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AHRQ Research Studies Date
Topics
- Access to Care (8)
- Adverse Drug Events (ADE) (1)
- Ambulatory Care and Surgery (1)
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- Children/Adolescents (1)
- (-) Community-Based Practice (16)
- Dental and Oral Health (1)
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- (-) Medicaid (16)
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- Social Determinants of Health (1)
- Tobacco Use (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 16 of 16 Research Studies DisplayedHogg-Graham R, Mamaril CB, Benitez JA
Impact of state Medicaid expansion on cross-sector health and social service networks: evidence from a longitudinal cohort study.
This study’s objective was to examine the impact of state Medicaid expansion on the delivery of population health activities in cross-sector health and social services networks. The authors used data measuring the composition of cross-sector population health networks from the 2006-2018 National Longitudinal Survey of Public Health Systems (NALSYS) linked with the Area Health Resource File. They restricted their data to jurisdictions serving populations of 100,000 or more and states that had NALSYS observations across all time periods, resulting in a final sample size of 667. Results indicated that Medicaid expansion was associated with a 2.3 percentage point increase in the density of population health networks. Communities in states with expanded Medicaid experienced significant increases in the participation of local public health, local government, hospitals, nonprofits, insurers, and K-12 schools. Of the organizations with significant increases in expansion communities, nonprofits (7.7 percentage points,), local public health agencies (6.5 percentage points), hospitals (5.8 percentage points), and local government agencies (6.0 percentage points) had the largest gains.
AHRQ-funded; HS025494.
Citation: Hogg-Graham R, Mamaril CB, Benitez JA .
Impact of state Medicaid expansion on cross-sector health and social service networks: evidence from a longitudinal cohort study.
Health Serv Res 2023 Jun; 58(3):634-41. doi: 10.1111/1475-6773.14144..
Keywords: Medicaid, Health Insurance, Community-Based Practice, Access to Care
Luo Q, Moghtaderi A, Markus A
Financial impacts of the Medicaid expansion on community health centers.
This study’s objective was to determine the impact of Medicaid expansion on community health centers. The authors combined data from the Uniform Data System, IRS nonprofit tax returns, and county-level characteristics from the Census Bureau. Their final dataset included 5841 center-year observations. They found a $2.08 million relative increase in Medicaid revenues, offset by a $0.44 million decrease in total grants among community health centers in expansion states compared with centers in non-expansion states. They found a large but not statistically significant $0.98 million relative increase in total expenditures among expansion state centers. Uncompensated care for health centers in expansion states decreased by $1.19 million relative to their counterparts in non-expansion states.
AHRQ-funded; HS026816.
Citation: Luo Q, Moghtaderi A, Markus A .
Financial impacts of the Medicaid expansion on community health centers.
Health Serv Res 2022 Jun;57(3):634-43. doi: 10.1111/1475-6773.13897..
Keywords: Medicaid, Community-Based Practice, Healthcare Costs
Raffo JE, Titcombe C, Henning S
Clinical-community linkages: the impact of standard care processes that engage Medicaid-eligible pregnant women in home visiting.
The purpose of this study was to describe how practice sites operationalized clinical-community linkage strategies that best suited their setting and to determine if efforts resulted in improved Maternal Infant Health Program participation and other service use. Findings showed that clinical-community linkages can significantly improve participation of Medicaid-insured women in an evidence-based home visiting program and other prenatal services.
AHRQ-funded; HS020208.
Citation: Raffo JE, Titcombe C, Henning S .
Clinical-community linkages: the impact of standard care processes that engage Medicaid-eligible pregnant women in home visiting.
Womens Health Issues 2021 Nov-Dec;31(6):532-39. doi: 10.1016/j.whi.2021.06.006..
Keywords: Pregnancy, Maternal Care, Women, Medicaid, Community-Based Practice
Cottrell EK, Dambrun K, O'Malley J
Documenting new ways of delivering care under Oregon's Alternative Payment and Advanced Care Model.
