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 (12)
- Adverse Drug Events (ADE) (1)
- Asthma (1)
- Behavioral Health (8)
- Cancer: Breast Cancer (1)
- Care Management (1)
- Children's Health Insurance Program (CHIP) (3)
- Children/Adolescents (15)
- Clinician-Patient Communication (1)
- Community-Based Practice (4)
- Dental and Oral Health (2)
- Disparities (4)
- Elderly (1)
- Electronic Health Records (EHRs) (3)
- Emergency Department (3)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (1)
- Eye Disease and Health (1)
- Family Health and History (1)
- Healthcare Cost and Utilization Project (HCUP) (3)
- Healthcare Costs (12)
- Healthcare Delivery (1)
- Healthcare Utilization (12)
- Health Insurance (26)
- Health Services Research (HSR) (1)
- Health Status (3)
- Health Systems (1)
- Heart Disease and Health (1)
- Hospitalization (3)
- Hospital Readmissions (5)
- Hospitals (2)
- Human Immunodeficiency Virus (HIV) (6)
- Inpatient Care (2)
- Labor and Delivery (2)
- Low-Income (11)
- Maternal Care (2)
- (-) Medicaid (70)
- Medical Expenditure Panel Survey (MEPS) (3)
- Medicare (6)
- Medication (13)
- Newborns/Infants (3)
- Nutrition (1)
- Obesity (1)
- Opioids (2)
- Outcomes (3)
- Pain (1)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (1)
- Payment (4)
- Policy (16)
- Practice Patterns (2)
- Pregnancy (3)
- Prevention (3)
- Primary Care (3)
- Provider: Pharmacist (2)
- Provider Performance (1)
- Quality Indicators (QIs) (2)
- Quality Measures (1)
- Quality of Care (4)
- Racial and Ethnic Minorities (4)
- Risk (2)
- Sickle Cell Disease (1)
- Social Determinants of Health (4)
- Substance Abuse (3)
- Surgery (1)
- Tobacco Use (1)
- Uninsured (7)
- Vaccination (1)
- Vulnerable Populations (2)
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 70 Research Studies DisplayedHeintzman J, Marino M, Hoopes M
Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?
The researchers sought to validate electronic health record (EHR) insurance information for low-income pediatric patients at Oregon community health centers (CHCs), compared to reimbursement data and Medicaid coverage data. They concluded that EHR coverage data for children had a high overall correspondence with Medicaid data and reimbursement data, suggesting that in some systems EHR data could be utilized to promote insurance stability in their patients.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Hoopes M .
Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?
J Am Med Inform Assoc 2015 Jul;22(4):909-13. doi: 10.1093/jamia/ocv033..
Keywords: Electronic Health Records (EHRs), Health Insurance, Medicaid, Low-Income, Children/Adolescents
Woodworth L
A leak in the lifeboat: the effect of Medicaid managed care on the vitality of safety-net hospitals.
Woodworth estimated the impact of Medicaid managed care on safety-net hospitals by exploiting a Florida pilot program that required Medicaid recipients in five counties to enroll in managed care. The results suggested that this mandate led to a small reduction in safety-net hospitals' average ratio of payment-to-cost and that the effect on safety-net hospitals was disproportionate.
AHRQ-funded; HS022236.
Citation: Woodworth L .
A leak in the lifeboat: the effect of Medicaid managed care on the vitality of safety-net hospitals.
J Regul Econ 2016 Dec;50(3):251-70. doi: 10.1007/s11149-016-9312-8.
.
.
Keywords: Hospitals, Medicaid, Health Insurance
Lipton BJ, Wherry LR, Miller S
AHRQ Author: Lipton BJ, Decker S
Previous Medicaid expansion may have had lasting positive effects on oral health of non-Hispanic black children.
The researchers estimated the relationship between adult oral health and the extent of state public health insurance eligibility for pregnant women, infants, and children throughout childhood separately for non-Hispanic whites, non-Hispanic blacks, and Hispanics. They found that expanded Medicaid coverage geared toward pregnant women and children during their first year of life was linked to better oral health in adulthood among non-Hispanic blacks.
