Analysis Finds Trade-Offs Associated With ACA-Enabled Medicaid, Marketplace Expansion

Issue #594
AHRQ News Now is a weekly newsletter that highlights agency research and program activities.
December 5, 2017

AHRQ Stats: Hospital Stays For Kidney Failure Most Common in South

Patients living in the South had the highest rate of hospital stays for acute kidney failure in 2014. The rate—82 stays per 100,000 people—increased 66 percent since 2005. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #231: Acute Renal Failure Hospitalizations, 2005-2014.)

Today's Headlines:

Analysis Finds Trade-Offs Associated With ACA-Enabled Medicaid, Marketplace Expansion

Following passage of the Affordable Care Act (ACA) in 2010, the percentage of near-poor Americans with health insurance increased at approximately the same rate for people who became eligible for Medicaid and for people who became eligible for subsidized private insurance through ACA marketplaces, an AHRQ analysis found. The analysis, published in today’s Health Affairs, found that as of 2015, the uninsurance rate among nonelderly near-poor adults—those with incomes between 100 and 138 percent of federal poverty guidelines—declined 22 percentage points in states that expanded Medicaid, while the rate declined 18 percentage points in states that offered this group subsidized private coverage. Researchers also found that among these adults, those in Medicaid expansion states experienced larger reductions in out-of-pocket spending, but faced greater difficulty accessing physician care compared with those in nonexpansion states. Access the abstract.

Highest Growth in 'Acute Care Surgery' Has Been in Large Urban Teaching Hospitals

While the number of U.S. hospitals providing “acute care surgery” grew from 34 in 2001 to 272 in 2015, implementation has occurred most frequently in hospitals that are urban, have more than 500 beds and are teaching hospitals, according to an AHRQ-funded study in JAMA Surgery. Acute care surgery is defined as an organized system of trauma, general surgery and critical care for patients with medical emergencies. Researchers hoped that this type of care could help solve what they termed as a “crisis” in emergency general surgery for vulnerable populations such as the poor, blacks and Hispanics. Implementation in rural areas, however, has been limited. Researchers concluded that understanding the gaps in acute care surgery access will be crucial to ensure health equity for people with general surgery emergencies. Access the abstract.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Registration Open for Dec. 12 Webinar on Preventing Pressure Ulcers in Nursing Homes

Register now for a webinar on Dec. 12, from 1 to 2 p.m. ET, to learn about successes of AHRQ's Safety Program for Nursing Homes: On-Time Prevention. Speakers will describe how trained facilitators implemented the project in 47 nursing homes across 18 states. Webinar attendees will learn how to prevent pressure ulcers by improving risk assessment, communication and coordination. Continuing education credits will be available at no cost.

Trigger Tool Applied to Electronic Health Records Helps Identify Hospital Adverse Events

Applying a modified version of the Institute for Healthcare Improvement’s global trigger tool to data from electronic health records (EHRs) can effectively identify preventable adverse events in hospitals, according to an AHRQ-funded study in BMJ Quality & Safety. The study, based on hospital stays at a large health system between 2010 and 2015, examined “escalated” care hospital stays that involved patient transfers to intensive care or activation of a rapid response team within 15 days of admission. Only lower risk patients were included. Of nearly 88,500 hospitalizations, 41 involved preventable adverse events, either due to flaws in care management or diagnostic errors. Researchers concluded that using EHR data with the modified trigger tool could reveal adverse event causes and lead to improvement strategies. Access the abstract.

AHRQ in the Professional Literature

The effect of physician and hospital market structure on medical technology diffusion. Karaca-Mandic P, Town RJ, Wilcock A. Health Serv Res 2017 Apr;52(2):579-98. Epub 2016 May 16.Access the abstract on PubMed®.

Primary interventions to support breastfeeding. Kato E, Rajupet S. Am Fam Physician 2017 Apr 15;95(8):517-18. Access the abstract on PubMed®.

Evaluation of a sickle cell disease educational website for emergency providers. Kayle M, Brennan-Cook J, Carter BM, et al. Adv Emerg Nurs J. 2016 Apr-Jun;38(2):123-32. Access the abstract on PubMed®.

Persistence of atopic dermatitis (AD): a systematic review and meta-analysis. Kim JP, Chao LX, Simpson EL, et al. J Am Acad Dermatol 2016 Oct;75(4):681-87.e11. Epub 2016 Aug 17. Access the abstract on PubMed®.

Factors affecting willingness to share electronic health data among California consumers. Kim KK, Sankar P, Wilson MD, et al. BMC Med Ethics 2017 Apr 4;18(1):25. Access the abstract on PubMed®.

Methods to model and predict the ViewRay treatment deliveries to aid patient scheduling and treatment planning. Liu S, Wu Y, Wooten HO, et al. J Appl Clin Med Phys 2016 Mar 8;17(2):50-62. Access the abstract on PubMed®.

Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study. Liu Z, Zhang K, Du XL. BMC Cancer 2016 Apr 26;16:294. Access the abstract on PubMed®.

Family behaviors and type 2 diabetes: what to target and how to address in interventions for adults with low socioeconomic status. Mayberry LS, Harper KJ, Osborn CY. Chronic Illn 2016 Sep;12(3):199-215. Epub 2016 Apr 19. Access the abstract on PubMed®.

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Page last reviewed December 2017
Page originally created December 2017
Internet Citation: Analysis Finds Trade-Offs Associated With ACA-Enabled Medicaid, Marketplace Expansion. Content last reviewed December 2017. Agency for Healthcare Research and Quality, Rockville, MD.