National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- (-) Access to Care (32)
- Behavioral Health (5)
- Cancer (5)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Community-Based Practice (2)
- Diabetes (1)
- Disparities (1)
- Elderly (1)
- Electronic Prescribing (E-Prescribing) (1)
- Evidence-Based Practice (1)
- Healthcare Costs (1)
- Healthcare Delivery (3)
- Healthcare Utilization (3)
- Health Information Technology (HIT) (1)
- Health Insurance (7)
- Health Services Research (HSR) (1)
- Hepatitis (2)
- Hospitalization (1)
- Human Immunodeficiency Virus (HIV) (3)
- Implementation (3)
- Long-Term Care (1)
- Low-Income (2)
- Medicaid (9)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (2)
- (-) Medication (32)
- Nursing Homes (1)
- Opioids (11)
- Pain (1)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (1)
- Policy (6)
- Practice Patterns (4)
- Primary Care (5)
- Provider: Pharmacist (2)
- Racial and Ethnic Minorities (4)
- Rural Health (4)
- Sickle Cell Disease (1)
- Social Determinants of Health (1)
- Social Stigma (1)
- Substance Abuse (11)
- Tobacco Use (1)
- Tobacco Use: Smoking Cessation (1)
- Treatments (1)
- Uninsured (1)
- Urban Health (1)
- Vaccination (1)
- Vulnerable Populations (5)
- Women (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 32 Research Studies DisplayedHughes PM, Carda-Auten J, DiRosa EA
"You can get a couple of ramen noodle packs for a Buspar(Ⓡ)": a qualitative examination of medication access, policy, and procedures in southern jails.
Over10 million people are being incarcerated every year in the US, and jails are required to provide health care to them, a substantial percentage of whom require medications. However, not much is known about the medication prescription, acquisition, and administration process for incarcerated persons in jails. The purpose of this study was to characterize access to medication and related medication policies and procedures in jails. The researchers administered semi-structured interviews with administrators and health workers from 34 jails (of 125 contacted) across 5 states in the southeastern US. The qualitative interview guide encompassed all facets of healthcare in jails from entry to release, but the current study focused only on medications. The study found that 4 processes characterized medication utilization from intake to release: 1) jail entry and health screening, 2) pharmacy and medication protocols, 3) protocols specific to medication dispensing and administration, and 4) medications upon release. Many jails had processes for utilizing medications brought to the jail from home, although some jails did not agree to use those medications. Researchers discovered that contracted healthcare providers were the primary medication decision-makers in jails, and most medications were obtained from contract pharmacies. The study also found almost all jails banned narcotics, but other medication restrictions varied by jail. Most jails charged a copay for medications. Study participants shared a variety of privacy practices related to the distribution of medication, as well as approaches to the prevention of diversion of medications away from intended recipients and into the prison population. Transition planning for pre-release medication management processes ranged from no planning to sending additional prescriptions to the patient's pharmacy.
AHRQ-funded; HS000032.
Citation: Hughes PM, Carda-Auten J, DiRosa EA .
"You can get a couple of ramen noodle packs for a Buspar(Ⓡ)": a qualitative examination of medication access, policy, and procedures in southern jails.
Res Social Adm Pharm 2023 Sep; 19(9):1298-306. doi: 10.1016/j.sapharm.2023.05.013..
Keywords: Medication, Vulnerable Populations, Access to Care
Enzinger AC, Ghosh K, Keating NL
Racial and ethnic disparities in opioid access and urine drug screening among older patients with poor-prognosis cancer near the end of life.
This research characterized racial and ethnic disparities and trends in opioid access and urine drug screening (UDS) among older patients dying of cancer, and to explore potential mechanisms. Among 18,549 non-Hispanic White (White), Black, and Hispanic Medicare decedents older than 65 years with poor-prognosis cancers, the authors examined 2007-2019 trends in opioid prescription fills and potency (morphine milligram equivalents [MMEs] per day [MMEDs]) near the end of life (EOL), defined as 30 days before death or hospice enrollment. They found that between 2007 and 2019, White, Black, and Hispanic decedents experienced steady declines in EOL opioid access and rapid expansion of UDS. Compared with White patients, Black and Hispanic patients were less likely to receive any opioid (Black, -4.3 percentage points; Hispanic, -3.6 percentage points) and long-acting opioids (Black, -3.1 percentage points; Hispanic, -2.2 percentage points). They also received lower daily doses (Black, -10.5 MMED; Hispanic, -9.1 MMED) and lower total doses (Black, -210 MMEs; Hispanic, -179 MMEs). Black patients were also more likely to undergo UDS (0.5 percentage points).