AHRQ-authored.
Citation: Lipton BJ, Wherry LR, Miller S .
Previous Medicaid expansion may have had lasting positive effects on oral health of non-Hispanic black children.
Health Aff 2016 Dec;35(12):2249-58. doi: 10.1377/hlthaff.2016.0865.
.
.
Keywords: Medicaid, Dental and Oral Health, Children/Adolescents, Disparities, Racial and Ethnic Minorities
. .
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.
.
.
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.
.
.
Keywords: Medicaid, Healthcare Costs, Primary Care, Healthcare Utilization
O'Malley JP, O'Keeffe-Rosetti M, Lowe RA
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
The authors sought to assess changes in emergency department, primary care, mental and behavioral health care, and specialist care visit rates among individuals gaining Medicaid over 24 months postinsurance gain and also to evaluate the association of previous insurance with utilization. They found that primary care visit rates in both newly and returning insured individuals significantly exceeded those of the continuously insured in months 4 through 12, but were not significantly elevated in the second year. In contrast, emergency department utilization rates were significantly higher in returning insured compared with newly or continuously insured individuals and remained elevated over time. New visits to primary and specialist care were higher among those who gained Medicaid compared with the continuously insured throughout the study period. They concluded that expansion evaluations should allow for rate stabilization.
AHRQ-funded; HS021522.
Citation: O'Malley JP, O'Keeffe-Rosetti M, Lowe RA .
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
Med Care 2016 Nov;54(11):984-91. doi: 10.1097/mlr.0000000000000600.
.
.
Keywords: Medicaid, Healthcare Delivery, Healthcare Utilization, Emergency Department, Emergency Medical Services (EMS)
Kirby JB, Vistnes JP
AHRQ Author: Kirby JB, Vistnes JP
Access to care improved for people who gained Medicaid or marketplace coverage in 2014.
Newly available longitudinal survey data show that people who lacked health insurance in 2013 and gained coverage through Medicaid or the Marketplaces in 2014 were far more likely to obtain a usual source of care and receive preventive care services than their counterparts who remained uninsured in 2014.
AHRQ-authored.
Citation: Kirby JB, Vistnes JP .
Access to care improved for people who gained Medicaid or marketplace coverage in 2014.
Health Aff 2016 Oct 1;35(10):1830-34. doi: 10.1377/hlthaff.2016.0716.
.
.
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Medicaid, Health Insurance
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.
.
.
Keywords: Healthcare Costs, Payment, Health Systems, Medicaid, Medicare
Sommers BD, Blendon RJ, Orav EJ
Changes in utilization and health among low-income adults after Medicaid expansion or expanded private insurance.
The researchers assessed changes in access to care, utilization, and self-reported health among low-income adults in 3 states taking alternative approaches to the ACA. They concluded that in the second year of expansion, Kentucky's Medicaid program and Arkansas's private option were associated with significant increases in outpatient utilization, preventive care, and improved health care quality; reductions in emergency department use; and improved self-reported health.
AHRQ-funded; HS021291.
Citation: Sommers BD, Blendon RJ, Orav EJ .
Changes in utilization and health among low-income adults after Medicaid expansion or expanded private insurance.
JAMA Intern Med 2016 Oct;176(10):1501-09. doi: 10.1001/jamainternmed.2016.4419.
.
.
Keywords: Healthcare Utilization, Low-Income, Health Insurance, Medicaid, Access to Care
Bailey SR, Hoopes MJ, Marino M
Effect of gaining insurance coverage on smoking cessation in community health centers: a cohort study.
This study aimed to determine if uninsured community health center (CHC) patients who gain Medicaid coverage experience greater primary care utilization, receive more cessation medication orders, and achieve higher quit rates, compared to continuously uninsured smokers. It found that newly insured patients had increased odds of quit smoking status over 24 months of follow-up than those who remained uninsured.
AHRQ-funded; HS021522; HS024270.
