Payment Policy Research Articles

Drivers of infliximab biosimilar uptake: A comparative analysis of new biosimilar initiations versus switching in a national rheumatology registry.

To analyze the variability in new infliximab biosimilar starts as well as switching from bio-originator to biosimilar infliximab, across insurance payers and rheumatology practices nationally. Data came from Rheumatology Informatics System for Effectiveness, a national registry with electronic health records from over 1100 US rheumatologists. Key outcomes include ever use of a biosimilar, date of initiation, and date of switching. Key variables of interest include insurance payer and practice. Secondary analysis of 37,560 patients aged ≥18 years administered infliximab (bio-originator or biosimilar) between April 2016 and September 2022 in Rheumatology Informatics System for Effectiveness. We tested for differences in use of biosimilar infliximab by demographic characteristics, socioeconomic status, and diagnosis using standard mean differences and multivariable modified Poisson regression. We used generalized estimating equations to assess the adjusted effect of insurance and year of initiation on new biosimilar starts. We analyzed variation in biosimilar switching by insurance, date of switch, and practice. A total of 8196 (21.8%) infliximab users ever used a biosimilar and use did not differ significantly by demographic or clinical characteristics. In 2022, uptake among new users was higher among those with Medicaid (55%; 95%CI 43%-68%) and private insurance (51%; 95%CI 46%-57%) compared to Medicare (36%; 95%CI 29%-43%). Few prevalent bio-originator infliximab users switched to a biosimilar, and switching was lowest among Medicare beneficiaries (7% vs. 14.2% in Medicaid and 16.9% among privately insured). In adjusted analyses, practice level differences explained 37% of variation among new biosimilar starts and 34% of variation among those switching to a biosimilar. Our findings underscore two critical areas for enhancing biosimilar infliximab usage: increasing switching among prevalent users and increasing uptake among Medicare beneficiaries initiating treatment. Significant variation in uptake across practices also suggests that local switching policies are likely key drivers of uptake.

The impact of reform of medical insurance payment method on medical service pricing—based on empirical analysis of matched medical finance comprehensive data

BackgroundThe medical insurance payment method (MIPM) has an important impact on medical service pricing (MSP) in China. The objective of this study is to examine the impact of medical insurance payment method on medical service pricing with the hope of providing insights into appropriate MSP and resource allocation.MethodFrom the perspective of information asymmetry, using the matched medical finance comprehensive data of Chengdu City, our study empirically analyzed the effect of fixed payment by disease (FPD) on MSP by the difference in difference (DID) model.ResultsThe study found that FPD not only optimizes the allocation of medical resources, saves a large amount of medical insurance funds, but also reduces the personal burden of patients. FPD is adjusted by optimizing the structure of medical expenses and medical insurance compensation, which has certain effects on saving medical insurance funds, improving the quality of medical services, and reducing the burden on patients. It has achieved the goal of medical insurance payment method reform, and make the mechanism of MSP relatively more reasonable.ConclusionThis study provided policy implications for the government to implement multiple and compound medical insurance payment method and establish a more scientific and reasonable pricing mechanism for medical services.

The Impact of Cashless Payment Policies on Consumer Behavior at Kesiangan Coffee, Batam City

This research aims to analyze the effect of cashless payment policy on consumer behavior at Kesiangan Coffee, Batam City. With the increasing use of technology in various aspects of life, especially in the payment sector, it is important to understand how cashless policies affect consumer behavior. This study used a survey method with questionnaires distributed to 100 respondents. Data analysis was conducted using SPSS software, and it included validity, reliability, and linear regression analysis. The results showed that the R-value was 0.128 and the R Square was 0.165, indicating that only 16.5% of the variation in the cashless payment policy could be explained by consumer behavior. The validity and reliability test results show that all research instruments are valid and reliable, but the influence of consumer behavior on this policy is still relatively low. This finding suggests that other more dominant factors, such as technological infrastructure, level of security, and consumer demographics, influence the acceptance of cashless payments. Therefore, it is recommended that relevant parties, such as financial institutions and the government, focus on education and infrastructure development to increase the acceptance of this payment system among the public. Further research is needed to explore other factors that play a role in influencing cashless payment policies, so that more effective strategies can be implemented to encourage the use of this technology in various sectors.