This study’s objective was to describe trends in rates of traditional face-to-face office visits and “Care Services That Engage Patients” (Care STEPs) documentation among community health centers (CHCs) involved in the first 3 phases Oregon’s Alternative Payment and Advanced Care Model (APCM) pilot program. In this program, participating community health centers (CHCs) received per-member-per-month payments for empaneled Medicaid patients in lieu of standard fee-for-service Medicaid payments. Among participating CHCs, the mean rate of face-to-face visits with billable providers declined. Care STEPS documentation increased, but the difference was not statistically significant. The Care STEPs category New Visit Types were documented most frequently. There were significant increases in document of Patient Care Coordination and Integration, and a smaller but still significant increase in Reducing Barriers to Health. There was a significant decrease in documentation done by physicians and advanced practice providers with an increase by ancillary staff.
AHRQ-funded; R01 HS022651.
Citation: Cottrell EK, Dambrun K, O'Malley J .
Documenting new ways of delivering care under Oregon's Alternative Payment and Advanced Care Model.
J Am Board Fam Med 2021 Jan-Feb;34(1):78-88. doi: 10.3122/jabfm.2021.01.200027..
Keywords: Healthcare Delivery, Payment, Community-Based Practice, Medicaid
Huguet N, Valenzuela S, Marino M
Following uninsured patients through Medicaid expansion: ambulatory care use and diagnosed conditions.
The authors assessed ambulatory care use and diagnosed health conditions among a cohort of community health center (CHC) patients uninsured before enactment of the Affordable Care Act (ACA) and followed them after enactment. They found that, post-ACA, 20.9% of patients remained uninsured, 15.0% gained Medicaid, 12.4% gained other insurance, and 51.7% did not have a visit. The authors concluded that a significant percentage of CHC patients remained uninsured; that many who remained uninsured had diagnosed health conditions; and that one-half continued to have three or more visits to CHCs, which continue to be essential providers for uninsured patients.
AHRQ-funded; HS024270.
Citation: Huguet N, Valenzuela S, Marino M .
Following uninsured patients through Medicaid expansion: ambulatory care use and diagnosed conditions.
Ann Fam Med 2019 Jul;17(4):336-44. doi: 10.1370/afm.2385..
Keywords: Access to Care, Ambulatory Care and Surgery, Community-Based Practice, Health Insurance, Healthcare Delivery, Medicaid, Policy, Uninsured
Timbie JW, Kranz AM, Mahmud A
Specialty care access for Medicaid enrollees in expansion states.
The goal of this study was to assess current levels of difficulty accessing specialty care for patients at community health centers (CHCs) by insurance type, in order to identify specific barriers and the strategies that CHCs use to overcome these barriers. A cross-sectional survey was administered to medical directors at CHCs in nine states as well as the District of Columbia, all of which had expanded Medicaid. Among the barriers reported by CHCs were few specialists in Medicaid managed care organization (MCO) networks accepting new patients and MCO administrative requirements for obtaining specialist consults. Strategies to enhance access to specialists included entering into referral agreements, developing appointment reminder systems, and participation in data exchange and other community-based initiatives. The authors conclude that payment policies and network adequacy rules may need to be reexamined to address these challenges.
AHRQ-funded; HS024067.
Citation: Timbie JW, Kranz AM, Mahmud A .
Specialty care access for Medicaid enrollees in expansion states.
Am J Manag Care 2019 Mar;25(3):e83-e87..
Keywords: Access to Care, Community-Based Practice, Healthcare Delivery, Medicaid
Cole MB, Wright B, Wilson IB
Medicaid expansion and community health centers: care quality and service use increased for rural patients.
Investigators studied the impact of Medicaid expansion in rural areas. Data from 2011-2015 found that there was an 11.4% decline in uninsured patients and a 13.5% increase in Medicaid patients at community health centers (CHCs). Relative improvements were shown in patients with chronic conditions such as asthma and hypertension; and an increase in visits for mammograms and substance abuse disorders.
AHRQ-funded; HS024652.
Citation: Cole MB, Wright B, Wilson IB .
Medicaid expansion and community health centers: care quality and service use increased for rural patients.