Citation: Bailey SR, Hoopes MJ, Marino M .
Effect of gaining insurance coverage on smoking cessation in community health centers: a cohort study.
J Gen Intern Med 2016 Oct;31(10):1198-205. doi: 10.1007/s11606-016-3781-4.
.
.
Keywords: Tobacco Use, Health Insurance, Community-Based Practice, Medicaid, Healthcare Utilization
Vistnes JP, Cohen JW
AHRQ Author: Vistnes JP, Cohen JW
Gaining coverage in 2014: new estimates of marketplace and Medicaid transitions.
The researchers used data from the Medical Expenditure Panel Survey-Household Component to examine coverage transitions for nonelderly US adults. They found that 71.5 percent of Marketplace enrollees in 2014 had some period of uninsurance before enrollment. In Medicaid expansion states, 17.4 percent of adults who were uninsured throughout 2013 gained Medicaid coverage in 2014, compared with only 5.6 percent in those states between 2012 and 2013.
AHRQ-authored.
Citation: Vistnes JP, Cohen JW .
Gaining coverage in 2014: new estimates of marketplace and Medicaid transitions.
Health Aff 2016 Oct 1;35(10):1825-29. doi: 10.1377/hlthaff.2016.0500.
.
.
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Medicaid, Uninsured, Policy
Sommers BD, Gourevitch R, Maylone B
Insurance churning rates for low-income adults under health reform: lower than expected but still harmful for many.
The researchers explored the frequency and implications of changes in insurance coverage over time (i.e., "churning,")through surveying low-income adults in Kentucky, which used a traditional expansion of Medicaid; Arkansas, which chose a "private option" expansion that enrolled beneficiaries in private Marketplace plans; and Texas, which opted not to expand. They found that churning was associated with disruptions in physician care and medication adherence, and increased emergency department use.
AHRQ-funded; HS021291.
Citation: Sommers BD, Gourevitch R, Maylone B .
Insurance churning rates for low-income adults under health reform: lower than expected but still harmful for many.
Health Aff 2016 Oct;35(10):1816-24. doi: 10.1377/hlthaff.2016.0455.
.
.
Keywords: Medicaid, Uninsured, Policy, Health Insurance
Doll JA, Hellkamp AS, Goyal A
Treatment, outcomes, and adherence to medication regimens among dual Medicare-Medicaid-eligible adults with myocardial infarction.
The purpose of the study was to examine the association of dual-eligible status with clinical outcomes and adherence to medication regimens among older adults after MI. The investigators found that compared with Medicare-only patients, older adults with dual Medicare-Medicaid eligibility presenting with MI had superior rates of medication adherence but higher rates of postdischarge readmission and adverse cardiovascular outcomes.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp AS, Goyal A .
Treatment, outcomes, and adherence to medication regimens among dual Medicare-Medicaid-eligible adults with myocardial infarction.
JAMA Cardiol 2016 Oct 1;1(7):787-94. doi: 10.1001/jamacardio.2016.2724..
Keywords: Elderly, Medicaid, Medicare, Medication, Heart Disease and Health, Outcomes, Patient Adherence/Compliance
Shah AY, LLanos K, Dougherty D
AHRQ Author: Dougherty D
State challenges to child health quality measure reporting and recommendations for improvement.
The authors sought to assess reporting barriers of the Children's Health Insurance Program (CHIP) and to identify potential opportunities for improvement. They found that low reporting states believed they had inadequate staffing and that data collection and extraction was too time-consuming. They concluded that possible solutions to improve reporting would include funding and staff support, refining the technical assistance provided, and creating venues for state-to-state interaction.
AHRQ-authored.
Citation: Shah AY, LLanos K, Dougherty D .
State challenges to child health quality measure reporting and recommendations for improvement.
Healthc 2016 Sep;4(3):217-24. doi: 10.1016/j.hjdsi.2016.03.001.
.
.