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL .
Racial and ethnic disparities in opioid access and urine drug screening among older patients with poor-prognosis cancer near the end of life.
J Clin Oncol 2023 May 10; 41(14):2511-22. doi: 10.1200/jco.22.01413..
Keywords: Elderly, Opioids, Medication, Cancer, Racial and Ethnic Minorities, Disparities, Access to Care
Coburn SB, Lang R, Zhang J
Statins utilization in adults with HIV: the treatment gap and predictors of statin initiation.
The purpose of this study was to describe trends in statin eligibility and subsequent statin initiation among people with HIV (PWH) from and identify the predictors of statin initiation. The researchers collected data from 12 United States cohorts between 2001 and 2017. The study found that among 16,409 PWH, 45% met statin eligibility criteria per guidelines for the time period from 2001 to 2017. Statin eligibility ranged from 22% to 25% from 2001 to 2013, and initiation increased from 13% to 45%. In 2014, 51% were statin-eligible, among whom 25% initiated statins, which increased to 32% by 2017. The researchers concluded that there is a substantial statin treatment gap, expanded by the 2013 ACC/AHA guidelines.
AHRQ-funded; 90047713.
Citation: Coburn SB, Lang R, Zhang J .
Statins utilization in adults with HIV: the treatment gap and predictors of statin initiation.
J Acquir Immune Defic Syndr 2022 Dec 15;91(5):469-78. doi: 10.1097/qai.0000000000003083..
Keywords: Medication, Human Immunodeficiency Virus (HIV), Access to Care, Practice Patterns, Cardiovascular Conditions
Auty SG, Griffith KN, Shafer PR
Improving access to high-value, high-cost medicines: the use of subscription models to treat hepatitis C using direct acting antivirals in the United States.
This paper discusses the use of state-sponsored subscription models to support increased access to high-value medications such as direct acting antivirals (DAAs) which can cure chronic Hepatitis C virus (HCV). The authors discuss the use of subscription models, a type of advanced purchase commitment (APC), to support increased access to high-value DAAs to treat HCV. They provide background information on HCV, its treatment, and state financing of prescription medications. They review the implementation of HCV subscription models in two states, Louisiana and Washington, and early evidence of their impact, as DAAs can cost upwards of $90,000 for treatment course.
AHRQ-funded; HS026395.
Citation: Auty SG, Griffith KN, Shafer PR .
Improving access to high-value, high-cost medicines: the use of subscription models to treat hepatitis C using direct acting antivirals in the United States.
J Health Polit Policy Law 2022 Dec 1;47(6):691-708. doi: 10.1215/03616878-10041121..
Keywords: Hepatitis, Medication, Chronic Conditions, Access to Care
Grove LR, Rao N, Domino ME
Are North Carolina clinicians delivering opioid use disorder treatment to Medicaid beneficiaries?
This study’s goal was to inform efforts to increase prescriptions of medications for opioid use disorder (MOUD) among Medicaid beneficiaries. A retrospective study of North Carolina licensed physicians, physician assistants, and nurse practitioners was conducted to estimate Medicaid participation prevalence among clinicians authorized to prescribe buprenorphine and to estimate the association between clinician characteristics and OUD care delivery to Medicaid beneficiaries. Outcomes looked for were indicators of any Medicaid professional claims and Medicaid claims data for buprenorphine and naltrexone. Licensure data from 2018 was merged with 2019 US Drug Enforcement Administration to identify clinicians who used the DEA waiver required to prescribe buprenorphine (n = 1714). Services by waivered clinicians to Medicare beneficiaries ranged from 67% of behavioral health clinicians to 82.9% of specialist physicians. Prevalence of prescribing buprenorphine to Medicaid beneficiaries ranged from 30.3% among specialist physicians to 51.6% among behavioral health clinicians.
AHRQ-funded; HS000032.
Citation: Grove LR, Rao N, Domino ME .
