National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Behavioral Health (1)
- Children/Adolescents (2)
- (-) Healthcare Costs (17)
- Healthcare Utilization (2)
- Health Insurance (6)
- Health Status (1)
- Health Systems (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Human Immunodeficiency Virus (HIV) (1)
- Inpatient Care (2)
- Low-Income (2)
- (-) Medicaid (17)
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- Medication (1)
- Nutrition (1)
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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 17 of 17 Research Studies DisplayedChen LM, Epstein AM, Orav EJ
Association of practice-level social and medical risk with performance in the Medicare physician value-based payment modifier program.
The objective of this cross-sectional observational study was to compare performance in the Physician Value-Based Payment Modifier (PVBM) Program by practice characteristics. The investigators found that during the first year of the Medicare Physician Value-Based Payment Modifier Program, physician practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs.
AHRQ-funded; HS024698.
Citation: Chen LM, Epstein AM, Orav EJ .
Association of practice-level social and medical risk with performance in the Medicare physician value-based payment modifier program.
JAMA 2017 Aug 1;318(5):453-61. doi: 10.1001/jama.2017.9643..
Keywords: Healthcare Costs, Medicaid, Medicare, Payment, Quality of Care
Ndumele CD, Schpero WL, Schlesinger MJ
Association between health plan exit from Medicaid managed care and quality of care, 2006-2014.
This study aimed to determine the frequency and interstate variation of health plan exit from Medicaid managed care and evaluate the relationship between health plan exit and market-level quality. It found that between 2006 and 2014, health plan exit from the US Medicaid program was frequent; however the exits were not associated with significant overall changes in quality or patient experience in the plans in the Medicaid market.
AHRQ-funded; HS017589; HS016978.
Citation: Ndumele CD, Schpero WL, Schlesinger MJ .
Association between health plan exit from Medicaid managed care and quality of care, 2006-2014.
JAMA 2017 Jun 27;317(24):2524-31. doi: 10.1001/jama.2017.7118.
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Keywords: Medicaid, Healthcare Costs, Health Insurance, Quality of Care
Frean M, Gruber J, Sommers BD
Premium subsidies, the mandate, and Medicaid expansion: coverage effects of the Affordable Care Act.
Using premium subsidies for private coverage, an individual mandate, and Medicaid expansion, the Affordable Care Act (ACA) has increased insurance coverage. Win this study, the investigators provide the first comprehensive assessment of these provisions' effects, using the 2012-2015 American Community Survey and a triple-difference estimation strategy that exploits variation by income, geography, and time.
AHRQ-funded; HS021291.
Citation: Frean M, Gruber J, Sommers BD .
Premium subsidies, the mandate, and Medicaid expansion: coverage effects of the Affordable Care Act.
J Health Econ 2017 May;53:72-86. doi: 10.1016/j.jhealeco.2017.02.004..
Keywords: Healthcare Costs, Health Insurance, Policy, Medicaid
Jacobs PD, Hill SC, Abdus S
AHRQ Author: Jacobs PD, Hill SC, Abdus S
Adults are more likely to become eligible for Medicaid during future recessions if their state expanded Medicaid.
The researchers simulated eligibility for Medicaid for the period 2005-14 in two scenarios: assuming that each state's eligibility rules in 2009, the year before passage of the Affordable Care Act (ACA), were in place during the entire study period; and assuming that the ACA's expanded eligibility rules were in place during the entire period for all states. Their simulations showed that the ACA expansion increased Medicaid's responsiveness to changes in unemployment.
AHRQ-authored.
Citation: Jacobs PD, Hill SC, Abdus S .
Adults are more likely to become eligible for Medicaid during future recessions if their state expanded Medicaid.
Health Aff 2017 Jan;36(1):32-39. doi: 10.1377/hlthaff.2016.1076.
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Keywords: Medicaid, Health Insurance, Policy, Healthcare Costs
DeLia D
Spending carveouts substantially improve the accuracy of performance measurement in shared savings arrangements: findings from simulation analysis of Medicaid ACOs.
This study uses data from New Jersey Medicaid accountable care organizations (ACOs) to examine how carving out uncontrollable components of spending affects the accuracy of performance measures in shared savings arrangements. It concluded that failure to carve out uncontrollable spending above $100,000 per person generates bias ranging from -5 to +5 percentage points and increases mean squared error by factors of 13 or more.
AHRQ-funded; HS023493.
Citation: DeLia D .
Spending carveouts substantially improve the accuracy of performance measurement in shared savings arrangements: findings from simulation analysis of Medicaid ACOs.
Inquiry 2017 Jan 1;54:46958017734047. doi: 10.1177/0046958017734047.
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Keywords: Healthcare Costs, Medicaid, Payment
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Why did the Affordable Care Act raise coverage?