Optimal strategies for collective defined contribution plans when the stock and labor markets are co-integrated

This paper investigates a collective defined contribution (CDC) pension fund scheme in continuous time, where members' contributions are fixed in advance, and benefit payments depend on the final salary rate. We take account of the co-integration between labor income and the stock market by letting the difference between logs of labor and dividends follow a mean-reverting process. Further, labor income is also a product of aggregate labor income and member's idiosyncratic shocks whose constant growth rate is unknown. It can be modeled by a continuous-time two-state hidden Markov chain. Further, the pension fund can be invested in the financial market consisting of one risky asset and one risk-free asset to enhance profits. After using Hamilton-Jacobi-Bellman (HJB) equations, the closed-form solutions for the optimal asset allocation and the benefit payment policies are obtained to maximize the social welfare and the terminal surplus wealth. Numerical examples are also conducted to illustrate the sensitivity of parameters on the optimal strategies.

Impact of the Diagnosis-Intervention Packet Payment Reform on Provider Behavior in China: A Controlled Interrupted Time Series Study.

China has developed a novel case-based payment method called the DiagnosisIntervention Packet (DIP) to regulate healthcare providers' behavior. G city, a metropolis in southeast China, has shifted its payment policy from fixed rate per admission to DIP under regional global budget since 2018. This study examined the immediate and trend changes in provider behavior after this payment reform. Discharge data in G city between 2016 and 2019 was used, covering more than 10 million inpatient cases in 320 hospitals. A counterfactual scenario was developed to assign insured and uninsured inpatients across the study period to specific DIP groups under consistent rules. Controlled interrupted time-series (ITS) analyses were performed, with uninsured inpatients as control. Outcomes included inpatient volume, average DIP weight (similar to case-mix index in Diagnosis-Related Groups), and two innovative indicators (average diagnostic weight and average treatment weight) to decompose the changes in DIP weight. Subgroup analyses were conducted for different hospital levels and 21 major disease categories. After the DIP reform, monthly trend of inpatient volume decreased (-1085.34, P=0.052), while monthly growth of average DIP weight increased (2.17, P=0.02). No significant changes in average diagnostic weight were observed. Monthly trend of average treatment weight increased (2.38, P=0.001) after the reform. Secondary and tertiary hospitals experienced insignificantly decreased inpatient volume and elevated average DIP weight, accompanied by negligible change in average diagnostic weight and significant increase in average treatment weight. Primary hospitals experienced reduced inpatient volume and stable average DIP weight, along with increase in average diagnostic weight and decrease in average treatment weight. By differentiated payments for severity, DIP induced hospitals to shift their focus from volume to weight of inpatients. Instead of diagnostic upcoding, hospitals responded to the DIP reform primarily by increasing treatment intensity. Primary hospitals may face financial risks under regional competition.

Aligning Training, Regulation, and Payment Policy to Advance the Behavioral Health Workforce

Aligning Training, Regulation, and Payment Policy to Advance the Behavioral Health Workforce

Abstract 4138420: Impact of the American Heart Association Get-With-The-Guidelines Heart Failure A.S.I.A. Program in Taiwanese hospitals

Introduction: The American Heart Association (AHA) Get With the Guidelines – Heart Failure program has been implemented for years in the United States with extensive literature supporting its benefits. In 2022, the AHA Heart Failure Adherence to Science Implementation in Asia (HF A.S.I.A.) powered by Get With The Guidelines program was first introduced in five Asian countries. Research Question: This study aims to explore the impact of this program's implementation in Taiwanese hospitals. Methods: Data were sourced from the Taiwan Society of Cardiology-HF-Registry 2020, a prospective registry that tracks HF cases from 27 hospitals in Taiwan between 2020 and 2024. Among these, four hospitals began participating in the HF A.S.I.A. program in January 2022. This study compared patients from hospitals that participated and did not participate in the HF A.S.I.A. program. Results: A total of 1,933 HF patients with a left ventricular ejection fraction ≤ 40% were included, comprising 460 participants from the HF A.S.I.A. program and 1,473 non-participants. The HF A.S.I.A. group was younger, had significantly lower systolic blood pressure, larger left ventricular diameter, and experienced more frequent prior hospitalizations for HF. However, there were no significant differences between the two groups in terms of baseline heart rate, estimated glomerular filtration rate, blood potassium levels, and most comorbidities. During the study period, due to changes in payment policies, the use of angiotensin receptor neprilysin inhibitor (ARNI) decreased in the non-participant group, while the use of sodium glucose co-transporter 2 inhibitor (SGLT2i) increased. Conversely, the use of ARNI in the HF A.S.I.A. group continued to rise in line with guideline recommendations and the usage of SGLT2i was higher than in the non-participant group. After adjustment, one-year lost to follow-up rate was significantly lower (3.0% vs. 5.6%, p =0.032) and all-cause mortality rate trended non-significantly lower (7.6% vs. 11.4%, p =0.096) among the HF A.S.I.A. group. Conclusion: Despite enrolling sicker patients, participation in HF A.S.I.A. program was associated with higher quality of HF care.