Are North Carolina clinicians delivering opioid use disorder treatment to Medicaid beneficiaries?
Addiction 2022 Nov;117(11):2855-63. doi: 10.1111/add.15854..
Keywords: Opioids, Substance Abuse, Behavioral Health, Vulnerable Populations, Medication, Access to Care, Medicaid
Wyse JJ, Mackey K, Lovejoy TI
Expanding access to medications for opioid use disorder through locally-initiated implementation.
The purpose of this study was to identify and describe locally- and internally-developed approaches to improve patient access to medication treatment for opioid use disorder (MOUD). The researchers utilized the Consolidated Framework for Implementation Research (CFIR) to guide qualitative interviews and ethnographic observations to examine the planning, design, and implementation of a locally-initiated process to expand access to MOUD. The study found that a self-appointed local team successfully developed and implemented a Primary Care-based Buprenorphine Clinic and E-Consult Service to expand access to MOUD to patients across the health care system, including national and local policy changes, identifying appropriate and widely supported models of care delivery and consultation, and increasing staff investment in the efforts by including them in collaborative planning and problem-solving. The study concluded that a local team can plan, develop and build new processes of care that are customized to meet local needs and contribute to long-term sustainability in the community.
AHRQ-funded; HS026370.
Citation: Wyse JJ, Mackey K, Lovejoy TI .
Expanding access to medications for opioid use disorder through locally-initiated implementation.
Addict Sci Clin Pract 2022 Jun 20;17(1):32. doi: 10.1186/s13722-022-00312-7..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication, Access to Care, Practice Patterns, Implementation
Meiselbach MK, Drake C, Saloner B
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
This study examined variation in access to in-network buprenorphine-prescribing primary care providers that can treat opioid use disorder among Medicaid managed care enrollees. Approximately 32.2% of Medicaid enrollees had fewer than one in-network network buprenorphine-prescribing primary care providers per 100,000 county residents. There was on average a greater number of in-network buprenorphine-prescribing primary care providers in states with higher compared with lower overdose death rates, but most enrollees lived in areas with a shortage of these providers. The authors found that a 25 percent higher network participation rate by prescribers compared with nonprescribers could improve the probability that enrollees see a prescriber by approximately 25 percent.
AHRQ-funded; HS000029.
Citation: Meiselbach MK, Drake C, Saloner B .
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
Health Aff 2022 Jun;41(6):901-10. doi: 10.1377/hlthaff.2021.01719..
Keywords: Medicaid, Primary Care, Access to Care, Medication, Care Management, Opioids, Substance Abuse, Behavioral Health
Enzinger AC, Ghosh K, Keating NL
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
This study looked at trends in opioid prescriptions for cancer patients near the end-of-life (EOL) defined as the 30 days before death or hospice enrollment. The authors looked at Medicare part D data from 2007 to 2017 for 270,632 Medicare fee-for-service decedents with poor prognosis cancers. During that time, the proportion of decedents with poor prognosis cancers receiving 1 or greater opioid prescriptions near EOL declined 15.5% and the proportion receiving 1 or greater long-acting opioid prescriptions declined 36.5% to 18.1%. The mean daily dose fell from 24.5%, from 85.6 morphine milligram equivalents per day (MMED) to 64.6. The total amount of opioids prescribed fell from 1,075 morphine milligram equivalents per decedent to 666 morphine milligram equivalents per decedents. At the same time, the proportion of patients with pain-related ED visits increase 50.8% from 13.2% to 19.9%.
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL .
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
J Clin Oncol 2021 Sep 10;39(26):2948-58. doi: 10.1200/jco.21.00476..
Keywords: Cancer, Opioids, Palliative Care, Pain, Access to Care, Medication, Practice Patterns
Cole ES, DiDomenico E, Green S
The who, the what, and the how: a description of strategies and lessons learned to expand access to medications for opioid use disorder in rural America.
This study looked at the problems of treatment access for opioid use disorder (OUD) in rural areas within the United States. Providers must complete 8-24 hours of training to obtain the Drug Addiction Treatment Act (DATA) 2000 waiver to have the legal authority to prescribe buprenorphine. The authors executed 5 AHRQ-funded dissemination and implementation grants to study and address barriers to providing Medications for Opioid Use Disorder Treatment (MOUD), including psychosocial supports. Obtaining the DATA 2000 waiver was found to be just one component of meaningful treatment using MOUD, and there are other significant barriers that providers face daily. The researchers’ initiatives and common lessons learned across their grants are summarized and recommendations are offered how primary care providers can be better supported to expand access to MOUD across rural America.