Health Aff 2018 Jun;37(6):900-07. doi: 10.1377/hlthaff.2017.1542..
Keywords: Medicaid, Community-Based Practice, Rural Health, Access to Care, Quality of Care, Healthcare Utilization, Primary Care
Kirby JB, Sharma R
AHRQ Author: Kirby JB
The availability of community health center services and access to medical care.
This study examined the associations between the availability of Community Health Centers (CHCs) services in communities and two key measures of ambulatory care access - having a usual source of care and having any office-based medical visits over a one year period. It found that the availability of CHC services was positively associated with both measures of access among those with no insurance coverage.
AHRQ-authored.
Citation: Kirby JB, Sharma R .
The availability of community health center services and access to medical care.
Healthc 2017 Dec;5(4):174-82. doi: 10.1016/j.hjdsi.2016.12.006.
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Keywords: Access to Care, Community-Based Practice, Medicaid, Medical Expenditure Panel Survey (MEPS), Uninsured
Gao YN, Nocon RS, Sharma R
What factors are associated with Medicaid patients' use of health centers?.
This study identified patient and neighborhood factors associated with health center (HC) use. Dually eligible patients and those with high chronic disease burden had lower odds of HC use. Temporary Assistance for Needy Families participants and Hispanic beneficiaries had higher odds. Local HC presence predicted higher HC use.
AHRQ-funded; HS000084.
Citation: Gao YN, Nocon RS, Sharma R .
What factors are associated with Medicaid patients' use of health centers?.
J Prim Care Community Health 2017 Jul;8(3):141-46. doi: 10.1177/2150131916687919.
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Keywords: Community-Based Practice, Healthcare Utilization, Medicaid, Primary Care, Social Determinants of Health
Bailey SR, Hoopes MJ, Marino M
Effect of gaining insurance coverage on smoking cessation in community health centers: a cohort study.
This study aimed to determine if uninsured community health center (CHC) patients who gain Medicaid coverage experience greater primary care utilization, receive more cessation medication orders, and achieve higher quit rates, compared to continuously uninsured smokers. It found that newly insured patients had increased odds of quit smoking status over 24 months of follow-up than those who remained uninsured.
AHRQ-funded; HS021522; HS024270.
Citation: Bailey SR, Hoopes MJ, Marino M .
Effect of gaining insurance coverage on smoking cessation in community health centers: a cohort study.
J Gen Intern Med 2016 Oct;31(10):1198-205. doi: 10.1007/s11606-016-3781-4.
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Keywords: Tobacco Use, Health Insurance, Community-Based Practice, Medicaid, Healthcare Utilization
Marino M, Bailey SR, Gold R
Receipt of preventive services after Oregon's randomized Medicaid experiment.
This study examined the three-year impact of Oregon's 2008 randomized Medicaid expansion (the "Oregon Experiment") on receipt of 12 preventive care services in community health centers using electronic health record data. They found that Medicaid coverage significantly increased the odds of receipt of most preventive services. They concluded that rates of preventive services receipt will likely increase as community health center patients gain insurance through Affordable Care Act expansions. They recommended continued effort to increase health insurance coverage in an effort to decrease health disparities in vulnerable populations.
AHRQ-funded; HS021522.
Citation: Marino M, Bailey SR, Gold R .
Receipt of preventive services after Oregon's randomized Medicaid experiment.
Am J Prev Med 2016 Feb;50(2):161-70. doi: 10.1016/j.amepre.2015.07.032.
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Keywords: Access to Care, Community-Based Practice, Health Insurance, Medicaid, Prevention
Hoopes MJ, Angier H, Gold R
Utilization of community health centers in Medicaid expansion and nonexpansion states, 2013-2014.
Using electronic health record data, the researchers examined longitudinal changes in community health center (CHC) visit rates from 2013 through 2014 in Medicaid expansion versus nonexpansion states. Rates increased in expansion state CHCs for new patient, preventive, and limited-service visits (14 percent, 41percent, and 23 percent, respectively), whereas these rates remained unchanged in nonexpansion states.
