National Healthcare Quality and Disparities Report
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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 25 of 190 Research Studies DisplayedKistler A, Decker S, Steiger D
AHRQ Author: Decker S
A multimode strategy to contact participants and collect responses in a supplement to a longitudinal household survey.
In seeking to understand connections between Americans’ health care expenditures and use and social determinants of health, The Agency for Healthcare Research and Quality (AHRQ) and Westat conducted a new Medical Expenditure Panel Survey (MEPS) supplemental study in 2021 using a multimode (web and paper) instrument. Participants were encouraged to complete the web survey, but were provided the option of responding by paper. Response was encouraged through a multimode contact strategy, including text messages, emails, and/or mailings. The purpose of this paper was to review the protocol for encouraging web response and the response rates when utilizing various contact modes. The overall unweighted response rate for the survey was 74.2%, with 69.3% of responses submitted via the web. Response rates were 85.5% which was the highest among adults for whom both email and mobile phone information were provided.
AHRQ-authored.
Citation: Kistler A, Decker S, Steiger D .
A multimode strategy to contact participants and collect responses in a supplement to a longitudinal household survey.
Survey Methods: Insights From the Field 2024 May 1. doi: 10.13094/SMIF-2024-00001..
Keywords: Medical Expenditure Panel Survey (MEPS)
Decker SL, Zuvekas SH
AHRQ Author: Decker SL, Zuvekas SH
A nationally representative summary of 2020 changes in the use of health care in the United States.
The authors used Medical Expenditure Panel Survey data to summarize changes in all types of health care from 2018 to 2020. The results showed that outpatient and emergency department visits, as well as inpatient admissions each fell ~35% in April 2020; dental visits fell by over 80%, and mammograms 82%. By the end of 2020, specialist physician visits recovered, though primary care and dental visits remained 12% lower than in 2019. Psychiatric visits, however, rose slightly.
AHRQ-authored.
Citation: Decker SL, Zuvekas SH .
A nationally representative summary of 2020 changes in the use of health care in the United States.
J Ambul Care Manage 2024 Apr-Jun; 47(2):64-83. doi: 10.1097/jac.0000000000000488.
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Healthcare Delivery, Public Health
Zuvekas SH
AHRQ Author: Zuvekas SH
COVID-19, mental health, and mental health treatment among adults.
This AHRQ-authored paper seeks to examine the impact of the COVID-19 pandemic on mental health status and mental health treatment among adults residing in the U.S. civilian, non-institutionalized population. Data from the 2019-2020 MEPS was used. The author examined unadjusted and regression-adjusted differences between 2019 and 2020 in perceived mental health status (excellent, very good, good, fair, poor) and in the K6 general psychological distress, the PHQ-2 depression screener, and the VR-12 mental component summary score. Similarly, using the detailed MEPS data on health care encounters and prescription drug fills, he examined differences in mental health use treatment between 2019 and 2020. He focused specifically on changes in continuity of treatment among those already in treatment in January and February, before the pandemic fully struck, as well differences in the initiation of new episodes of treatment after the pandemic began. Results were that all four mental health scales included in the MEPS showed statistically significant declines in mental health between 2019 and 2020, particularly among younger adults. However, the percentage of US adults receiving mental health treatment did not change significantly. Continuity of treatment increased slightly in 2020, with 87.1% of adults in treatment January or February still receiving care in the second quarter, an increase of 2.5 percentage points. However, there were significant declines in the initiation of new treatment, especially in the second quarter of 2020.
AHRQ-authored.
Citation: Zuvekas SH .
COVID-19, mental health, and mental health treatment among adults.
J Ment Health Policy Econ 2023 Dec 1; 26(4):159-83..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Behavioral Health
Bernard DM, Selden TM, Fang Z
AHRQ Author: Bernard
The joint distribution of high out-of-pocket burdens, medical debt, and financial barriers to needed care.
This AHRQ-authored paper examined the joint distribution of three financial problems related to healthcare: high out-of-pocket burdens, medical debt, and financial barriers to needed care. The authors applied relatively strict definitions of financial problems to data from the 2018-2019 MEPS and found that 27% of nonsenior adults lived in families with at least one of the three financial strains assessed. The percentage of participants who faced more broadly defined financial problems was 45.5%. This prevalence varied across sociodemographic characteristics, families' health care needs, insurance coverage, and financial resources.
AHRQ-authored.
Citation: Bernard DM, Selden TM, Fang Z .