AHRQ-funded.
Citation: Cole ES, DiDomenico E, Green S .
The who, the what, and the how: a description of strategies and lessons learned to expand access to medications for opioid use disorder in rural America.
Subst Abus 2021;42(2):123-29. doi: 10.1080/08897077.2021.1891492..
Keywords: Opioids, Medication, Primary Care, Rural Health, Substance Abuse, Access to Care
Salvador JG, Bhatt SR, Jacobsohn VC
Feasibility and acceptability of an online ECHO intervention to expand access to medications for treatment of opioid use disorder, psychosocial treatments and supports.
This study examined acceptability and feasibility of an online Extensions for Community Healthcare Outcomes (ECHO) model intervention developed to support rural primary care clinics to expand treatment and is part of a larger study tracking the impact of participation in this ECHO on expansion of medications for opioid use disorder (MOUD) in rural primary care. Using qualitative interviews and post-session questionnaires across 27 rural clinics in New Mexico, findings suggested evidence of feasibility and acceptability of MOUD ECHO to support expansion of this treatment.
AHRQ-funded; HS025345.
Citation: Salvador JG, Bhatt SR, Jacobsohn VC .
Feasibility and acceptability of an online ECHO intervention to expand access to medications for treatment of opioid use disorder, psychosocial treatments and supports.
Subst Abus 2021;42(4):610-17. doi: 10.1080/08897077.2020.1806184..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication, Access to Care, Rural Health, Primary Care, Patient-Centered Healthcare
Green TC, Donovan E, Klug B
Revisiting pharmacy-based naloxone with pharmacists and naloxone consumers in 2 states: 2017 perspectives and evolving approaches.
The authors sought to examine similarities and differences in experiences obtaining naloxone at the pharmacy over a 1-year period in 2 states, and to explore reactions from people with opioid use disorder, patients taking opioids for chronic pain, caregivers of opioid users, and pharmacists to communication tools and patient outreach materials designed to improve naloxone uptake. Through focus groups in Massachusetts and Rhode Island, they found that experiences dispensing naloxone are quickly evolving, and a greater diversity of patients are obtaining pharmacy naloxone. They concluded that persistent stigma-related concerns underscore the need for tools to help pharmacists offer naloxone, facilitate patient requests, and provide reassurance when getting naloxone.
AHRQ-funded; HS024021.
Citation: Green TC, Donovan E, Klug B .
Revisiting pharmacy-based naloxone with pharmacists and naloxone consumers in 2 states: 2017 perspectives and evolving approaches.
J Am Pharm Assoc (2003) 2020 Sep-Oct;60(5):740-49. doi: 10.1016/j.japh.2020.03.005..
Keywords: Opioids, Medication, Substance Abuse, Community-Based Practice, Healthcare Delivery, Social Stigma, Access to Care
Maclean JC, Halpern MT, Hill SC
AHRQ Author: Hill SC
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
The purpose of this study was to quantify the effects of the Affordable Care Act Medicaid expansion on prescriptions for effective breast cancer hormonal therapies (tamoxifen and aromatase inhibitors) among Medicaid enrollees. Data from the Medicaid State Drug Utilization Database was used. Findings showed that Medicaid expansion may have had a meaningful impact on the ability of lower-income women to access effective hormonal therapies used to treat breast cancer.
AHRQ-authored.
Citation: Maclean JC, Halpern MT, Hill SC .
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
Health Serv Res 2020 Jun;55(3):399-410. doi: 10.1111/1475-6773.13289..
Keywords: Medicaid, Cancer: Breast Cancer, Cancer, Medication, Policy, Women, Healthcare Utilization, Access to Care, Health Insurance
Bailey SR, Marino M, Ezekiel-Herrera D
Tobacco cessation in Affordable Care Act Medicaid expansion states versus non-expansion states.
