Inequities in Telehealth Use Associated with Payer Type During the COVID-19 Pandemic.

Introduction: The COVID-19 pandemic has prompted a shift in health care delivery and compelled a heavier reliance on telehealth. The objective of this study was to determine if differences in coverage policies by payer type resulted in differential telehealth use during the first 3 months of the COVID-19 pandemic. In this population-based cohort study of low-income Arkansans, Medicaid beneficiaries enrolled in the traditional Primary Care Case Management (PCCM) program were compared with Medicaid beneficiaries covered through premium assistance in private Qualified Health Plans (QHPs). Methods: A retrospective review was conducted of insurance claims records from June 1, 2019, to June 30, 2020, for synchronous telehealth and mobile health (m-health) visits, as well as other forms of telehealth. To establish the baseline equivalence of enrollees in the two groups, propensity score matching design was used on demographic and geographic characteristics, Charlson Comorbidity Index, broadband availability, and prior service utilization. Results: Compared with enrollees in the PCCM program, Medicaid expansion enrollees in QHPs had higher odds of having had at least one telehealth visit (adjusted odds ratio [aOR] = 1.35, 95% confidence interval [CI]: 1.29-1.42) during the early phase of the COVID-19 pandemic. Categorizing utilizations by domain, QHP enrollees were more likely to use synchronous telehealth (aOR = 1.31; 95% CI: 1.25-1.37) and m-health (aOR = 5.91; 95% CI: 4.25-8.21). A higher proportion of QHP enrollees also had at least one mental or behavioral health telehealth session (aOR = 1.13; 95% CI: 1.07-1.19). Conclusions: Our study demonstrated that within low-income populations, payer type was associated with inequitable access to telehealth during the early phase of the COVID-19 pandemic.

Free-standing carbon nanotube/graphene hybrid papers as next generation adsorbents.

The adsorption of a series of aromatic compounds from aqueous solution onto purified, free-standing single-walled carbon nanotube/graphene nanoplatelet hybrid papers is studied both experimentally and theoretically. Experimental data is obtained via changes in optical absorption spectra of the aqueous solutions and is used to extract all parameters required to implement a semi-empirical mass-transfer model. Agreement between experiment and theory is excellent and data from all compounds can be cast on a universal adsorption curve. Results indicate that the rate of adsorption and long-time capacity of many aromatic compounds on hybrid paper adsorbent significantly exceeds that of activated carbon by at least an order of magnitude. The combination of carbon nanotubes and graphene also promotes on the order of a 25% improvement in adsorption rates and capacities than either component alone. Hybrid nanocomposites show significant promise as adsorption materials used for environmental remediation efforts.