AHRQ-funded; HS024270.
Citation: Hoopes MJ, Angier H, Gold R .
Utilization of community health centers in Medicaid expansion and nonexpansion states, 2013-2014.
J Ambul Care Manage 2016 Jan 13;39(4):290-8. doi: 10.1097/jac.0000000000000123.
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Keywords: Electronic Health Records (EHRs), Community-Based Practice, Healthcare Utilization, Medicaid, Uninsured
DeVoe JE, Marino M, Gold R
Community health center use after Oregon's randomized medicaid experiment.
To better understand the effect of new Medicaid coverage on community health center (CHC)use over time, the researchers studied Oregon’s 2008 randomized Medicaid expansion (the “Oregon Experiment”). Their results suggest that use of many different types of CHC services will increase as patients gain Medicaid through Affordable Care Act expansions.
AHRQ-funded; HS021522.
Citation: DeVoe JE, Marino M, Gold R .
Community health center use after Oregon's randomized medicaid experiment.
Ann Fam Med 2015 Jul;13(4):312-20. doi: 10.1370/afm.1812..
Keywords: Community-Based Practice, Healthcare Utilization, Medicaid, Primary Care
Angier H, Hoopes M, Gold R
An early look at rates of uninsured safety net clinic visits after the Affordable Care Act.
The researchers tested the hypothesis that rates of uninsured safety net clinic visits would significantly decrease in states that implemented Medicaid expansion, compared with states that did not. They found that, overall, clinics in the expansion states had a 40% decrease in the rate of uninsured visits in the postexpansion period and a 36% increase in the rate of Medicaid-covered visits, while clinics in the nonexpansion states had a significant 16% decline in the rate of uninsured visits but no change in the rate of Medicaid-covered visits. They concluded that their findings suggest that Affordable Care Act-related Medicaid expansions have successfully decreased the number of uninsured safety net patients in the United States.
AHRQ-funded; HS021522.
Citation: Angier H, Hoopes M, Gold R .
An early look at rates of uninsured safety net clinic visits after the Affordable Care Act.
Ann Fam Med 2015 Jan-Feb;13(1):10-6. doi: 10.1370/afm.1741.
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Keywords: Uninsured, Community-Based Practice, Primary Care, Medicaid, Access to Care
Kranz AM, Rozier RG, Preisser JS
Examining continuity of care for Medicaid-enrolled children receiving oral health services in medical offices.
To understand continuity of oral health services for Medicaid-enrolled children utilizing the North Carolina (NC) Into the Mouths of Babes (IMB) preventive oral health program, the researchers examined the time to a dentist visit after a child’s third birthday. They found that children with only IMB visits compared to only dentist visits before age 3 had lower rates of dentist visits after their third birthday.
AHRQ-funded; HS000032.
Citation: Kranz AM, Rozier RG, Preisser JS .
Examining continuity of care for Medicaid-enrolled children receiving oral health services in medical offices.
Matern Child Health J 2015 Jan;19(1):196-203. doi: 10.1007/s10995-014-1510-3..
Keywords: Access to Care, Children/Adolescents, Community-Based Practice, Dental and Oral Health, Medicaid
Snyder ME, Frail CK, Jaynes H
Predictors of medication-related problems among Medicaid patients participating in a pharmacist-provided telephonic medication therapy management program.
The objective of this study was to identify predictors of medication-related problems (MRPs) among Medicaid patients participating in a telephonic medication therapy management (MTM) program. The analysis of study results supports the relative importance of number of medications as a predictor of MRPs in the Medicaid population and identifies other predictors.
AHRQ-funded; HS022119.
Citation: Snyder ME, Frail CK, Jaynes H .
Predictors of medication-related problems among Medicaid patients participating in a pharmacist-provided telephonic medication therapy management program.
Pharmacotherapy 2014 Oct;34(10):1022-32. doi: 10.1002/phar.1462..
Keywords: Adverse Drug Events (ADE), Care Management, Community-Based Practice, Medicaid, Medication, Provider: Pharmacist