This study examined whether states that expanded Medicaid eligibility under the ACA had increased smoking quit rates, tobacco cessation medication orders, and greater health care utilization compared to patients in non-expansion states. The researchers used electronic health record (EHR) data from 219 community health centers (CHCs) in 10 states that expanded Medicaid as of January 2014. They identified patients aged 19-64 with tobacco use status in their records within six months prior to ACA Medicaid expansion and 1 or more visits. They found that patients in expansion states had increased adjusted odds of quitting, having a medication ordered and having follow-up visits compared to patients in non-expansion states.
AHRQ-funded; HS024270.
Citation: Bailey SR, Marino M, Ezekiel-Herrera D .
Tobacco cessation in Affordable Care Act Medicaid expansion states versus non-expansion states.
Nicotine Tob Res 2020 Jun;22(6):1016-22. doi: 10.1093/ntr/ntz087..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Substance Abuse, Medication, Medicaid, Policy, Healthcare Utilization, Access to Care, Health Insurance
Kayle M, Valle J, Paulukonis S
Impact of Medicaid expansion on access and healthcare among individuals with sickle cell disease.
The purpose of this study was to examine whether Medicaid expansion in California, increased Medicaid enrollment, increased hydroxyurea prescriptions filled, and decreased acute healthcare utilization in sickle cell disease (SCD). Findings showed that Medicaid expansion did not appear to have improved enrollment or acute healthcare utilization among individuals with SCD in California. Recommendations included future studies exploring whether individuals with SCD transitioned to other insurance plans or became uninsured post-expansion, the underlying reasons for low hydroxyurea utilization, and the lack of effect on hospital admissions despite a modest effect on emergency department visits.
AHRQ-funded; HS023011; HS025297.
Citation: Kayle M, Valle J, Paulukonis S .
Impact of Medicaid expansion on access and healthcare among individuals with sickle cell disease.
Pediatr Blood Cancer 2020 May;67(5):e28152. doi: 10.1002/pbc.28152..
Keywords: Sickle Cell Disease, Medicaid, Access to Care, Healthcare Utilization, Medication, Hospitalization, Health Insurance
Olivieri-Mui BL, Koethe B, Briesacher B
Economic barriers to antiretroviral therapy in nursing homes.
In this study, the investigators’ aim was to clarify if persons living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) have adequate economic access to antiretroviral therapy (ART) when admitted to nursing homes (NHs). They concluded that people living with HIV in NHs do not always receive lifesaving ART, but the reasons are unclear and appear unrelated to economic barriers.
AHRQ-funded; HS025662.
Citation: Olivieri-Mui BL, Koethe B, Briesacher B .
Economic barriers to antiretroviral therapy in nursing homes.
J Am Geriatr Soc 2020 Apr;68(4):777-82. doi: 10.1111/jgs.16288..
Keywords: Human Immunodeficiency Virus (HIV), Nursing Homes, Long-Term Care, Medication, Access to Care
Springer R, Marino M,, Bailey SR
Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.
This study compared the prevalence of receipt of opioid prescriptions and opioid use disorder (OUD), along with time from OUD diagnosis to medication-assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014 or returned to Medicaid coverage after expansion.
AHRQ-funded; HS024270.
Citation: Springer R, Marino M,, Bailey SR .
Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.
Addiction 2019 Oct;114(10):1775-84. doi: 10.1111/add.14667..
Keywords: Opioids, Medication, Substance Abuse, Medicaid, Practice Patterns, Health Insurance, Access to Care, Policy
McManus KA, Debolt C, Elwood S
Facilitators and barriers: clients' perspective on the Virginia AIDS Drug Assistance Program's Affordable Care Act implementation.
This study examined low-income HIV patients’ perspective on the Virginia AIDS Drug Assistance Program (ADAP) Affordable Care Act (ACA) implementation. Patients were recruited at three HIV clinics in Virginia with the goal of enrolling greater than 5% of those who were eligible for the Qualified Health Plan (QHP). The recruitment goals were met with 53 patients enrolled. Two-thirds of patients were recruited to the QHP via case managers and social workers at the HIV clinics. Concerns about privacy using the mail-order pharmacy was the biggest barrier with 9 out of 10 participants. Otherwise, most participants had positive perceptions of the QHP.
AHRQ-funded; HS024196.
Citation: McManus KA, Debolt C, Elwood S .
Facilitators and barriers: clients' perspective on the Virginia AIDS Drug Assistance Program's Affordable Care Act implementation.
