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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 50 Research Studies DisplayedChen SI, Wang Y, Dreyer R
Insurance and prehospital delay in patients </=55 years with acute myocardial infarction.
The authors assessed whether gender differences in health insurance help explain gender differences in delay in seeking care for patients with acute myocardial infarction (AMI) in the US and in Spain. They concluded that in the US, women were more likely than men to delay, although it was not explained by differences in insurance status. Further, the lack of gender differences in prehospital delays in Spain suggests that these differences may vary by health care system and culture.
AHRQ-funded; HS023000.
Citation: Chen SI, Wang Y, Dreyer R .
Insurance and prehospital delay in patients </=55 years with acute myocardial infarction.
Am J Cardiol 2015 Dec 15;116(12):1827-32. doi: 10.1016/j.amjcard.2015.09.018.
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Keywords: Healthcare Delivery, Emergency Medical Services (EMS), Health Insurance, Heart Disease and Health, Sex Factors
Herring B, Trish E
Explaining the growth in US health care spending using state-level variation in income, insurance, and provider market dynamics.
The authors estimated a regression model for state personal health care spending for 1991-2009, then used the results to produce state-level projections of health care spending for 2010-2013 and compared those average projected state values with actual national spending for 2010-2013. They found that at least 70% of the recent slowdown in health care spending can likely be explained by long-standing patterns.
AHRQ-funded; HS000046.
Citation: Herring B, Trish E .
Explaining the growth in US health care spending using state-level variation in income, insurance, and provider market dynamics.
Inquiry 2015 Dec 9;52. doi: 10.1177/0046958015618971.
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Keywords: Healthcare Costs, Health Insurance, Provider: Health Personnel, Policy, Policy
Decker SL, Lipton BJ
AHRQ Author: Decker SL
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
This article examines the effect of Medicaid adult dental coverage on use of dental care and dental health outcomes using state-level variation in dental coverage during 2000-2012. Its findings imply that dental coverage is associated with an increase in the likelihood of a recent dental visit, with the size of the effect increasing with Medicaid payment rates to dentists, and a reduction in the likelihood of untreated dental caries.
AHRQ-authored.
Citation: Decker SL, Lipton BJ .
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
J Health Econ 2015 Dec;44:212-25. doi: 10.1016/j.jhealeco.2015.08.009.
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Keywords: Access to Care, Dental and Oral Health, Health Insurance, Healthcare Utilization, Medicaid, Outcomes
Ellimoottil C, Miller S, Davis M
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
The researchers examined rates of elective surgery in previously insured individuals before and after Massachusetts health care reform. They observed no increase in the overall rate of selected discretionary inpatient surgeries in Massachusetts versus control states for the entire population , as well as among the white and low-income subgroups.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Davis M .
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
Surg Innov 2015 Dec;22(6):588-92. doi: 10.1177/1553350615573579.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Policy, Hospitalization
Jacobs PD, Banthin JS, Trachtman S
AHRQ Author: Jacobs PD
Insurer competition in federally run marketplaces is associated with lower premiums.
The researchers studied insurer participation and premiums during the first two years of the Marketplaces. They found that the addition of a single insurer in a county was associated with a 1.2 percent lower premium for the average silver plan and a 3.5 percent lower premium for the benchmark plan in the federally run Marketplaces.
AHRQ-authored.
Citation: Jacobs PD, Banthin JS, Trachtman S .
Insurer competition in federally run marketplaces is associated with lower premiums.
Health Aff 2015 Dec;34(12):2027-35. doi: 10.1377/hlthaff.2015.0548..
Keywords: Healthcare Costs, Health Insurance
Neprash HT, Wallace J, Chernew ME
Measuring prices in health care markets using commercial claims data.
The objective of this study was to compare methods of price measurement in health care markets. It concluded that market-level price measures reflecting broad sets of services are likely to rank markets similarly. Price indices relying on individual sentinel services may be more appropriate for examining specialty- or service-specific drivers of prices.
AHRQ-funded; HS000055.
Citation: Neprash HT, Wallace J, Chernew ME .
Measuring prices in health care markets using commercial claims data.
Health Serv Res 2015 Dec;50(6):2037-47. doi: 10.1111/1475-6773.12304..
Keywords: Data, Healthcare Costs, Health Insurance, Health Services Research (HSR)
Luft HS
Policy-oriented research on improved physician incentives for higher value health care.
Policy makers (both public and private) are seeking ways to improve the value delivered within our health care system. To inform such policy changes, this paper identifies areas in which little is known about the effects of specific incentives (FFS, salary, etc.) on the two components of value: resource use and quality. Specific suggestions are offered focusing on fundamental "building block" studies.
AHRQ-funded.
Citation: Luft HS .
