National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedCreedon TB, Zuvekas SH, Hill SC
AHRQ Author: Zuvekas SH, Hill SC, McClellan C
Effects of Medicaid expansion on insurance coverage and health services use among adults with disabilities newly eligible for Medicaid.
The purpose of this study was to explore the impact of Affordable Care Act (ACA) Medicaid expansion on insurance coverage and health services use for adults with disabilities newly eligible for Medicaid. The researchers utilized the 2008-2018 Medical Expenditure Panel Survey data and the Agency for Healthcare Research and Quality (AHRQ) PUBSIM model to identify adults between the ages of 26-64 years with disabilities who were newly Medicaid-eligible in expansion states or would have been eligible in non-expansion states if those states had opted in to ACA Medicaid expansion. The study found that among adults with disabilities who were newly eligible for Medicaid, Medicaid expansion was associated with significant increases in full-year Medicaid coverage, receipt of primary care, receipt of flu shots and a significant decrease in out-of-pocket spending. There were greater improvements for adults with disabilities compared to those without disabilities in full-year Medicaid coverage and receipt of flu shots. The researchers concluded that Medicaid expansion was associated with improvements in full-year insurance coverage, receipt of primary and preventive care, and out-of-pocket spending for adults with disabilities who were newly eligible for Medicaid, and there were greater improvements for adults with disabilities than for adults without disabilities.
AHRQ-authored.
Citation: Creedon TB, Zuvekas SH, Hill SC .
Effects of Medicaid expansion on insurance coverage and health services use among adults with disabilities newly eligible for Medicaid.
Health Serv Res 2022 Dec;57(suppl 2):183-94. doi: 10.1111/1475-6773.14034..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicaid, Health Insurance, Disabilities, Policy, Access to Care
Kirby JB, Nogueira L, Zhao J
AHRQ Author: Kirby JB
Do disruptions in health insurance continue to affect access to care even after coverage is regained?
Researchers investigated the association between having a usual source of care provider (USCP) and past disruptions in insurance coverage among insured adults using a longitudinal, nationally representative sample. Using MEPS data, they found that, compared to people who were continuously insured, those with previous insurance coverage disruptions, even short ones, were less likely to have a USCP.
AHRQ-authored.
Citation: Kirby JB, Nogueira L, Zhao J .
Do disruptions in health insurance continue to affect access to care even after coverage is regained?
J Gen Intern Med 2022 Aug;37(10):2579-81. doi: 10.1007/s11606-021-07187-5..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Access to Care
Levine DM, Chalasani R, Linder JA
Association of the Patient Protection and Affordable Care Act with ambulatory quality, patient experience, utilization, and cost, 2014-2016.
The national impact of the Patient Protection and Affordable Care Act (ACA) continues to be debated. The purpose of this cross-sectional study was to determine the relationship between the ACA and ambulatory quality, patient experience, utilization, and cost by comparing outcomes before (2011-2013) and after (2014-2016) ACA implementation. The study focused on United States adults between 18 and 64 years of age with income less than and greater than or equal to 400% of the federal poverty level (FPL), who had responded to the annual Medical Expenditure Panel Survey. Researchers conducted analysis of data from a sample of 123,171 individuals between January 2021 and March 2022. The study found that after the implementation of ACA, adults with income levels less than 400% of the FPL received increased high value care such as diagnostic and preventive testing when compared with adults with income 400% or higher of the FPL, and there were no differences in the other quality measures. Individuals with income less than 400% of the FPL had greater improvements in access, experience, and communication measures compared with those who had income greater than or equal to 400% of the FPL. Receipt of primary care services increased for individuals with lower income compared to individuals with higher income and for those with lower income compared to those with higher income, total out-of-pocket expenditures decreased. There were no other differences in utilization or cost between those groups. The researchers concluded that in this study, the ACA was not associated with changes in utilization, quality, or cost, but was related to decreased out-of-pocket expenditures and improved patient access, communication, and experience.
AHRQ-funded; 233201500020I; HS026506; HS028127.
Citation: Levine DM, Chalasani R, Linder JA .
Association of the Patient Protection and Affordable Care Act with ambulatory quality, patient experience, utilization, and cost, 2014-2016.
JAMA Netw Open 2022 Jun 1;5(6):e2218167. doi: 10.1001/jamanetworkopen.2022.18167..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Healthcare Utilization, Ambulatory Care and Surgery, Health Insurance, Access to Care
Jacobs PD, Abdus S
AHRQ Author: Jacobs PD, Abdus S
Changes in preventive service use by race and ethnicity after Medicare eligibility in the United States.
Researchers examined whether widespread eligibility for Medicare at age 65 narrows disparate preventive service use by race and ethnicity. Using MEPS data and examining six preventive services, they found that, for non-Hispanic Black adults, preventive service use increased after age 65. Further, for all four preventive health measures that were lower for Hispanic adults compared with non-Hispanic White adults prior to age 65, service use was indistinguishable between these groups after reaching the Medicare eligibility age. They concluded that Medicare eligibility appeared to reduce most racial and ethnic disparities in preventive service use.
AHRQ-authored.
Citation: Jacobs PD, Abdus S .
Changes in preventive service use by race and ethnicity after Medicare eligibility in the United States.
Prev Med 2022 Apr;157:106996. doi: 10.1016/j.ypmed.2022.106996..
Keywords: Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities, Medicare, Prevention, Access to Care, Disparities, Health Insurance
Meiselbach MK, Eisenberg MD, Bai G
Labor market concentration and worker contributions to health insurance premiums.
This study’s objective was to examine if labor market concentration was associated with higher worker contributions to health plan premiums. The authors combined publicly available data from the Census to calculate labor market concentration and the Medical Expenditure Panel Survey Insurance/Employer Component to determine premium contributions from 2010 to 2016 for metropolitan areas. They found that higher labor market concentration was associated with higher worker contributions to health plan premiums, lower take-home income, and no change in employer contributions to premiums consistent with their hypothesis.
AHRQ-funded; HS000029.
Citation: Meiselbach MK, Eisenberg MD, Bai G .
Labor market concentration and worker contributions to health insurance premiums.
Med Care Res Rev 2022 Apr;79(2):198-206. doi: 10.1177/10775587211012992..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Costs
Decker SL, Abdus S, Lipton BJ
AHRQ Author: Decker SL, Abdus S
Eligibility for and enrollment in Medicaid among nonelderly adults after implementation of the Affordable Care Act.
The authors used simulation modeling to examine Medicaid eligibility and participation during 2014 to 2017. They found that more than one in five adults were Medicaid-eligible in expansion states, while about one in 30 adults were Medicaid-eligible in non-expansion states. Further, while eligibility rates differed substantially by expansion status, participation rates among Medicaid-eligible adults were similar in both sets of states, indicating that differences in eligibility, rather than in participation rates, explained differences in enrollment between expansion and non-expansion states during the study period.
AHRQ-authored.
Citation: Decker SL, Abdus S, Lipton BJ .
Eligibility for and enrollment in Medicaid among nonelderly adults after implementation of the Affordable Care Act.
Med Care Res Rev 2022 Feb;79(1):125-32. doi: 10.1177/1077558721996851..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicaid, Health Insurance