AIDS Res Hum Retroviruses 2019 Aug;35(8):734-45. doi: 10.1089/aid.2018.0254..
Keywords: Human Immunodeficiency Virus (HIV), Access to Care, Medication, Low-Income, Vulnerable Populations
Cochran G, Cole ES, Warwick J
Rural access to MAT in Pennsylvania (RAMP): a hybrid implementation study protocol for medication assisted treatment adoption among rural primary care providers.
This paper reports the design and protocol of an implementation study seeking to advance availability of medication-assisted treatment (MAT) for opioid use disorder (OUD) in rural Pennsylvania counties for patients insured by Medicaid in primary care settings. Results showed an urgent need in the US to expand access to high quality, evidence-based OUD treatment, particularly in rural areas where capacity is limited for service delivery, in order to improve patient health and protect lives. Further, results of this study will provide needed evidence in the field for appropriate methods for implementing MAT among a large number of rural primary care providers.
AHRQ-funded; HS025072.
Citation: Cochran G, Cole ES, Warwick J .
Rural access to MAT in Pennsylvania (RAMP): a hybrid implementation study protocol for medication assisted treatment adoption among rural primary care providers.
Addict Sci Clin Pract 2019 Aug 1;14(1):25. doi: 10.1186/s13722-019-0154-4..
Keywords: Opioids, Substance Abuse, Rural Health, Medication, Access to Care, Implementation, Primary Care, Healthcare Delivery, Medicaid
Cole ES, DiDomenico E, Cochran G
The role of primary care in improving access to medication-assisted treatment for rural Medicaid enrollees with opioid use disorder.
The authors examined the degree to which rural residents with opioid use disorder (OUD) are engaged with primary care providers (PCPs); they also described the role of rural PCPs in medication-assisted treatment (MAT) delivery, and estimated the association between enrollee distance to MAT prescribers and MAT utilization. They concluded that PCP utilization among rural Medicaid enrollees diagnosed with OUD is high, presenting a potential intervention point to treat OUD, particularly if the enrollee's PCP is located nearer than their MAT prescriber.
AHRQ-funded; HS025072.
Citation: Cole ES, DiDomenico E, Cochran G .
The role of primary care in improving access to medication-assisted treatment for rural Medicaid enrollees with opioid use disorder.
J Gen Intern Med 2019 Jun;34(6):936-43. doi: 10.1007/s11606-019-04943-6..
Keywords: Opioids, Substance Abuse, Rural Health, Medication, Access to Care, Implementation, Primary Care, Healthcare Delivery, Medicaid
Lindau ST
CommunityRx, an e-prescribing system connecting people to community resources.
CommunityRx is an e-prescribing system that make it easier for patients in communities to connect with health resources. NowPow, LLC is an information technology enterprise that is part of CommunityRx. NowPow participated in AHRQ’s EvidenceNow grants program and worked with hundreds of small Midwestern primary care practices in the Healthy Hearts in the Heartland study. By 2018, over 1600 youths had been employed (many for the first-time) and generated annual asset census for Chicago, New York, and two rural areas of North Carolina. CommunityRx has been successful in providing health resource information to lower-income communities such as Chicago’s South Side. They also found that half of people who received a HealtheRx e-prescription use the information to help others.
AHRQ-funded; HS023921.
Citation: Lindau ST .
CommunityRx, an e-prescribing system connecting people to community resources.
Am J Public Health 2019 Apr;109(4):546-47. doi: 10.2105/ajph.2019.304986..
Keywords: Access to Care, Community-Based Practice, Electronic Prescribing (E-Prescribing), Evidence-Based Practice, Health Information Technology (HIT), Medication, Vulnerable Populations
Myerson R, Lu T, Tonnu-Mihara I
Medicaid eligibility expansions may address gaps in access to diabetes medications.
The purpose of this study was to examine the impacts of Medicaid expansion on access to diabetes medications, researchers analyzed data on over ninety-six million prescription fills using Medicaid insurance in the period January 2008-December 2015. The researchers found that the increase in prescription fills grew significantly over time. Overall, fills for insulin and for newer medications increased by 40 percent and 39 percent, respectively.
AHRQ-funded; HS023964.
Citation: Myerson R, Lu T, Tonnu-Mihara I .