The joint distribution of high out-of-pocket burdens, medical debt, and financial barriers to needed care.
Health Aff 2023 Nov; 42(11):1517-26. doi: 10.1377/hlthaff.2023.00604..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Access to Care, Health Insurance
Decker SL, Zuvekas SH
AHRQ Author: Decker SL, Zuvekas SH
Primary care spending in the US population.
This AHRQ-authored research letter describes an analysis of primary care spending estimates in the US population using MEPS data. This survey study looked at the entire population, regardless of insurance source. The authors reported 2019 estimates of primary care spending, total medical spending, percentage of medical spending on primary care visits, and percentage with 0 spending on primary care visits. They analyzed race and ethnicity data to test whether primary care spending was greater in some groups compared with others. A total of 28,512 MEPS participants were included in the sample with a mean age of 38.6 and weighted percentages of 51.1% female, 18.5% Hispanic, 12.3% non-Hispanic Black, 59.7% non-Hispanic White, and 9.6% non-Hispanic individuals of other races and ethnicities. Primary care spending totaled $439 per person in 2019. Spending was highest for the Medicare population, Hispanics (52.7%), non-Hispanic Black (49.0%), and non-Hispanic other (44.3%), 79.9% for uninsured individuals and lowest for the uninsured. Average spending was $461 for those with group private insurance. The percentage of medical spending on primary care was 7.0% for the population and was lower for those younger than age 65 (5.1%), those in worse health (5.6%), and those with Medicare (5.3%). Almost 41% of the population had no primary care spending.
AHRQ-authored.
Citation: Decker SL, Zuvekas SH .
Primary care spending in the US population.
JAMA Intern Med 2023 Aug; 183(8):880-81. doi: 10.1001/jamainternmed.2023.1551..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Primary Care
Leininger LJ, Tomaino M, Meara E
Health-related quality of life in high-cost, high-need populations.
This retrospective longitudinal study examined health care utilization, expenditures, and patient-reported health for high-cost, high-need (HCHN) populations comparing a baseline (year 1) and follow-up year (year 2). The sample included adults (n = 46,934) participating in the Medical Expenditure Panel Survey between 2011 and 2016. The authors estimated health-related quality of life (HRQOL) for each sample member using the physical and mental health scales from the Medical Outcomes Study Short Form 12. They compared HRQOL stratified by HCHN, defined as patients whose baseline (year 1) demographics, utilization, and clinical characteristics predicted top decile health spending in year 2. The physical health scale exhibited robust measure validity, reliability, and responsiveness, but the mental health scale did not. Mean physical health was 1.25 SDs lower in HCHN vs other patients (37.9 vs 51.0 on a 0-100 scale increasing in self-perceived health). Patient-reported health outcomes continued to remain poor in HCHN populations, even after health care utilization recedes.
AHRQ-funded; HS024075.
Citation: Leininger LJ, Tomaino M, Meara E .
Health-related quality of life in high-cost, high-need populations.
Am J Manag Care 2023 Jul; 29(7):362-68. doi: 10.37765/ajmc.2023.89396..
Keywords: Medical Expenditure Panel Survey (MEPS), Quality of Life, Healthcare Costs
Olfson M, Zuvekas SH, McClellan C
AHRQ Author: Zuvekas SH, McClellan C
Racial-ethnic disparities in outpatient mental health care in the United States.
Using data from the 2018-19 Medical Expenditure Panel Survey, researchers compared national rates and patterns of use for outpatient mental health care among Hispanic, non-Hispanic Black, and non-Hispanic White individuals. Analyses focused on individuals using psychotropic medications, psychotherapy, or both, and receipt of minimally adequate mental health care. The results showed that the rate of outpatient mental health service use was more than twice as high for White individuals, and that Black and Hispanic patients were significantly less likely to receive psychotropic medications; Black and Hispanic patients were more likely to receive psychotherapy. No significant differences were found in patients who received minimally adequate treatment for depression, anxiety, attention-deficit hyperactivity disorder, or disruptive behavior disorders. The authors concluded that achieving racial-ethnic equity will require dedicated efforts to promote greater mental health service access for Black and Hispanic persons in need.
AHRQ-authored.
Citation: Olfson M, Zuvekas SH, McClellan C .
Racial-ethnic disparities in outpatient mental health care in the United States.
Psychiatr Serv 2023 Jul; 74(7):674-83. doi: 10.1176/appi.ps.20220365..