Policy-oriented research on improved physician incentives for higher value health care.
Health Serv Res 2015 Dec;50 Suppl 2:2187-215. doi: 10.1111/1475-6773.12423.
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Keywords: Policy, Health Insurance, Payment, Health Services Research (HSR)
Vistnes J, Selden TM, Zawacki A
AHRQ Author: Vistnes J, Selden TM
Several factors responsible for the recent slowdown in premium growth in employer-sponsored insurance.
Researchers have been seeking to identify which factors behind the recent spending slowdown . This study found that the slowdown in premium growth that preceded the recession reflected declining growth rates in per policyholder premiums. For 2009-11, however, the dominant contributors to the slowdown were factors underlying declining employee enrollment: a sharp downturn in employment in 2009, followed by eroding offer and eligibility rates.
AHRQ-authored.
Citation: Vistnes J, Selden TM, Zawacki A .
Several factors responsible for the recent slowdown in premium growth in employer-sponsored insurance.
Health Aff 2015 Dec;34(12):2036-43. doi: 10.1377/hlthaff.2015.0436..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Costs, Health Insurance
Robinson JC, Brown TT, Whaley C
Association of reference payment for colonoscopy with consumer choices, insurer spending, and procedural complications.
The researchers ascertained the effect of reference payment on facility choice, insurer spending, consumer cost sharing, and procedural complications for colonoscopy. They concluded that Implementation of reference payment for colonoscopy was associated with reduced spending and no change in complications.
AHRQ-funded; HS022098.
Citation: Robinson JC, Brown TT, Whaley C .
Association of reference payment for colonoscopy with consumer choices, insurer spending, and procedural complications.
JAMA Intern Med 2015 Nov;175(11):1783-9. doi: 10.1001/jamainternmed.2015.4588..
Keywords: Colonoscopy, Healthcare Costs, Adverse Events, Health Insurance
Abdus S, Mistry KB, Selden TM
AHRQ Author: Mistry KB, Selden TM
Racial and ethnic disparities in services and the Patient Protection and Affordable Care Act.
The researchers examined pre-reform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). They found that minorities were disproportionately represented among those targeted by the coverage provisions of the ACA.
AHRQ-authored.
Citation: Abdus S, Mistry KB, Selden TM .
Racial and ethnic disparities in services and the Patient Protection and Affordable Care Act.
Am J Public Health 2015 Nov;105(Suppl 5):S668-75. doi: 10.2105/ajph.2015.302892..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Disparities, Racial and Ethnic Minorities, Access to Care
Ndumele CD, Sommers BD, Trivedi AN
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
Following the Affordable Care Act’s coverage expansion, many newly-insured older enrollees will lose Medicaid coverage on their 65th birthday and transition from Medicaid to Medicare as their primary insurer. This article discusses the transition in primary health insurance coverage that includes changes to benefits, patient cost-sharing, and provider reimbursement, which could have profound consequences on the use of health services and associated health outcomes for low-income seniors.
AHRQ-funded; HS021291.
Citation: Ndumele CD, Sommers BD, Trivedi AN .
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
J Gen Intern Med 2015 Nov;30(11):1704-6. doi: 10.1007/s11606-015-3328-0..
Keywords: Health Insurance, Medicare, Elderly, Low-Income
Garcia Mosqueira A, Hua LM, Sommers BD
Racial differences in awareness of the Affordable Care Act and application assistance among low-income adults in three Southern states.
The researchers explored potential factors related to racial/ethnic differences in ACA enrollment - awareness of the law and receipt of application assistance such as navigator services. Their results highlight the importance of ACA outreach efforts to increase awareness among low-income and less educated populations to close existing disparities in coverage.
AHRQ-funded; HS021291.
Citation: Garcia Mosqueira A, Hua LM, Sommers BD .
Racial differences in awareness of the Affordable Care Act and application assistance among low-income adults in three Southern states.
Inquiry 2015 Oct 8;52. doi: 10.1177/0046958015609607.
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Keywords: Disparities, Health Insurance, Low-Income, Medicaid, Racial and Ethnic Minorities
Golberstein E, Gonzales G, Sommers BD
California's early ACA expansion increased coverage and reduced out-of-pocket spending for the state's low-income population.
The researchers used data from the National Health Interview Survey to examine the impact of California’s Low Income Health Program. Their study demonstrates that the county-by-county rollout of expanded public insurance coverage in California significantly increased coverage, by 7 percentage points, and significantly reduced the likelihood of any family out-of-pocket medical spending in the previous year, by 10 percentage points, among low-income adults.
AHRQ-funded; HS021291.
Citation: Golberstein E, Gonzales G, Sommers BD .
California's early ACA expansion increased coverage and reduced out-of-pocket spending for the state's low-income population.