Inequities in Inpatient Pediatric Patient Safety Events by Category.

Few studies have analyzed potential inequities in both pediatric patient safety events (PSEs) and adverse events (AEs) - PSEs leading to harm - nor in PSEs by event type. We sought to examine potential inequities in rates of pediatric PSEs overall, by severity, and by category based on race and ethnicity, insurance payor, and language as measured using voluntary incident reports (IRs). We conducted a retrospective cohort study of pediatric hospitalizations between January 19, 2012 through December 31, 2019 at a US urban, tertiary care children's hospital. Analyzing 85 458 hospitalizations, we compared PSEs overall, by severity, and by event category by race and ethnicity, insurance payor, and language using incident rate ratios (IRRs). In models controlling for covariates, we found that hospitalizations of Latinx (IRR 1.17, 95% confidence interval [CI] 1.07-1.29), non-Latinx Black/African American (IRR 1.17, 95% CI 1.01-1.34), publicly insured (IRR 1.10, 95% CI 1.02-1.20), and nonprivately/nonpublicly insured (IRR 1.12, 95% CI 1.02-1.23) children had higher rates of PSEs compared with reference groups, but the association between language and PSEs was not significant. There were similar patterns among AEs, although only the association between hospitalizations of Latinx patients and AEs was significant. Medication, fluid, or blood and lines or tubes PSEs drove many inequities. We found inequities in PSEs as recorded by IRs, suggesting differences in care related to race, ethnicity, and payor. Limitations include analysis of a single center, that event categories are unique to the institution analyzed, and the voluntary nature of IRs.

Evaluating the References of Insurance Policies for Computer-Assisted Navigation in Total Knee Arthroplasty Compared With the American Academy of Orthopaedic Surgeons Clinical Practice Guideline.

This study aimed to investigate the quality and quantity of sources cited by insurance payers for computer-assisted navigation (CAN) in total knee arthroplasty (TKA) and to compare these sources with those cited by the American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guideline (CPG). References were included from insurance payer policies on CAN that discussed the use of CAN in TKA, while every reference from the AAOS CPG for surgical navigation in TKA was included. Fifty-four unique articles from insurance payers met criteria, with 68.5% being primary journal articles and 18.5% being reviews. The quality of cited studies was relatively evenly distributed between level of evidence (LOE) I/II (42.6%) and LOE III and below (50.0%). The 14 references cited in the AAOS CPG were 100% primary articles and 100% LOE I/II. Only 16.3% of cited insurance references were AAOS CPG articles. Nine of the 14 AAOS CPG studies were not cited by any of the insurance payer policies. Compared with the AAOS CPG, insurance policies cited older articles with lower LOE. We recommend continued updating of the AAOS CPG and insurance policies as more research into the use of CAN in TKA is published. [Orthopedics. 202x;4x(x):xx-xx.].

Trends in Medicare Reimbursement and Service Volume of Vitreoretinal Procedures: 2000 to 2021.

