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AHRQ Research Studies Date
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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 8 of 8 Research Studies DisplayedKeohane LM, Trivedi A, Mor V
States with medically needy pathways: differences in long-term and temporary Medicaid entry for low-income Medicare beneficiaries.
Between January 2009 and June 2010, states with medically needy pathways had a higher percentage of low-income beneficiaries join Medicaid than states without such programs. However, among new full Medicaid participants, living in a state with a medically needy pathway was associated with an increase in the probability of switching to partial Medicaid and an increase in the probability of exiting Medicaid within 12 months. Alternative strategies for protecting low-income Medicare beneficiaries' access to care could provide more stable coverage.
AHRQ-funded; HS023016.
Citation: Keohane LM, Trivedi A, Mor V .
States with medically needy pathways: differences in long-term and temporary Medicaid entry for low-income Medicare beneficiaries.
Med Care Res Rev 2019 Dec;76(6):711-35. doi: 10.1177/1077558717737152..
Keywords: Vulnerable Populations, Low-Income, Medicaid, Medicare, Policy
Fleming MD, Guo C, Knox M
Impact of social needs case management on use of medical and behavioral health services: secondary analysis of a randomized controlled trial.
This research letter describes a secondary analysis that was conducted of a randomized encouragement study that assigned Medicaid beneficiaries with high risk for acute care use to social needs case management or to be administratively observed in the control group from August 2017 through December 2018. These services connect patients to resources such as food assistance, housing, transportation, or income benefits in addition to facilitating access to health care and behavioral health services. The study group included adults 18 years or older, who are residents of Contra Costa County in California, and enrolled in full-scope Medicaid. The case management enrollees were assigned to a case manager who assessed their needs, created a patient-centered care plan, and provided ongoing support including community resource referrals, coordination with primary care providers, and collaboration on applications for public benefits. Case managers had diverse backgrounds and included public health nurses, social workers, substance misuse counselors, mental health clinicians, homeless service specialists, and community health workers. Case management was offered either in-person or by remote telephonic services for 1 year. About 40% (n = 8577) of enrolled patients used the services. There were 21,422 intervention group enrollments and 22,839 in the weighted control group. The intervention group had significantly higher rates of primary care visits compared with the control group. No differences were found between the treatment groups for specialty care visits, behavioral health visits, psychiatric emergency visits, or jail intakes.
AHRQ-funded; HS027648.
Citation: Fleming MD, Guo C, Knox M .
Impact of social needs case management on use of medical and behavioral health services: secondary analysis of a randomized controlled trial.
Ann Intern Med 2023 Aug; 176(8):1139-41. doi: 10.7326/m23-0876..
Keywords: Medicaid, Vulnerable Populations, Social Determinants of Health, Care Management, Care Coordination
Gordon SH, Sommers BD, Wilson I
The impact of Medicaid expansion on continuous enrollment: a two-state analysis.
Researchers assessed the impact of Medicaid expansion under the Affordable Care Act on continuity of Medicaid coverage among those enrolled prior to expansion. Comparing Colorado to Utah, they found that, following Medicaid expansion, enrollees in Colorado gained an additional 2 months of coverage over two years of follow-up and were 16 percentage points less likely to experience a coverage disruption in a given year relative to enrollees in Utah. They concluded that increasing Medicaid eligibility levels appeared to be an effective strategy with important implications for other states that are considering Medicaid expansion.
AHRQ-funded; HS025560.
Citation: Gordon SH, Sommers BD, Wilson I .
The impact of Medicaid expansion on continuous enrollment: a two-state analysis.
J Gen Intern Med 2019 Sep;34(9):1919-24. doi: 10.1007/s11606-019-05101-8..
Keywords: Medicaid, Health Insurance, Policy, Access to Care, Vulnerable Populations
Roberts ET, Hayley Welsh J, Donohue JM
Association of state policies with Medicaid disenrollment among low-income Medicare beneficiaries.