Health Aff 2015 Oct;34(10):1688-94. doi: 10.1377/hlthaff.2015.0290..
Keywords: Low-Income, Healthcare Costs, Health Insurance, Uninsured
Gray SH, Trudell EK, Emans SJ
Total direct medical expenses and characteristics of privately insured adolescents who incur high costs.
This study assessed health care expenditures for high-cost adolescents and described the patient characteristics associated with high medical costs. It concluded that total direct medical expenses for privately insured high-cost adolescents are associated with medical complexity, mental health conditions, and obesity. Cost reduction strategies in similar populations should be tailored to these cost drivers.
AHRQ-funded; HS023092.
Citation: Gray SH, Trudell EK, Emans SJ .
Total direct medical expenses and characteristics of privately insured adolescents who incur high costs.
JAMA Pediatr 2015 Oct;169(10):e152682. doi: 10.1001/jamapediatrics.2015.2682..
Keywords: Access to Care, Children/Adolescents, Healthcare Costs, Health Insurance
Portela M, Sommers BD
On the outskirts of national health reform: a comparative assessment of health insurance and access to care in Puerto Rico and the United States.
This article presents an overview of Puerto Rico’s health care system and a comparative analysis of coverage and access to care in Puerto Rico and the mainland United States. It found that uninsured rates were significantly lower in Puerto Rico;. Medicaid was far more common in Puerto Rico. Puerto Rican residents were more likely than those in the mainland United States to have a usual source of care and to have had a checkup within the past year.
AHRQ-funded; HS021291.
Citation: Portela M, Sommers BD .
On the outskirts of national health reform: a comparative assessment of health insurance and access to care in Puerto Rico and the United States.
Milbank Q 2015 Sep;93(3):584-608. doi: 10.1111/1468-0009.12138..
Keywords: Health Insurance, Access to Care, Policy, Medicaid, Uninsured
Davidoff AJ, Hill SC, Bernard D
AHRQ Author: Hill SC, Bernard D
The Affordable Care Act and expanded insurance eligibility among nonelderly adult cancer survivors.
The researchers examined potential improvements in access to insurance for cancer survivors through adult Medicaid expansions and premium tax credits in the new insurance marketplaces under the Affordable Care Act (ACA). They found that under the ACA, many of the uninsured and a larger proportion of survivors facing financial hardship will be eligible for Medicaid or premium tax credits in the Marketplaces.
AHRQ-authored.
Citation: Davidoff AJ, Hill SC, Bernard D .
The Affordable Care Act and expanded insurance eligibility among nonelderly adult cancer survivors.
J Natl Cancer Inst 2015 Sep;107(9):djv181. doi: 10.1093/jnci/djv181..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Medicaid
Rivera-Hernandez M, Galarraga O
Type of insurance and use of preventive health services among older adults in Mexico.
The main purpose of this study was to assess the differences between Seguro Popular (SP) and employer-based health insurance in the use of preventive services,. It found that SP enrollees were more likely to use screening tests for diabetes, cholesterol, hypertension, and cervical cancer than the uninsured; however, those in employment-based and private insurances had higher odds of using preventive care for most services.
AHRQ-funded; HS0000011.
Citation: Rivera-Hernandez M, Galarraga O .
Type of insurance and use of preventive health services among older adults in Mexico.
J Aging Health 2015 Sep;27(6):962-82. doi: 10.1177/0898264315569457..
Keywords: Health Insurance, Health Insurance, Prevention, Screening
Hudson JL, Abdus S
AHRQ Author: Hudson JL
Coverage and care consequences for families in which children have mixed eligibility for public insurance.
The researchers used data from the Medical Expenditure Panel Survey (MEPS) Household Component for 2001–12 to examine insurance coverage, access to care, and health care use for eligible children in families with mixed eligible siblings compared to those in families where all siblings were eligible for one program. They found that mixed eligibility has a significant dampening effect for eligible children.
AHRQ-authored
Citation: Hudson JL, Abdus S .
Coverage and care consequences for families in which children have mixed eligibility for public insurance.
Health Aff 2015 Aug;34(8):1340-8. doi: 10.1377/hlthaff.2015.0128..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Health Insurance, Access to Care, Healthcare Utilization
DeVoe JE, Crawford C, Angier H
The association between Medicaid coverage for children and parents persists: 2002-2010.
The researchers assessed the likelihood of children’s having public health insurance coverage and their parents’ maintenance, gain, or loss of public coverage. The study found that, despite differing eligibility requirements, strong associations persisted between coverage continuity for parents and children in Oregon’s public health insurance program.
AHRQ-funded; HS018569
Citation: DeVoe JE, Crawford C, Angier H .
The association between Medicaid coverage for children and parents persists: 2002-2010.
