Macro Perspectives
Insights
Healthcare access, underserved populations, and improving social outcomes — by Matthew Sexton, LCSW.
When the Hospital Closes, the Neighborhood Pays: Urban Demand Concentration and the Hidden Equity Crisis
Urban hospital closures disproportionately hit low-income and minority neighborhoods, driving patients toward ERs as primary care. This is not a supply problem. It is a structural failure that compounds every other social determinant of health.
The IOTA Model Is Here — But Dialysis Centers Are Still Missing the Patients Who Need It Most
CMS's new IOTA Model incentivizes transplant centers to improve kidney access. It's a meaningful policy move. But it starts at the wrong end of the pipeline — and the 80% of ESRD patients who never make it to evaluation are still being left behind.
The Urban-Rural Healthcare Divide: Why More Supply Doesn't Mean More Access
Urban areas have more providers but longer wait times. Rural areas have fewer providers and longer drives. Neither population is well-served by the current model.
The system is broken. Let's build something better.
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