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Additional file 1: Figure S1. Comparing Predicted and Observed COVID-19 Cases (lagged 5 days) for Models A-F. Table S1. State-specific estimates of COVID-19 cases averted with social distancing policies compared to projected cases without social distancing (3 weeks after school closure).

Additional file 1: Appendix Table S1. Bivariate Analysis of Health Care Use and Costs among New Medicaid Enrollees During COVID, by Month, North Carolina Appendix Table S2. Unadjusted Modified Poisson Regression Results of Health Care Use among New Medicaid Enrollees Pre-COVID and New Medicaid Enrollees During COVID, North Carolina Appendix Table S3. Unadjusted Two-Part Model Results of Having Any Health Care Costs and Per Member Per Month Cost Models among New Medicaid Enrollees Pre-COVID and New Enrollees During COVID, North Carolina Appendix Table S4. Unadjusted Models of Health Care Use and Costs of New North Carolina Medicaid Enrollees During COVID Compared to New Enrollees Pre-COVID, Stratified by Eligibility Pathway Appendix Table S5. Adjusted Models of Health Care Use and Costs of New North Carolina Medicaid Enrollees During COVID Compared to New Enrollees Pre-COVID, Stratified by Eligibility Pathway Appendix Table S6. Unadjusted and Adjusted Two-Part Model Results of Per Member Per Month Cost Models of New North Carolina Medicaid Enrollees During COVID Compared to New Enrollees Pre-COVID, Stratified by Eligibility Pathway Figures S1 – S12. Monthly Trends in Health Care Use and Costs among New North Carolina Medicaid Enrollees Before and During COVID

Background The massage therapy profession in the United States has grown exponentially, with 35% of the profession’s practitioners in practice for three years or less. Investigating personal and social factors with regard to the massage therapy profession could help to identify constructs needed to be successful in the field. Purpose This data-gathering exercise explores massage therapists’ perceptions on what makes a successful massage therapist that will provide guidance for future research. Success is defined as supporting oneself and practice solely through massage therapy and related, revenue-generating field activity. Participants and Setting Ten successful massage therapy practitioners from around the United States who have a minimum of five years of experience. Research Design Semistructured qualitative interviews were used in an analytic induction framework; index cards with preidentified concepts printed on them were utilized to enhance conversation. An iterative process of interview coding and analysis was used to determine themes and subthemes. Results Based on the participants input, the categories in which therapists needed to be successful were organized into four main themes: effectively establish therapeutic relationships, develop massage therapy business acumen, seek valuable learning environments and opportunities, and cultivate strong social ties and networks. The four themes operate within specific contexts (e.g., regulation and licensing requirements in the therapists’ state), which may also influence the success of the massage therapist. Conclusions The model needs to be tested to explore which constructs explain variability in success and attrition rate. Limitations and future research implications are discussed.

Additional file 1. Includes detailed descriptions of each step performed in the Coincidence Analysis

Additional file 2. Provides the full analytic dataset used in this analysis to allow for independent replication and verification of results

Additional file 3. Provides the complete R script used in this analysis to support independent replication

Objective. The goal of this research is to evaluate preventable hospital utilization among Medicaid-insured federally qualified health center (FQHC) patients in North Carolina and to determine organizational factors associated with preventable hospital use. Methods. Using 2013-2015 Medicaid claims data, we applied instrumental variable analysis using two-stage residual inclusion to account for differential patient selection into FQHCs and estimated the association of FQHC use on preventable hospital utilization. Because there is no “gold standard” in performance classification, we applied three different methodologies to rank FQHC organizations according to their relative rates of preventable hospital use and estimated an overall performance ranking that incorporated the results of the three statistical approaches. Finally, we estimated patient-level regression models with FQHC fixed effects and ran organization-level configurational comparative analyses to identify organizational characteristics associated with preventable hospital utilization. Results. Across all model specifications in this study sample, we found that FQHC patients had a significantly higher probability of preventable hospital utilization when compared to patients accessing primary care services from non-FQHC providers. We identified variation in the absolute rankings of FQHC organizations across performance classification methodologies, but the organizations comprising the top- and bottom-performance quartiles remained consistent. We demonstrated that the geometric mean could be used to estimate an overall performance ranking across methodologies. Finally, we found that patients utilizing FQHCs with a broader scope of non-medical services and more of certain non-medical services staff were more likely to experience preventable hospital use even after controlling for patient characteristics. However, these results were associated with significant limitations. Conclusions. The differential effect of FQHC use may be driven by higher emergency department utilization among FQHC patients, as this comprised the majority of hospital use among pediatric asthma patients in this study. Patients using FQHCs with a broader scope of non-medical services and more of certain types of non-medical services staff were more likely to have preventable hospital utilization, but these organization-level factors do not reflect patient-level utilization of services. Children may be accessing non-medical services in FQHCs less frequently than adults, for example. Future research should incorporate FQHCs’ electronic health record data and qualitative interviews to best identify organization structures and processes associated with performance. This research also underscores the need for policymakers and payers to incorporate encounter-level data on non-medical services in claims submissions in order to better measure the effect of non-medical services on health care costs, utilization and outcomes across all provider types.