Matern Child Health J. 2015 Aug;19(8):1766-74. doi: 10.1007/s10995-015-1690-5..
Keywords: Medicaid, Children/Adolescents, Health Insurance
Jacobs PD, Buntin MB
AHRQ Author: Jacobs PD
Determinants of Medicare plan choices: are beneficiaries more influenced by premiums or benefits?
This study evaluated the sensitivity of Medicare beneficiaries to premiums and benefits when selecting healthcare plans after the introduction of Part D. It found that Medicare Advantage enrollees are relatively insensitive to premiums, but more responsive to reductions in medical cost sharing in their benefit packages.
AHRQ-authored.
Citation: Jacobs PD, Buntin MB .
Determinants of Medicare plan choices: are beneficiaries more influenced by premiums or benefits?
Am J Manag Care 2015 Jul;21(7):498-504..
Keywords: Medicare, Health Insurance, Healthcare Costs
Trish EE, Herring BJ
How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?
The authors examined the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006-2011 KFF/HRET Employer Health Benefits Survey. They found that premiums are higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration.
AHRQ-funded; HS000046.
Citation: Trish EE, Herring BJ .
How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?
J Health Econ 2015 Jul;42:104-14. doi: 10.1016/j.jhealeco.2015.03.009.
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Keywords: Health Insurance, Healthcare Costs, Payment, Health Insurance, Hospitals
Dusetzina SB, Ellis S, Freedman RA
How do payers respond to regulatory actions? The case of bevacizumab.
This study examined payer-specific trends in bevacizumab use after the FDA's regulatory actions in granting and revoking an approved indication for metastatic breast cancer. It concluded that although insurers varied in public statements regarding coverage intentions, bevacizumab use declined similarly among all payers, suggesting that provider decision making, rather than payer-specific coverage policies, drove reductions.
AHRQ-funded; HS0189960.
Citation: Dusetzina SB, Ellis S, Freedman RA .
How do payers respond to regulatory actions? The case of bevacizumab.
J Oncol Pract 2015 Jul;11(4):313-8. doi: 10.1200/jop.2015.004218.
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Keywords: Policy, Medication, Health Insurance, Policy
Herring B, Trish E
The distributional effects of the Affordable Care Act's Cadillac tax by worker income.
The authors discuss a provision of the ACA that will introduce a 40 percent excise tax on health benefits exceeding a $10,200 threshold for single coverage and a $27,500 threshold for family coverage, annually. They argue that the low-income workers receive a relatively smaller subsidy to offset a portion of the Cadillac tax while the high-income workers receive a relatively larger subsidy to offset a portion of the Cadillac tax. All this adds up to a regressive effect.
AHRQ-funded; HS000046.
Citation: Herring B, Trish E .
The distributional effects of the Affordable Care Act's Cadillac tax by worker income.
AMA J Ethics 2015 Jul;17(7):672-9. doi: 10.1001/journalofethics.2015.17.7.sect1-1507..
Keywords: Healthcare Costs, Health Insurance, Policy
Zuvekas SH
AHRQ Author: Zuvekas SH
The take-up of employer-sponsored insurance among Americans with mental disorders: Implications for health care reform.
This study used data from the 2004-2008 Medical Expenditure Panel Survey to examine differences in offers and take-up of employer-sponsored health insurance (ESI) coverage among adults aged 27-54 by mental health status. It found little difference in the take-up of offers of ESI coverage between those with and without mental disorders.
AHRQ-authored
Citation: Zuvekas SH .
The take-up of employer-sponsored insurance among Americans with mental disorders: Implications for health care reform.
J of Behav Health Serv and Res. 2015 Jul;42(3):279-91. doi: 10.1007/s11414-015-9459-6..
Keywords: Behavioral Health, Medical Expenditure Panel Survey (MEPS), Health Insurance
Shih YC, Smieliauskas F, Geynisman DM
Trends in the cost and use of targeted cancer therapies for the privately insured nonelderly: 2001 to 2011.
This study sought to define and identify drivers of trends in cost and use of targeted therapeutics among privately insured nonelderly patients with cancer receiving chemotherapy between 2001 and 2011. It found a large increase in the use of targeted intravenous anticancer medications and a gradual increase in targeted oral anticancer medications; targeted therapies accounted for 63 percent of all chemotherapy expenditures in 2011.
AHRQ-funded; HS018535; HS020263.
Citation: Shih YC, Smieliauskas F, Geynisman DM .
Trends in the cost and use of targeted cancer therapies for the privately insured nonelderly: 2001 to 2011.
J Clin Oncol 2015 Jul 1;33(19):2190-6. doi: 10.1200/jco.2014.58.2320..
Keywords: Healthcare Costs, Cancer, Health Insurance, Medication