with a sample of approximately 100 women who have a child under 6 years of age. Participants will be recruited from parental-child health programs and clinics in Los Angeles and will complete surveys at baseline, immediately after tax filing season, and six months after tax filing season to assess 1) frequency of tax filing after referral (Feasibility), 2) the acceptability of the tax filing app from the perspective of users (Acceptability), and 3) pre/posttest changes to parent and child health, child development, and healthcare utilization measures for users (preliminary efficacy).
What safety data exists for healthcare provider referrals for financial support in low-income families?The provided research does not contain any safety data related to healthcare provider referrals for financial support in low-income families or related interventions like tax filing services. The studies focus on adverse drug event reporting and electronic health records, which are unrelated to the financial support referral interventions.346713
Is the treatment of healthcare provider referral to a tax filing app promising for financial support in low-income families?Yes, the treatment is promising because it helps low-income families by connecting them to free tax services, which can increase their tax refunds and reduce financial stress. This approach can improve both financial and health outcomes by addressing poverty-related issues.89101112
What data supports the idea that Healthcare Provider Referrals for Financial Support in Low-Income Families is an effective treatment?The available research shows that Medical-Financial Partnerships (MFPs), which include healthcare provider referrals for financial support, can improve both financial and health outcomes for low-income families. Specifically, the study on a pediatric medical home with an embedded Volunteer Income Tax Assistance (VITA) site found that it was a convenient and trusted way to change tax-filing behavior, which can help maximize tax refunds and reduce financial stress. This reduction in financial stress is linked to better health outcomes, making this treatment effective in addressing the root causes of health issues related to poverty.12589
Do I have to stop taking my current medications for this trial?The trial protocol does not specify whether you need to stop taking your current medications. However, since the study focuses on tax filing and not medical treatment, it's unlikely that you would need to change your medication routine.
Eligibility Criteria
This trial is for low-income parents with a child under 6, earning less than $75,000 annually. Participants must have internet access and a valid tax filing ID. It aims to help them get tax credits by using a healthcare provider-referred tax app.Treatment Details
The study tests if referrals from healthcare providers to use a tax filing app can increase the number of low-income families receiving tax credits. About 100 women will be surveyed before, immediately after, and six months post-tax season.
1Treatment groups
Experimental Treatment
Group I: InterventionExperimental Treatment1 Intervention
This arm will receive a healthcare provider referral to a tax filing app
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Research locations nearbySelect from list below to view details:
UCLA School of NursingLos Angeles, CA
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Who is running the clinical trial?
University of California, Los AngelesLead Sponsor
References
Postscript: health disparity and collaborative care. [2019]In this report, we compare healthcare processes for patients with low (n = 7467) and adequate financial status (n = 43,701) after adjustment for age, gender, burden of illness, and health behaviors. Patients with low financial status were 10% to 30% less likely to report good service and collaborative care; they report that markers of disease management and prevention were 7% to 18% below the levels of patients with adequate income. From the patient perspective, these results confirm that inadequate financial status has a broad and adverse influence on health and healthcare. Technology for patient-centered, collaborative care alone will not remedy the problem of health disparity.
Determinants of primary care physicians' referral pattern: a structural equation model approach. [2021]This study examines patient referrals by primary care physicians (PCP) with nurse practitioners and physician assistants (NP-PA) in their medical practices as compared to practices without them. The study uses data from the Robert Wood Johnson Foundation community tracking study (CTS) Physician Survey, Round I (1996-97) and II (1998-99). Structural equations with binary dependent variables were used to examine the links among managed care, the use of NP-PA, the complexity of patient's conditions, and the number of referrals. PCP's with NP-PA were found to have a greater likelihood of treating patients with complex conditions instead of referring them to specialists. Managed care related variables (i.e., large group practice/HMO, the percentage of patients for whom PCPs acted as gatekeepers, and the percentage of managed care revenue from capitated/prepaid contracts) affected PCP' patient referrals, but only through the increased use of NP-PA. PCP's with NP-PA were also found to provide appropriate care to the complex patients. These findings indicate that NP-PA enable PCP to concentrate on patients with more complex conditions thus reducing the number of referrals. In addition, NP-PA is found to affect the gatekeeper role of PCPs.
Secondary use of electronic health record data: spontaneous triggered adverse drug event reporting. [2019]Physicians in the United States report fewer than 1% of adverse drug events (ADEs) to the Food and Drug Administration (FDA), but frequently document ADEs within electronic health records (EHRs). We developed and implemented a generalizable, scalable EHR-based system to automatically send electronic ADE reports to the FDA in real-time.
