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 (1)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (1)
- Emergency Department (2)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (3)
- Healthcare Utilization (2)
- (-) Health Insurance (15)
- Health Services Research (HSR) (1)
- Health Status (1)
- Hospitalization (1)
- Intensive Care Unit (ICU) (1)
- Low-Income (5)
- Medicaid (6)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (1)
- Mortality (1)
- Payment (1)
- (-) Policy (15)
- Provider: Health Personnel (1)
- Surgery (1)
- Uninsured (3)
- Young Adults (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 15 of 15 Research Studies DisplayedHerring 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.
.
.
Keywords: Healthcare Costs, Health Insurance, Provider: Health Personnel, Policy, Policy
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.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Policy, Hospitalization
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.
.
.
Keywords: Policy, Health Insurance, Payment, Health Services Research (HSR)
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
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.
.
.
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
Sommers BD, Maylone B, Nguyen KH
The impact of state policies on ACA applications and enrollment among low-income adults in Arkansas, Kentucky, and Texas.
The researchers surveyed nearly 3,000 low-income adults in late 2014 to compare experiences in three states with markedly different policies: Kentucky, Arkansas, and Texas. They found that application rates, successful enrollment, and positive experiences with the ACA were highest in Kentucky, followed by Arkansas, with Texas performing worst. Limited awareness remains a critical barrier: Fewer than half of adults had heard some or a lot about the coverage expansions.
AHRQ-funded; HS021291.
Citation: Sommers BD, Maylone B, Nguyen KH .
The impact of state policies on ACA applications and enrollment among low-income adults in Arkansas, Kentucky, and Texas.
Health Aff 2015 Jun;34(6):1010-8. doi: 10.1377/hlthaff.2015.0215..
Keywords: Policy, Low-Income, Medicaid, Health Insurance
Pati S, Wong AT, Calixte RE
Medicaid and CHIP retention among children in 12 states.
The authors sought to determine reproducibility of public insurance retention rates for children using 3 different metrics at the state and county level. They found that all 3 metrics demonstrated reproducible estimates at the state level. Reproducibility of relative rankings for child health insurance retention of counties within states were sensitive to county child population size and the amount of variability in retention rates within the county and at the state level.
AHRQ-funded; HS020508.
Citation: Pati S, Wong AT, Calixte RE .
Medicaid and CHIP retention among children in 12 states.
Acad Pediatr 2015 May-Jun;15(3):249-57. doi: 10.1016/j.acap.2014.09.012.
.
.
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Policy, Medicaid
Hill SC
AHRQ Author: Hill SC
Medicaid expansion in opt-out states would produce consumer savings and less financial burden than exchange coverage.
This study simulated potential differences in out-of-pocket spending for uninsured adults gaining eligibility for Marketplace coverage (silver plan) because their states have not used the provisions of the Affordable Care Act to expand Medicaid. Compared with having a Marketplace silver plan, being able to take advantage to expanded Medicaid would reduce average out-of-pocket spending by more than 50 percent for these adults and their families.
AHRQ-authored.
Citation: Hill SC .
Medicaid expansion in opt-out states would produce consumer savings and less financial burden than exchange coverage.
Health Aff. 2015 Feb;34(2):340-9. doi: 10.1377/hlthaff.2014.1058..
Keywords: Healthcare Costs, Health Insurance, Policy, Low-Income, Medicaid, Uninsured
DeCamp M, Lehmann LS
Guiding choice--ethically influencing referrals in ACOs.
The authors believe that accountable care organizations can influence referrals in an ethical manner that simultaneously enhances choice and improves patient outcomes if they consider three basic issues: transparency, appropriate metrics, and the right incentives. In this paper, they discuss these three issues and how they might be accomplished ethically.
AHRQ-funded; HS023684.
Citation: DeCamp M, Lehmann LS .
Guiding choice--ethically influencing referrals in ACOs.
N Engl J Med 2015 Jan 15;372(3):205-7. doi: 10.1056/NEJMp1412083.
.
.
Keywords: Health Insurance, Policy
Lee J, Ding R, Zeger SL
Impact of subsidized health insurance coverage on emergency department utilization by low-income adults in Massachusetts.