Keywords: Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities, Disparities, Behavioral Health, Ambulatory Care and Surgery
Jacobs PD, Moriya AS
AHRQ Author: Jacobs PD, Moriya AS
Changes in health coverage during the COVID-19 pandemic.
This AHRQ-authored paper used data from MEPS to examine patterns of health insurance coverage during the COVID-19 pandemic. The authors compared the proportion of people whose source of coverage changed from 2019 to 2020 with the proportion of people whose source changed from 2018 to 2019. The sample was limited to those who were interviewed in both 2018 and 2019 or in both 2019 and 2020. The analysis looked at people aged 63 or younger in the first year of the sample. The authors found increased stability for children and nonelderly adults during the first year of the pandemic. Fewer people who had Medicaid in 2019 became uninsured in 2020 (4.3%) than in 2018-19 (7.8%). Residents of Medicaid expansion states who were enrolled in 2019 were less likely to become uninsured in 2020 (3.6%) than was the case in the 2018-2019 period (6.0%). This was also true in non-Medicaid expansion states (6.6% vs 12.4%). However, residents of expansion states were more likely to become enrolled in Medicaid in 2020 if they were previously uninsured in 2019 (21.5%) compared with 2018-2019 (15.3%). For nonexpansion states, there was no detectable change in the percentage transitioning from uninsured to Medicaid over the two time periods (8.5% compared with 6.9%).
AHRQ-authored.
Citation: Jacobs PD, Moriya AS .
Changes in health coverage during the COVID-19 pandemic.
Health Affairs 2023 May; 42(5):721-26. doi: 10.1377/hlthaff.2022.01469..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Health Insurance, Medicaid, Access to Care
McClellan C, Mitchell E, Anderson J
AHRQ Author: McClellan C, Mitchell E, Anderson J, Zuvekas S
Using machine-learning algorithms to improve imputation in the Medical Expenditure Panel Survey.
This AHRQ-authored study’s aim was to assess the feasibility of applying machine-learning (ML) methods to imputation in the Medical Expenditure Panel Survey (MEPS), using all data from the 2016-2017 survey. The authors examined five alternatives to linear regression: Gradient Boosting, Random Forests, Extreme Random Forests, Deep Neural Networks, and a Stacked Ensemble approach. Additionally, they introduced an alternative matching scheme which matches on a vector of predicted expenditures by sources of payment instead of a single total expenditure prediction to generate potentially superior matches. Their principal findings were that ML algorithms perform better at both prediction and matching imputation than Ordinary Least Squares (OLS), the most common prediction algorithm used in predictive mean matching (PMM). On average, the Stacked Ensemble approach that combines all the ML algorithms performs best, improving expenditure prediction R(2) by 108% and final imputation R(2) by 227%. There was also an improvement on alignment of sources of payments between donor and recipient events by matching on a prediction vector.
AHRQ-authored.
Citation: McClellan C, Mitchell E, Anderson J .
Using machine-learning algorithms to improve imputation in the Medical Expenditure Panel Survey.
Health Serv Res 2023 Apr;58(2):423-32. doi: 10.1111/1475-6773.14115.
Keywords: Medical Expenditure Panel Survey (MEPS), Health Information Technology (HIT)
Creedon 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
Parikh MA, Fabiyi C, Mistry KB
AHRQ Author: Fabiyi C, Mistry KB
Factors associated with postprocedure opioid prescribing and persistent opioid use among opioid-naive patients: A nationally representative sample.
This study’s objective was to examine factors associated with postprocedure opioid receipt and persistent opioid use among opioid-naive patients in a nationally representative sample. The authors used panels 18-20 in MEPS between the years 2013 and 2015. They found that younger age, Western location, and a high-school degree were associated with higher odds of postprocedure opioid receipt. Patients who had procedures in an inpatient, outpatient, and dental setting; or musculoskeletal diagnoses and injuries were more likely to have postprocedure opioid receipt. Persistent opioid use was associated with Midwest and Northeast location, musculoskeletal diagnosis, public insurance, and positive depression screening.
AHRQ-authored.
Citation: Parikh MA, Fabiyi C, Mistry KB .
Factors associated with postprocedure opioid prescribing and persistent opioid use among opioid-naive patients: A nationally representative sample.
Ann Surg 2022 Dec 1;276(6):e706-e13. doi: 10.1097/sla.0000000000004630..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Medication, Practice Patterns, Pain
Pritchard KT, Baillargeon J, Lee WC
Trends in the use of opioids vs nonpharmacologic treatments in adults with pain, 2011-2019.