Quality assessment of spontaneous triggered adverse event reports received by the Food and Drug Administration. [2012]The Food and Drug Administration (FDA) conducted a quality assessment of the Adverse Drug Events Spontaneous Triggered Event Reporting (ASTER) pilot study, which represented the FDA's first experience with the receipt of electronic health record (EHR)-triggered adverse event reports. The EHR-triggered adverse event reports from ASTER were evaluated for their utility in conducting FDA's pharmacovigilance work. FDA is sharing these findings to assist others who are pursuing the use of patient EHR data for electronic adverse event identification and reporting.
E-prescribing adoption and use increased substantially following the start of a federal incentive program. [2018]E-prescribing, or the electronic generation of a prescription and its routing to a pharmacy, is generally believed to improve health care quality and reduce costs. However, physicians were slow to embrace this technology until 2008, when Congress authorized e-prescribing incentives as part of the Medicare Improvements for Patients and Providers Act. Using e-prescribing data from Surescripts, we determined that as of December 2010, close to 40 percent of active e-prescribers had adopted the technology in response to the federal incentive program. The data also suggest that among providers who were already e-prescribing, the federal incentive program was associated with a 9-11 percent increase in the use of e-prescribing-equivalent to an additional 6.8-8.2 e-prescriptions per provider per month. We believe that financial incentives can drive providers' adoption and use of health information technology such as e-prescribing, and that health information networks can be a powerful tool in tracking incentives' progress.
FDA Adverse Event Reporting System: Recruiting Doctors to Make Surveillance a Little Less Passive. [2015]Within the last few decades, a shift has taken place in FDA's approach to drug development, with greater emphasis put on postmarketing data collection and less on the traditional premarketing scheme. The FDA Adverse Event Reporting System (FAERS) is the primary system for collecting Adverse Events, but has been criticized for years for the low reporting rate into the system and the poor quality of the information submitted. This paper argues that physicians need to be required to submit adverse event reports to FAERS, because such a requirement (1) would produce a greater number of the high quality reports necessary to better determine causality; (2) is merely an extension of physicians' ethical obligations; and (3) aligns with the approach in the Vaccine Adverse Event Reporting System (VAERS). Furthermore, advances in electronic health records can aid in reporting efficiency.
Community-level electronic prescribing and adverse drug event hospitalizations among older adults. [2020]This study sought to determine how the proportion of physicians using electronic prescribing in nine US states was associated with the hospitalization rate for adverse drug events among older adult patients. A discharge-level analysis of the relationship between county electronic prescribing and adverse drug event hospitalization rates was conducted. Data from the 2011 State Inpatient Databases, the Office of the National Coordinator Health IT Dashboard, and the Area Health Resource File were obtained for nine US states. The analysis examined the odds that a discharge for older adults would have been adverse drug event associated, versus other causes, using multivariable logistic regression models. After adjusting for patient, provider, health infrastructure, and community factors, the lowest county electronic prescribing rate quartile was associated with significantly greater odds of an adverse drug event hospitalization (odds ratio: 1.10; 95% confidence interval: 1.02-1.19). Early results indicate greater odds of adverse drug event hospitalizations among older adults living in counties with low electronic prescribing rates when compared to those in high electronic prescribing counties.
Medical-Financial Partnerships: Cross-Sector Collaborations Between Medical and Financial Services to Improve Health. [2023]Financial stress is the root cause of many adverse health outcomes among poor and low-income children and their families, yet few clinical interventions have been developed to improve health by directly addressing patient and family finances. Medical-Financial Partnerships (MFPs) are novel cross-sector collaborations in which health care systems and financial service organizations work collaboratively to improve health by reducing patient financial stress, primarily in low-income communities. Financial services provided by MFPs include individually tailored financial coaching, free tax preparation, budgeting, debt reduction, savings support, and job assistance, among others. MFPs have been shown to improve finances and, in the few existing studies available, health outcomes. We describe the rationale for MFPs and examine 8 established MFPs providing financial services under 1 of 3 models: full-scope on-site service partnerships; targeted on-site service partnerships; and partnerships facilitating referral to off-site financial services. The services MFPs provide complement clinical social risk screening and navigation programs by preventing or repairing common financial problems that would otherwise lead to poverty-related social needs, such as food and housing insecurity. We identify common themes, as well as unique strengths and solutions to a variety of implementation challenges MFPs commonly encounter. Given that the financial circumstances and health outcomes of socially marginalized patients and families are closely linked, MFPs represent a promising and feasible cross-sector service delivery approach and a new model for upstream health care to promote synergistic financial well-being and health improvement.