The authors aimed to estimate the change in emergency department (ED) utilization per individual among a cohort who qualified for subsidized health insurance following the Massachusetts health care reform. They concluded that expanding subsidized health insurance did not uniformly change ED utilization for all newly insured low-income adults in Massachusetts.
AHRQ-funded; HS017957.
Citation: Lee J, Ding R, Zeger SL .
Impact of subsidized health insurance coverage on emergency department utilization by low-income adults in Massachusetts.
Med Care 2015 Jan;53(1):38-44. doi: 10.1097/mlr.0000000000000279.
.
.
Keywords: Emergency Department, Healthcare Utilization, Health Insurance, Policy, Low-Income
Epstein AM, Sommers BD, Kuznetsov Y
Low-income residents in three states view Medicaid as equal to or better than private coverage, support expansion.
The authors explored what low-income Americans think about Medicaid. They found that nearly 80 percent of their telephone survey sample favored Medicaid expansion, and approximately two-thirds of uninsured respondents said that they planned to apply for either Medicaid or subsidized private coverage in 2014. Most viewed having Medicaid as better than being uninsured and at least as good as private insurance in overall quality and affordability.
AHRQ-funded; HS021291.
Citation: Epstein AM, Sommers BD, Kuznetsov Y .
Low-income residents in three states view Medicaid as equal to or better than private coverage, support expansion.
Health Aff 2014 Nov;33(11):2041-7. doi: 10.1377/hlthaff.2014.0747.
.
.
Keywords: Health Insurance, Policy, Low-Income, Medicaid, Uninsured
Hernandez-Boussard T, Burns CS, Wang NE
The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
The authors tested the impact of the Affordable Care Act (ACA) on how young adults used ED services. They found that the largest relative decreases were found in women and blacks. This relative decrease in ED use implies a total reduction of more than 60,000 visits from young adults across three states in 2011.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, Burns CS, Wang NE .
The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
Health Aff 2014 Sep;33(9):1648-54. doi: 10.1377/hlthaff.2014.0103.
.
.
Keywords: Emergency Department, Health Insurance, Policy, Healthcare Cost and Utilization Project (HCUP), Young Adults
Hill SC, Abdus S, Hudson JL
AHRQ Author: Hill SC, Hudson JL, Selden TM
Adults in the income range for the Affordable Care Act's Medicaid expansion are healthier than pre-ACA enrollees.
The investigators used MEPS data to compare nondisabled adults enrolled in Medicaid prior to the ACA with two other groups: adults who were eligible for Medicaid but not enrolled in it, and adults who were in the income range for the ACA's Medicaid expansion and thus newly eligible for coverage. They found that both the newly eligible and those eligible before the ACA but not enrolled were healthier on several measures than pre-ACA enrollees. They concluded that by expanding Medicaid eligibility, states could provide coverage to millions of healthier adults as well as to millions who have chronic conditions and who need care.
AHRQ-authored.
Citation: Hill SC, Abdus S, Hudson JL .
Adults in the income range for the Affordable Care Act's Medicaid expansion are healthier than pre-ACA enrollees.
Health Aff 2014 Apr;33(4):691-9. doi: 10.1377/hlthaff.2013.0743.
.
.
Keywords: Health Insurance, Policy, Health Status, Low-Income, Medicaid, Medical Expenditure Panel Survey (MEPS)
Lyon SM, Wunsch H, Asch DA
Use of intensive care services and associated hospital mortality after Massachusetts healthcare reform.
This study examined the impact of increased insurance coverage on intensive care unit (ICU) usage and mortality in Massachusetts where health insurance reform had expanded coverage. It found that reform was not associated with either significant changes in ICU use or changed hospital mortality for ICU patients.
AHRQ-funded; HS020672
Citation: Lyon SM, Wunsch H, Asch DA .
Use of intensive care services and associated hospital mortality after Massachusetts healthcare reform.
Crit Care Med. 2014 Apr;42(4):763-70. doi: 10.1097/CCM.0000000000000044..
Keywords: Intensive Care Unit (ICU), Health Insurance, Healthcare Utilization, Mortality, Policy