Purpose: To characterize trends in service volume and inflation-adjusted Medicare reimbursement of vitreoretinal procedures over the past 2 decades. Methods: Medicare Part B National Summary Data Files were accessed to identify the number of allowed services for vitreoretinal procedures. The Medicare Physician Fee Schedule was accessed to identify average annual national reimbursement rates. The Spearman correlation coefficient was used to evaluate time trends for each procedure. All analyses were conducted using Prism 9.5.1 software with 2-sided significance testing and statistical significance set at P ≤ .05. Results: From 2000 to 2021, the 2-tailed Spearman correlation showed that 20 of 38 procedures had statistically significant decreases in service volume over time. Intravitreal injections increased more than 1000-fold, from 2922 in 2000 to 3 444 500 injections in 2021 (ρ = 0.997; P < .001). Panretinal photocoagulation treatments declined from 104 865 to 48 533 procedures (ρ = -0.966; P = .003). Scleral buckling declined from 6502 to 587 procedures (ρ = -0.999; P < .001). Pars plana vitrectomy-associated procedures increased from 71 039 to 95 429 (ρ = 0.691; P < .001). From 2000 to 2021, the 2-tailed Spearman correlation showed that 29 of 38 procedures had statistically significant decreases in reimbursement over time. No procedure had a significant increase in payment. Conclusions: Vitreoretinal practice patterns have changed dramatically over the past 2 decades, with significant declines in inflation-adjusted Medicare reimbursement for most procedures. Awareness of service volume and reimbursement trends is vital to assessing economic viability and patient coverage under the current Medicare payment policies.

Trends in Short Interpregnancy Interval Births in the United States, 2016-2022.

To measure contemporary trends in the prevalence of short interpregnancy interval (IPI) births in the United States. We conducted a repeated cross-sectional analysis using 2016-2022 natality data from the National Vital Statistics System. We included all singleton live births to individuals with at least one prior live birth. We examined trends over time in short IPIs less than 18 months, as well as for specific durations within this time frame (less than 6 months, 6-11 months, and 12-17 months), using linear probability models that estimated changes in the prevalence of each IPI duration over time. We then estimated the prevalence of each short IPI duration by maternal race and ethnicity, socioeconomic characteristics (age, education, insurance payer at delivery), and geography (U.S. census region, state of residence). The study sample included 14,770,411 singleton live births to individuals with at least one prior live birth in 2016-2022. Roughly a third (29.8%) of births had an overall IPI of less than 18 months (5.0% less than 6 months, 11.0% 6-11 months, and 13.8% 12-17 months). For IPIs less than 6 months, a slight statistical decline in prevalence was identified over the study period in unadjusted and adjusted models (adjusted annual percentage point change -0.02, 95% CI, -0.03 to -0.02). Slight statistical increases in the prevalence of IPIs of 6-11 and 12-17 months were identified in unadjusted models but were no longer significant and reversed direction in adjusted models, respectively. Long-standing inequities in the distribution of the shortest IPIs (less than 6 months) were stable compared with prior work across the indicators examined in this study. Overall, it appears the prevalence of short IPIs has remained stable between 2016 and 2022.

Factors influencing low-income citizens’ choice of Sharia-subsidized housing credit in Indonesia

Purpose This paper aims to find several factors from religiosity aspects (perceived religiosity on property [PRP], perceived Islamic debt principle, perceived maqasid on homeownership, Shariah-compliant products [SCPs]) and financial aspects (mortgage repayment policy [MRP], well-versed bankers, perceived financial benefit [PFB], perceived risk), which influence the willingness of low-income people to choose Sharia-subsidized Kredit pemilikan rumah/mortgage (KPR) in Indonesia. Design/methodology/approach Research data was obtained from 235 respondents and analyzed using the partial least square-structural equation modeling method. Findings The research results show that PRP, SCPs, MRP and PFBs significantly influence the willingness to choose Sharia-subsidized mortgage. The practical implication that can be applied to increase the willingness of low-income people to choose Sharia-subsidized mortgage is by promoting it more massively with elements of community religiosity. Originality/value Sharia banking as the bank implementing Sharia-subsidized mortgage can consider the financial benefits of the debtor by implementing payment policies that make it easier for customers who have financial difficulties, such as rescheduling and payment holiday policies so that public interest in choosing Sharia-subsidized mortgage increases, so the problem of housing needs in low-income people can find its solution.

Compliance Corner: Incident-to Services

This article reviews incident-to policy or incident-to billing, a non-facility billing and payment policy. The following topics are addressed: What is an incident-to policy? When does an incident-to policy apply? When does incident-to policy not apply? Payer application of incident-to policy

Evidence That Regulatory And Market Forces Are Driving Adoption Of Biosimilars.