This article discusses NBER Working Paper No. 22213 on Premium Subsidies, the Mandate,and Medicaid Expansion: Coverage Effects of the Affordable Care Act by researchers Molly Frean, Jonathan Gruber, and Benjamin Sommers. The study’s key result is that the ACA’s premium subsidies led to a 0.85 percentage point increase in coverage, while the expansion of Medicaid to newly eligible individuals led to a 0.44 point increase.
AHRQ-funded; HS021291.
Citation: . . .
Why did the Affordable Care Act raise coverage?
Natl Bur Econ Res Bull Aging Health 2016(2):3.
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Keywords: Medicaid, Health Insurance, Policy, Healthcare Costs
Nocon RS, Lee SM, Sharma R
AHRQ Author: Ngo-Metzger Q
Health care use and spending for medicaid enrollees in federally qualified health centers versus other primary care settings.
This study compared health care use and spending of Medicaid enrollees seen at federally qualified health centers versus non-health center settings in a context of significant growth. It found that health center patients had lower use and spending than did non-health center patients across all services, with 22 percent fewer visits and 33 percent lower spending on specialty.
AHRQ-authored.
Citation: Nocon RS, Lee SM, Sharma R .
Health care use and spending for medicaid enrollees in federally qualified health centers versus other primary care settings.
Am J Public Health 2016 Nov;106(11):1981-89. doi: 10.2105/ajph.2016.303341.
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Keywords: Medicaid, Healthcare Costs, Primary Care, Healthcare Utilization
Peiris D, Phipps-Taylor MC, Stachowski CA
ACOs holding commercial contracts are larger and more efficient than noncommercial ACOs.
The researchers examined differences between commercial accountable care organizations (ACOs) and noncommercial ACOs. They found that among all ACOs, there was low uptake of quality and efficiency activities; commercial ACOs reported more use of disease monitoring tools, patient satisfaction data, and quality improvement methods; and about two-thirds of the ACOs had established processes for distributing any savings accrued. They concluded that ACO delivery systems remain at a nascent stage.
AHRQ-funded; HS024075.
Citation: Peiris D, Phipps-Taylor MC, Stachowski CA .
ACOs holding commercial contracts are larger and more efficient than noncommercial ACOs.
Health Aff 2016 Oct;35(10):1849-56. doi: 10.1377/hlthaff.2016.0387.
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Keywords: Healthcare Costs, Payment, Health Systems, Medicaid, Medicare
Fleishman JA, Monroe AK, Voss CC
AHRQ Author: Fleishman JA
Expenditures for persons living with HIV enrolled in Medicaid, 2006-2010.
The researchers used Medicaid claims data to comprehensively assess payments for care for persons living with HIV between 2006 and 2010. They found that estimated Medicaid payment amounts are higher than some prior estimates. More complete capture of expensive inpatient hospitalizations in Medicaid data may partially explain this finding.
AHRQ-authored.
Citation: Fleishman JA, Monroe AK, Voss CC .
Expenditures for persons living with HIV enrolled in Medicaid, 2006-2010.
J Acquir Immune Defic Syndr 2016 Aug 1;72(4):408-15. doi: 10.1097/qai.0000000000000985.
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Keywords: Human Immunodeficiency Virus (HIV), Medicaid, Healthcare Costs
Jacobs PD, Duchovny N, Lipton BJ
AHRQ Author: Jacobs PD
Changes in health status and care use after ACA expansions among the insured and uninsured.
The authors investigated average health status and use of health care following the Affordable Care Act's insurance expansion provisions in 2014, finding that Medicaid enrollees and the uninsured were both healthier in 2014 than those respective groups were in 2013, but that those with individual private insurance coverage appeared less healthy as a group.
AHRQ-authored.
Citation: Jacobs PD, Duchovny N, Lipton BJ .
Changes in health status and care use after ACA expansions among the insured and uninsured.
Health Aff 2016 Jul;35(7):1184-8. doi: 10.1377/hlthaff.2015.1539.
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Keywords: Healthcare Costs, Health Insurance, Policy, Health Status, Medicaid
Sonik RA
Massachusetts inpatient Medicaid cost response to increased supplemental nutrition assistance program benefits.
This study investigated the impact of an increase in Supplemental Nutrition Assistance Program (SNAP) benefits on Medicaid costs and use in Massachusetts. It found that compared with the overall Medicaid population, cost growth for people with the selected chronic illnesses was significantly greater before the SNAP increase, as was the decline in growth afterward. Reduced hospital admissions after the SNAP increase drove the cost declines.
AHRQ-funded; HS000062.
Citation: Sonik RA .
Massachusetts inpatient Medicaid cost response to increased supplemental nutrition assistance program benefits.
Am J Public Health 2016 Mar;106(3):443-8. doi: 10.2105/ajph.2015.302990.
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Keywords: Medicaid, Nutrition, Healthcare Costs, Inpatient Care
Sommers BD, Blendon RJ, Orav EJ
Both the 'private option' and traditional Medicaid expansions improved access to care for low-income adults.