This study examined the role that state policies play in Medicaid disenrollment among low-income Medicare beneficiaries. Medicaid disenrollment among fee-for-service Medicare beneficiaries was examined for the period 2012-2016. During that period, 18.2% of beneficiaries disenrolled for reasons other than death. Disenrollment was 24% lower in states that automatically enrolled recipients of the Supplemental Security Income program in full Medicaid, 33% lower in states with more generous provider payment policies, and 37% lower in states with less restrictive asset limits for partial Medicaid.
AHRQ-funded; HS026727.
Citation: Roberts ET, Hayley Welsh J, Donohue JM .
Association of state policies with Medicaid disenrollment among low-income Medicare beneficiaries.
Health Aff 2019 Jul;38(7):1153-62. doi: 10.1377/hlthaff.2018.05165..
Keywords: Medicare, Medicaid, Low-Income, Policy, Vulnerable Populations
Anderson VR, Ouyang F, Tu W
Medicaid coverage and continuity for juvenile justice-involved youth.
This retrospective cohort study examined Medicaid coverage and continuity for youth with varying levels of justice system involvement and the impact of a policy change allowing Medicaid suspension, rather than termination. The study highlighted the importance of maximizing opportunities to keep youth enrolled, as gaps in coverage likely affect juveniles' access to physical, mental, and behavioral health care.
AHRQ-funded; HS022681.
Citation: Anderson VR, Ouyang F, Tu W .
Medicaid coverage and continuity for juvenile justice-involved youth.
J Correct Health Care 2019 Jan;25(1):45-54. doi: 10.1177/1078345818820043..
Keywords: Access to Care, Children/Adolescents, Medicaid, Policy, Vulnerable Populations
Raghavan R, Allaire BT, Brown DS
Medicaid disenrollment patterns among children coming into contact with child welfare agencies.
The authors examined retention of Medicaid coverage over time for children in the child welfare system. Using Medicaid claims files from 36 states, they found that half retained Medicaid coverage across 4 years of follow up, with most disenrollments happening in year 4. They recommend finding ways to promote entry of child welfare-involved children into health insurance coverage in order to assure services.
AHRQ-funded; HS020269.
Citation: Raghavan R, Allaire BT, Brown DS .
Medicaid disenrollment patterns among children coming into contact with child welfare agencies.
Matern Child Health J 2016 Jun;20(6):1280-7. doi: 10.1007/s10995-016-1929-9.
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Keywords: Children/Adolescents, Family Health and History, Medicaid, Uninsured, Vulnerable Populations
Fischer MA, Allen-Coleman C, Farrell SF
Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.
Because children, pregnant women and people with mental illness have generally been underrepresented in research discussions, comparative effectiveness rsearch (CER) questions for these groups may be understudied. To address this problem, AHRQ commissioned a team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, they developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide.
AHRQ-funded; 290200500161.
Citation: Fischer MA, Allen-Coleman C, Farrell SF .
Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.
J Comp Eff Res 2015 Sep;4(5):465-71. doi: 10.2217/cer.15.26.
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Keywords: Comparative Effectiveness, Medicaid, Research Methodologies, Shared Decision Making, Vulnerable Populations
Vanderwerker L, Akincigil A, Olfson M
Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.
The researchers investigated the extent to which clinical diagnoses of externalizing disorders explain higher rates of antipsychotic use by foster care youths. They found that foster care youths had higher rates of externalizing disorders than the comparison group and greater antipsychotic use. Foster care remained a significant predictor of antipsychotic use after control for demographic and diagnostic covariates.
AHRQ-funded; HS017918; HS019937; HS021112.
Citation: Vanderwerker L, Akincigil A, Olfson M .
Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.
Psychiatr Serv 2014 Oct;65(10):1281-4. doi: 10.1176/appi.ps.201300455.
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Keywords: Children/Adolescents, Medication, Medicaid, Vulnerable Populations, Behavioral Health