This serial cross-sectional analysis on trends in the use of prescription opioids and nonpharmacologic alternatives in treating pain used MEPS to estimate the use of outpatient services by cancer-free adults with chronic or surgical pain from 2011 to 2019. A total of unweighted 46,420 respondents, 9643 (20.4% weighted) received surgery and 36,777 (79.6% weighted) did not. The prevalence of nonpharmacologic treatments increased in 2019 for both chronic and surgical pain cohorts, especially with exclusive use compared with 2011. Chiropractors and physical therapists were the most common licensed healthcare professionals used among the cohort who used nonpharmacologic treatment.
AHRQ-funded; T32HS026133.
Citation: Pritchard KT, Baillargeon J, Lee WC .
Trends in the use of opioids vs nonpharmacologic treatments in adults with pain, 2011-2019.
JAMA Netw Open 2022 Nov;5(11):e2240612. doi: 10.1001/jamanetworkopen.2022.40612..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Medication, Pain, Chronic Conditions, Treatments
Abdus S, Selden TM
AHRQ Author: Abdus S, Selden TM
Well-child visit adherence.
This article presents updated evidence on well-child visit adherence, using MEPS data to conduct a cross-sectional study. The results indicate that average adherence increased between 2006-07 and 2016-17, but the authors note that large gaps remain in such areas as race and ethnicity, poverty level, insurance coverage, and geographic region.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Well-child visit adherence.
JAMA Pediatr 2022 Nov;176(11):1143-45. doi: 10.1001/jamapediatrics.2022.2954..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Healthcare Utilization, 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
Koball H, Kirby J, Hartig S
AHRQ Author: Kirby J
The relationship between states' immigrant-related policies and access to health care among children of immigrants.
The purpose of this AHRQ-authored paper was to explore immigrants’ children’s access to preventive healthcare, and the impact of sanctuary policies (state policies that limit federal immigration enforcement involvement) and the provision of driver’s licenses for undocumented immigrants on that access. Primary outcomes included whether the child had a well child check-up, unmet medical needs, or a regular source for care. The 2008-2016 Medical Panel Expenditure Survey (MPES) merged with policy data at the state level were analyzed, with the researchers reporting that sanctuary policies and having a state driver’s license were both associated with having a regular source for care and less unmet medical needs among the children of immigrants. The researchers emphasized the importance of access to preventive care and concluded that sanctuary policies are related to increased access to preventive health care among the children of immigrants.
AHRQ-authored.
Citation: Koball H, Kirby J, Hartig S .
The relationship between states' immigrant-related policies and access to health care among children of immigrants.
J Immigr Minor Health 2022 Aug;24(4):834-41. doi: 10.1007/s10903-021-01282-9..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Policy, 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
Hegland TA, Berdahl TA
AHRQ Author: Hegland TA, Berdahl TA
High job flexibility and paid sick leave increase health care access and use among us workers.
This AHRQ-authored study explored the impact of job flexibility on health care access and use, including access to paid sick leave. The authors analyzed data from a national representative sample in the MEPS-Household Component for 2017 to 2019, combined with occupational data from the Occupational Information Network database, version 25.0. A one-unit increase in job flexibility was associated with a 2.15 percentage point increase in the likelihood of having an office-based health care visit in the past year and 2.42 percentage increase in the likelihood of having a usual source of care. Access to paid sick leave was associated with a 3.8 percentage point increase in the likelihood of going to an office-based health care visit. Black and Hispanic workers, as well as low-wage workers have less job flexibility and less access to paid sick leave.
AHRQ-authored.
Citation: Hegland TA, Berdahl TA .
High job flexibility and paid sick leave increase health care access and use among us workers.
Health Aff 2022 Jun;41(6):873-82. doi: 10.1377/hlthaff.2021.01876..
Keywords: Medical Expenditure Panel Survey (MEPS), 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
Encinosa W, Bernard D, Selden TM
AHRQ Author: Encinosa W, Bernard D, Selden TM
Opioid and non-opioid analgesic prescribing before and after the CDC's 2016 opioid guideline.