A Medical Financial Partnership in a Pediatric Medical Home. [2022]The Volunteer Income Tax Assistance (VITA) program is an underutilized free taxpreparation service that directly addresses poverty by maximizing tax refunds. A pediatric medical home (PMH) with an embedded VITA site provides an excellent opportunity for a medical-financial partnership. We sought to assess the knowledge, attitudes, and practices of caregivers of children who used a PMH after embedding a VITA site. We found that a PMH-VITA site was a convenient, trusted, useful, and potentially tax-filing behaviorchanging intervention. Importantly, most caregivers who did not use the PMH-VITA site had no knowledge of availability of free tax filing services but would consider using one the following year. Improved marketing is needed to increase utilization in our target population.
Improving Health Equity by Screening for Poverty: A Survey of Family Physician Screening Behaviors and Perceptions in Toronto, Canada. [2022]Purpose: Given the importance of socioeconomic status in both directly and indirectly influencing one's health, "poverty screening" by family physicians (FPs) may be one viable option to improve patient health. However, rates of screening for poverty are low, and reported barriers to screening are numerous. This study sought to collate and investigate reasons for refraining from screening among FPs, many of whom had opted into a Targeted Poverty Screening (TPS) Program, to be able to enhance uptake of the intervention. The TPS Program is a "targeted screening and referral process," whereby medical charts of adult patients residing in "deprived neighborhoods," as determined by postal code, were flagged for screening for FPs who elected to partake in the program. Methods: A survey containing 15 questions was developed through an iterative process with pilot-testing by faculty physicians. The survey was administered to FPs registered in the North York Family Health Team (NYFHT) using Qualtrics© research software. Results: Half of the respondents (n=19/38; 50%) indicated that they enrolled in the TPS program. Irrespective of enrollment in the TPS Program, the majority of respondents (n=31/38; 81.6%) stated that they elect to screen their patients for poverty using the evidence-based question of "do you have difficulty making ends meet at the end of the month?." Among those not enrolled in the program, 84.2% (n=16/19) of respondents indicated that they screened their patients for poverty and 15.8% (n=3/19) indicated they did not. Among respondents who said they did not screen (n=7/38; 18.4%), the reasons for not screening patients were as follows: forgot (n=2; 28.6%); time constraints/feel uncomfortable asking (n=1; 14.3%); and "feel I know patients well" (n=1; 14.3%). For the remaining respondents, a nurse or locum did the screening as part of a periodic health review (i.e., patient was screened, but not by the FP completing the survey (n=3). Conclusion: This study yielded numerous insights, such as barriers faced by FPs in undertaking poverty screening that differs from the literature. The findings suggest that (1) barriers faced by FPs in poverty screening can be mitigated, (2) there is a need to integrate screening into routines and normalize the activity, and (3) there is a need for enhanced training to support patients of lower socioeconomic status.
Characteristics of Health Care Financial Assistance Programs Serving the Most Populous U.S. Counties. [2022]County-based health care financial assistance programs offer improved access to health care for indigent populations by reducing or eliminating costs to receive care. We examined health care financial assistance programs serving the 10 most populous U.S. counties. We found that the percent enrollment in a county's program is strongly correlated with the percent uninsured (r=.86) and the percent undocumented (r=.83), and moderately correlated with the percent indigent (r=.43) in a county, suggesting the importance of health care financial assistance programs for these groups. Furthermore, the typical county-based health care financial assistance program covers the same income range (0-138% federal poverty level) and offers similar benefits (including coverage of emergency care and inpatient care) as Medicaid. Counseling services are frequently available to assist applicants. These characteristics allow them to serve as an alternative source of health care funding to those who are ineligible for Medicaid coverage.
TAX4U Pilot Trial: Addressing Material Needs in the Pediatric Hospital Setting. [2023]Interventions to address poverty and food insecurity in pediatric hospital care have been scarce. Access to government support is based on the completion of taxes. Medical-financial partnerships are defined as novel cross-sector collaborations in which health care systems and financial service organizations work collaboratively to improve health by reducing financial stress. The objective of our pilot study was to assess the feasibility of implementing a "free tax service" within a pediatric academic hospital setting.
Outcomes of a Medication Optimization Virtual Interdisciplinary Geriatric Specialist (MOVING) Program: A Feasibility Study. [2023]Adverse drug events among older adults result in significant mortality, morbidity and cost. This harm may be mitigated with appropriate prescribing and deprescribing. We sought to understand the prescribing outcomes of an interdisciplinary geriatric virtual consultation service.