Biosimilars present a key opportunity to contain the growing cost of biologic drug spending and to make essential medications more affordable. However, the lackluster performance of the US biosimilar market in its first decade was met with disappointment and concern for its future viability. To evaluate the evolution of the biosimilar market, we reviewed key distinctions in medication classes and the financial stakeholders involved in each. Within this context, we examined recent evidence that suggests that the maturing postapproval biosimilar marketplace is flourishing. The entry of biosimilars for adalimumab offers a case study demonstrating these recent market and policy dynamics. Building on recent gains, policy makers could take additional steps to accelerate biosimilar adoption through both payment and regulatory policy levers.

Pediatric Practices’ Experiences with Massachusetts’ Medicaid Accountable Care Organizations

ObjectiveTo examine the experience of Medicaid Accountable Care Organizations (ACOs) that include pediatric practices, including their motivations and experiences working together. MethodsThis mixed methods study is set within the first two years of the Massachusetts Medicaid ACO Program, which created 17 Medicaid ACOs across the Commonwealth in 2018. It combines qualitative interviews from organizational leaders across three Medicaid ACOs with pediatric representation (N=28; purposive sample; 2018) with a 44-item primary care practice leader survey (N=225 after 64% response rate; statewide stratified random sample of primary care practices; 2019). Interviews gathered information about organizational motivations and experiences with becoming a Medicaid ACO; the survey asked five domains of questions describing the experience of pediatric- and adult-focused primary care practices in joining Medicaid ACOs (e.g., how much practices solved problems jointly with the ACO). We used ordinary least squares regression to describe differences in experiences across pediatric vs. non-pediatric practices. ResultsLeaders of Medicaid ACO with pediatric representation expressed a desire to voice pediatric concerns regarding state Medicaid payment policy and to integrate social services as part of routine medical care. Relative to the experience of adult-focused primary care practice leaders, pediatric-focused practices reported less collaboration within the Medicaid ACO (95% confidence interval 0.81 to 0.05; p = 0.03) and less change toward standardization of policies such as physician compensation (95% confidence interval 0.61 to 0.02; p = 0.04). ConclusionsInitial Medicaid ACO experiences can differ based on the degree to which organizations joining Medicaid ACO programs serve pediatric populations. Article SummaryEarly in Massachusetts’ implementation of Medicaid Accountable Care Organizations (ACO), pediatric-focused practices reported less collaboration and standardization within their Medicaid ACOs than adult-focused practices.

Participation With Compensation: Ethical Considerations for Research Payment Practices With People Who Are Incarcerated.

The participation of incarcerated individuals in research is necessary to appropriately address the health disparities that affect them and to adapt and implement health services for the carceral setting. Incarceration significantly impacts health, leading to negative outcomes including accelerated aging and increased mortality, with these effects disproportionately impacting communities of color. The U.S. Department of Health and Human Services' Office for Human Research Protections outlines ethical approaches to compensating individuals who participate in research activities, yet lacks specific guidance for payment within carceral settings. Historical abuses in carceral research underscore the persistent need for robust protections for incarcerated research participants. Existing regulations offer some protection but inadequately address ethical payment practices. Substantial variability in payment policies across carceral systems and vague national guidelines pose ethical challenges in ensuring equitable treatment for incarcerated research participants. We outline the ethical concerns related to compensating incarcerated individuals for participating in research and present a framework of approaches to payment. We argue for payment parity between incarcerated and community research participants. More community-engaged research is needed to understand the perspectives of incarcerated individuals on ethical payment.

Digital health technology to support patient-centered shared decision making at point of care for juvenile idiopathic arthritis.

Despite availability of multiple FDA approved therapies, many children with juvenile idiopathic arthritis (JIA) suffer pain and disability due to uncontrolled disease. The term JIA includes a heterogeneous set of conditions unified by chronic inflammatory arthritis, collectively affecting 1:1,000 children. When reviewing treatment options with families the rheumatologist currently refers to the experience of the average patient in relatively small controlled clinical trials, to consensus-based treatment plans, or increasingly the choice is dictated by the formulary restrictions of insurance payers. The current paradigm for treatment selection does not incorporate real-world evidence of treatment effectiveness centered to the individual patients with whom decisions are to be made. Treatment decisions based on the evidence of the average patient are not optimized to reflect the unique clinical characteristics of an individual with JIA and their disease course, nor does it account for heterogeneous treatment effects. To guide treatment choices centered around each patient, we describe a novel concept of utilizing digital health technology to bring patient-centered information into shared decision-making discussions based on comparative effectiveness analysis of electronic health record or observational clinical registry data of patients with similar characteristics. The envisioned digital tool will organize and present data relevant to the individual patient and enable evidence-based individualized treatment decision making when used in a collaborative manner with the patient family and rheumatologist. Capabilities in digital health technology, data capturing, and analytical methodologies are ripe for this endeavor. This brings the concept of a learning health system directly to the point of care.