This study examined opioid and non-opioid prescribing before and after the issuing of CDC’s 2016 opioid guideline. The authors developed a theory of physician prescribing behavior under the CDC’s two-pronged incentive structure. They used MEPS survey data to empirically corroborate the theory that the regulations and guidelines have the intended effects of reducing opioid prescriptions for acute and chronic pain, as well as the predicted unintended effects-income effects cause regulations on acute pain treatment to increase chronic pain opioid prescriptions and the chronic pain treatment guidelines spillover to reduce opioids for acute pain. They also found that the guidelines work as intended in terms of the reduced usage, with chronic pain patients shifting to non-opioids and tapering off opioid doses.
AHRQ-authored.
Citation: Encinosa W, Bernard D, Selden TM .
Opioid and non-opioid analgesic prescribing before and after the CDC's 2016 opioid guideline.
Int J Health Econ Manag 2022 Mar;22(1):1-52. doi: 10.1007/s10754-021-09307-4..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Practice Patterns, Medication, Pain, Chronic Conditions
Kumar V, Encinosa W
AHRQ Author: Encinosa W
Revisiting the obesity paradox in health care expenditures among adults with diabetes.
This AHRQ-authored study explored and examined an obesity paradox identified by recent studies which suggests that in people without diabetes mortality risk increases with weight and in people with diabetes mortality risk decreases with weight. The researchers assessed changes in the association between body mass index (BMI) and health care expenditures in populations with diabetes and without diabetes while controlling for confounding risk factors. The researchers found that there is no obesity paradox; it is the result of statistical biases, and the study concluded that obesity in people with diabetes does not save costs.
AHRQ-authored.
Citation: Kumar V, Encinosa W .
Revisiting the obesity paradox in health care expenditures among adults with diabetes.
Clin Diabetes 2022 Spring;40(2):185-95. doi: 10.2337/cd20-0122..
Keywords: Medical Expenditure Panel Survey (MEPS), Obesity, Diabetes, 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
Kumar V, Encinosa W
AHRQ Author: Kumar V, Encinosa W
Explaining the obesity paradox in healthcare utilization among people with type 2 diabetes.
The authors sought to examine changes in the relationship between BMI and number of visits in diabetic vs nondiabetic populations, controlling for confounding risk factors. Using MEPS data, they found that the obesity paradox does not exist at the utilization level and is due to the presence of statistical biases such as confounding and reverse causation.
AHRQ-authored.
Citation: Kumar V, Encinosa W .
Explaining the obesity paradox in healthcare utilization among people with type 2 diabetes.
Diabetol Int 2022 Jan;13(1):232-43. doi: 10.1007/s13340-021-00530-5..
Keywords: Medical Expenditure Panel Survey (MEPS), Obesity, Diabetes, Chronic Conditions, Healthcare Utilization
McClellan C, Moriya A, Simon K
AHRQ Author: McClellan C Moriya A
Users of retail medications for opioid use disorders faced high out-of-pocket prescription spending in 2011-2017.
This paper provides national estimates of financial costs faced by the population receiving retail medications for opioid use disorders (MOUD). Using MEPS data, findings showed that patients with retail MOUD prescriptions spent 3.4 times more out-of-pocket for prescriptions on average than the rest of the U.S. population, with 18.8% of this population paying entirely out-of-pocket for their MOUD prescriptions. Insurance coverage was associated with reduced annual out-of-pocket MOUD expenditures. Future policies that expand insurance and address out-of-pocket spending on MOUD could increase access to medications among individuals with opioid use disorders.
AHRQ-authored.
Citation: McClellan C, Moriya A, Simon K .
Users of retail medications for opioid use disorders faced high out-of-pocket prescription spending in 2011-2017.
J Subst Abuse Treat 2022 Jan;132:108645. doi: 10.1016/j.jsat.2021.108645..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Substance Abuse, Behavioral Health, Healthcare Costs, Medication
Zuvekas SH, Kashihara D
AHRQ Author: Zuvekas SH
The impacts of the COVID-19 pandemic on the Medical Expenditure Panel Survey.
The COVID-19 pandemic caused substantial disruptions in the field operations of all 3 major components of the Medical Expenditure Panel Survey (MEPS). In this study, the investigators described how the MEPS program successfully responded to these challenges by reengineering field operations, including survey modes, to complete data collection and maintain data release schedules.
AHRQ-authored.
Citation: Zuvekas SH, Kashihara D .
The impacts of the COVID-19 pandemic on the Medical Expenditure Panel Survey.
Am J Public Health 2021 Dec;111(12):2157-66. doi: 10.2105/ajph.2021.306534..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Healthcare Costs, Data