Medicaid eligibility expansions may address gaps in access to diabetes medications.
Health Aff 2018 Aug;37(8):1200-07. doi: 10.1377/hlthaff.2018.0154..
Keywords: Access to Care, Diabetes, Policy, Medicaid, Medication
Tran Smith B, Seaton K, Andrews C
Benefit requirements for substance use disorder treatment in state health insurance exchanges.
This study assessed the extent to which state insurance departments regulate the types of substance use disorder (SUD) treatment that services and medications plans must provide, and also their use of utilization controls. Data were obtained from state insurance departments via an internet-based survey, as part of the National Drug Abuse Treatment System Survey. The results indicate that states vary widely in regulations on qualified health plans’ (QHPs) administration of SUD treatment benefits; some required plans to cover all the SUD treatment services and medications assessed in this study, while others did not require plans to cover any at all. Nearly all states allowed the plans to employ utilization controls, but reported little guidance on their usage. The authors conclude that by not requiring coverage for the entire SUD continuum of care, some states hinder client access to the appropriate types of care needed for recovery.
AHRQ-funded; HS000084.
Citation: Tran Smith B, Seaton K, Andrews C .
Benefit requirements for substance use disorder treatment in state health insurance exchanges.
Am J Drug Alcohol Abuse 2018;44(4):426-30. doi: 10.1080/00952990.2017.111934..
Keywords: Access to Care, Health Insurance, Medication, Policy, Substance Abuse
Smieliauskas F, Sharma H, Hurley C
State insurance mandates and off-label use of chemotherapy.
In this study, the investigators hypothesized that state health insurance mandates for private insurers to provide coverage for off-label use of cancer drugs cause higher rates of off-label use. They used Truven MarketScan data from 1999 to 2007 on utilization of 35 infused chemotherapy drugs in private health plans in the United States to study trends in off-label use of drugs, distinguishing between appropriate and inappropriate off-label use according to drug compendia, and estimated difference-in-difference regressions of the effect of state laws on off-label use.
AHRQ-funded; HS018535.
Citation: Smieliauskas F, Sharma H, Hurley C .
State insurance mandates and off-label use of chemotherapy.
Health Econ 2018 Jan;27(1):e55-e70. doi: 10.1002/hec.3537.
.
.
Keywords: Access to Care, Cancer, Treatments, Health Insurance, Medication
Adams AS, Madden JM, Zhang F
Effects of transitioning to Medicare Part D on access to drugs for medical conditions among dual enrollees with cancer.
This study evaluated the impact of transitioning from Medicaid to Medicare Part D drug coverage on the use of noncancer treatments among dual enrollees with cancer. Its findings suggest that the removal of drug caps under Part D had a modest impact on the treatment of hypercholesterolemia overall and may have reduced white-black gaps in the use of lipid-lowering and antidepressant therapies.
AHRQ-funded; HS018577.
Citation: Adams AS, Madden JM, Zhang F .
Effects of transitioning to Medicare Part D on access to drugs for medical conditions among dual enrollees with cancer.
Value Health 2017 Dec;20(10):1345-54. doi: 10.1016/j.jval.2017.05.023.
.
.
Keywords: Access to Care, Cancer, Medicare, Medication, Racial and Ethnic Minorities
Taira DA, Shen C, King M
Access to medications for Medicare enrollees related to race/ethnicity: results from the 2013 Medicare Current Beneficiary Survey.
Prescription medications are taken by millions of Americans to manage chronic conditions and treat acute conditions. These medications, however, are not equally accessible to all. The purpose of this study was to examine medication access by race/ethnicity among Medicare beneficiaries. The authors found that possible interventions for non-Hispanic blacks might include assisting them in finding the best drug plan to meeting their needs, connecting them to medication assistance programs, and discussing convenience of pharmacy with patients.
AHRQ-funded; HS023185.
Citation: Taira DA, Shen C, King M .
Access to medications for Medicare enrollees related to race/ethnicity: results from the 2013 Medicare Current Beneficiary Survey.
Res Social Adm Pharm 2017 Nov;13(6):1208-13. doi: 10.1016/j.sapharm.2016.10.021..
Keywords: Access to Care, Medicare, Medication, Racial and Ethnic Minorities, Social Determinants of Health