The Local Declines in Child SSI Applications and Awards During COVID

Child applications and awards for Supplemental Security Income (SSI) fell sharply at the outset of the COVID-19 pandemic. Cumulative applications from April to September 2020 were about 30% lower than applications over the same period in 2019 with substantial variation in rates of decline across local areas. In this article, we explore the factors correlated with the change in applications and awards across localities at the beginning of the pandemic. Our findings point to three particularly important factors influencing the magnitude of the change in applications and awards: (a) the restriction of in-person services in all Social Security Administration field offices in March 2020, (b) the pandemic’s disruptions to social and service networks through which people may learn about SSI, and (c) new economic stabilization policies, such as economic impact payments and supplemental unemployment insurance payments. These results highlight the substantial local variation in SSI participation. This variation is especially important in considering general issues around access to SSI, particularly for policies that aim to improve SSI access through outreach. Our findings underscore the importance of local networks in creating program awareness at local levels, and that they might be fruitful avenues for further outreach efforts.

Stages of automating pension determination in Azerbaijan

Pension is the restoration of a portion or the entire amount of a person’s lost salary. When a person loses their official job, a pension is provided as compensation for the lost job and salary. A pension is essentially an insurance product. Just as we insure our cars, homes, and lives, a pension serves as insurance for the job or salary we might lose. Therefore, it should be viewed purely as an economic mechanism. In this system, the State Social Protection Fund acts as the insurer. It collects annual insurance premiums and, in the event of an insurance occurrence, pays out benefits to individuals who have reached retirement age. The disbursement of social insurance payments, or pensions, begins with the determination of the pension amount. Today, in our country, the process of determining pension amounts is automated. The automation of this process has primarily eliminated subjective influences in the calculation and awarding of pensions. It must be understood that despite stringent control mechanisms, subjective influences cannot be completely eradicated where human factors are involved. Previously, there were instances of exploitation of citizens' lack of information during pension determination. The automated pension determination system has first and foremost removed direct citizen-official contact and ensured transparency. Additionally, it has achieved operational efficiency in the determination process, meaning that when a citizen reaches retirement age, they can realize their pension rights without going anywhere, applying, presenting documents, or facing any delays or bureaucratic hurdles. In this regard, the new system serves the interests of citizens.

Referral, enrollment, and health care use in a comprehensive patient-centered management program for osteoarthritis of the hip and knee

ObjectiveOsteoarthritis management programs (OAMPs) have become a more common way to deliver patient-centered care. However, there is limited information on real-world use of these programs to guide implementation, payment policy, accessibility, and scaling in the United States. This paper describes 5-year use metrics for the Duke Joint Health Program, an OAMP embedded within a US academic health system. MethodThis analysis includes patients referred into the Program between October 2017 and April 2022. We generated descriptive statistics of referral and enrollment totals, demographics and patient-reported measures of enrollees, retention and healthcare use metrics (e.g., office visit frequency), and data capture rates for patient-reported outcomes. ResultsDuring the study period, 6863 patients were referred to the program and 4162 (61 ​%) enrolled. We observed statistically significant differences between those who did and did not enroll by age (mean difference ​± ​SE: 2.49 ​± ​2.8 years), sex (70.0 ​% vs 67.7 ​% female), race (65.1 ​% vs 55.3 ​% Caucasian/White), employment status (50.0 ​% vs 40.2 ​% retired), and insurance type (53.5 ​% vs 47.0 ​% Medicare). The median (Q1, Q3) number of visits was 2 (1, 4) and ranged from 1 to 67. The median (Q1, Q3) number of days from first to last program visit was 23 (0, 84) days. Questionnaire completion rates were 72 ​% at baseline, 46 ​% at 6 weeks, 39 ​% at 3 months, and 40 ​% at 6 and 12 months. ConclusionFindings can guide the planning, development, and implementation of future OAMPs and inform policies to ensure programs are accessible and equitable.