This study found that other than coverage type and trouble paying medical bills (which decreased more in Kentucky than in Arkansas), there were no significant differences between Kentucky's traditional Medicaid expansion and Arkansas's private option, which suggests that both approaches improved access among low-income adults.
AHRQ-funded; HS021291.
Citation: Sommers BD, Blendon RJ, Orav EJ .
Both the 'private option' and traditional Medicaid expansions improved access to care for low-income adults.
Health Aff 2016 Jan;35(1):96-105. doi: 10.1377/hlthaff.2015.0917.
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Keywords: Medicaid, Low-Income, Healthcare Costs, Access to Care, Policy
Gooptu A, Moriya AS, Simon KI
AHRQ Author: Moriya AS
Medicaid expansion did not result in significant employment changes or job reductions in 2014.
To view the impact of the Affordable Care Act (ACA) on current labor market participation, the researchers analyzed labor-market participation among adults with incomes below 138 percent of the federal poverty level, comparing Medicaid expansion and nonexpansion states and Medicaid-eligible and -ineligible groups, for the pre-ACA period (2005-13) and the first fifteen months of the expansion (January 2014-March 2015). Medicaid expansion did not result in significant changes in employment, job switching, or full- versus part-time status.
AHRQ-authored; AHRQ-funded; HS021291.
Citation: Gooptu A, Moriya AS, Simon KI .
Medicaid expansion did not result in significant employment changes or job reductions in 2014.
Health Aff 2016 Jan;35(1):111-8. doi: 10.1377/hlthaff.2015.0747.
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Keywords: Medicaid, Health Insurance, Healthcare Costs, Policy, Policy
Berry JG, Hall M, Neff J
Children with medical complexity and Medicaid: spending and cost savings.
The authors described the expenditures for children with medical complexity insured by Medicaid across the care continuum, reported the increasingly large amount of spending on hospital care for these children, and presented a business case that estimates how cost savings might be achieved from potential reductions in hospital and emergency department use and shows how the savings could underwrite investments in outpatient and community care. They concluded by discussing the importance of these findings in the context of Medicaid's quality of care and health care reform.
AHRQ-funded; HS023092.
Citation: Berry JG, Hall M, Neff J .
Children with medical complexity and Medicaid: spending and cost savings.
Health Aff 2014 Dec;33(12):2199-206. doi: 10.1377/hlthaff.2014.0828.
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Keywords: Children/Adolescents, Medicaid, Healthcare Costs, Inpatient Care, Quality of Care
Raghavan R, Brown DS, Allaire BT
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
The authors aimed to quantify the magnitude of Medicaid expenditures incurred in the purchase of psychotropic drugs for children with histories of abuse or neglect. They concluded that Medicaid agencies should focus their cost containment strategies on antidepressants and antimanic drugs, consider expanding primary care case management arrangements, and expand use of instruments such as the Child Behavior Checklist to identify and treat high-need children.
AHRQ-funded; HS020269.
Citation: Raghavan R, Brown DS, Allaire BT .
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
Psychiatr Serv 2014 Dec;65(12):1445-51. doi: 10.1176/appi.ps.201400028.
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Keywords: Children/Adolescents, Healthcare Costs, Medicaid, Medication, Behavioral Health
Trudnak T, Kelley D, Zerzan J
AHRQ Author: Jiang HJ
Medicaid admissions and readmissions: understanding the prevalence, payment, and most common diagnoses.
The authors characterized acute care hospital admissions and thirty-day readmissions in the Medicaid population through a retrospective analysis in nineteen states. They found that Medicaid readmissions were both prevalent and costly, and that they represented 12.5 percent of Medicaid payments for all hospitalizations, with the most prevalent diagnostic categories being mental and behavioral disorders and diagnoses related to pregnancy, childbirth, and their complications.
AHRQ-authored; AHRQ-funded; 29020090015C.
Citation: Trudnak T, Kelley D, Zerzan J .
Medicaid admissions and readmissions: understanding the prevalence, payment, and most common diagnoses.
Health Aff 2014 Aug;33(8):1337-44. doi: 10.1377/hlthaff.2013.0632.
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Keywords: Healthcare Costs, Hospitalization, Medicaid, Hospital Readmissions
Schwartz AL, Sommers BD
Moving for Medicaid? Recent eligibility expansions did not induce migration from other states.
This study used 26 measures of low value services to examine service use and associated spending detected by these measures in Medicaid. In the six categories of care measured, services detected by a limited number of measures of low-value care constituted modest proportions of overall spending (2.7 percent) but affected 42 percent of beneficiaries.
AHRQ-funded; HS00055; HS021291
Citation: Schwartz AL, Sommers BD .
Moving for Medicaid? Recent eligibility expansions did not induce migration from other states.
Health Aff. 2014 Jan;33(1):88-94. doi: 10.1377/hlthaff.2013.0910..
Keywords: Medicaid, Healthcare Costs, Low-Income, Healthcare Utilization