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Medicaid, Quality Indicators (QIs)
Burns ME, Huskamp HA, Smith JC
The effects of the transition from Medicaid to Medicare on health care use for adults with mental illness.
The researchers estimated the effect of dual coverage after Medicaid enrollment during the required waiting period among adults with serious mental illness on health care use, overall and related to mental health and substance use disorders. They found that after 12 months of dual coverage, the probability of outpatient care use increased in both states from 4 percent to 9 percent.
AHRQ-funded; HS018577.
Citation: Burns ME, Huskamp HA, Smith JC .
The effects of the transition from Medicaid to Medicare on health care use for adults with mental illness.
Med Care 2016 Sep;54(9):868-77. doi: 10.1097/mlr.0000000000000572.
.
.
Keywords: Behavioral Health, Medicaid, Medicare, Hospitalization, Healthcare Utilization
Rosenthal MB, Landrum MB, Robbins JA
Pay for performance in Medicaid: evidence from three natural experiments.
This study examined the impact of pay for performance in Medicaid on the quality and utilization of care. Primary outcomes of interest were Healthcare Effectiveness Data and Information Set (HEDIS)-like process measures of quality, utilization by service category, and ambulatory care-sensitive admissions and emergency department visits. Its findings were mixed, with no measurable quality improvements across the three states (Pennsylvania, Minnesota, Alabama), but reductions in hospital admissions in two programs.
AHRQ-funded.
Citation: Rosenthal MB, Landrum MB, Robbins JA .
Pay for performance in Medicaid: evidence from three natural experiments.
Health Serv Res 2016 Aug;51(4):1444-66. doi: 10.1111/1475-6773.12426.
.
.
Keywords: Medicaid, Payment, Provider Performance, Healthcare Utilization, Quality of Care, Hospitalization, Emergency Department
McManus KA, Rhodes A, Bailey S
Affordable Care Act qualified health plan coverage: association with improved HIV viral suppression for AIDS drug assistance program clients in a Medicaid nonexpansion state.
The objective of this study was to characterize the demographic and healthcare delivery factors associated with Virginia AIDS Drug Assistance Programs (ADAPs) clients' qualified health plan (QHP) enrollment and to assess the relationship between qualified health coverage and human immunodeficiency virus (HIV) viral suppression. It concluded that QHP coverage was associated with viral suppression, an essential outcome for individuals and for public health.
AHRQ-funded; HS024196.
Citation: McManus KA, Rhodes A, Bailey S .
Affordable Care Act qualified health plan coverage: association with improved HIV viral suppression for AIDS drug assistance program clients in a Medicaid nonexpansion state.
Clin Infect Dis 2016 Aug;63(3):396-403. doi: 10.1093/cid/ciw277.
.
.
Keywords: Health Insurance, Human Immunodeficiency Virus (HIV), Medicaid, Medication, Outcomes
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.
.
.
Keywords: Human Immunodeficiency Virus (HIV), Medicaid, Healthcare Costs
Berry SA, Fleishman JA, Yehia BR
AHRQ Author: Fleishman JA
Healthcare coverage for HIV provider visits before and after implementation of the Affordable Care Act.
The researchers compared HIV provider coverage pre (2011-2013) versus post (first half of 2014) ACA among a total of 28,374 persons living with HIV (PLWH) followed in 4 sites in Medicaid expansion states (CA, OR, MD), 4 in a state (NY) that expanded Medicaid in 2001, and 2 in non-expansion states (TX, FL). In expansion state sites, half of PLWH relying on Ryan White HIVAIDS Program(RWHAP)/Uncomp shifted to Medicaid, while in NY and non-expansion state sites, reliance on RWHAP/Uncomp remained constant.
AHRQ-authored.
Citation: Berry SA, Fleishman JA, Yehia BR .
Healthcare coverage for HIV provider visits before and after implementation of the Affordable Care Act.
Clin Infect Dis 2016 Aug 1;63(3):387-95. doi: 10.1093/cid/ciw278.
.
.
Keywords: Human Immunodeficiency Virus (HIV), Medicaid, Medicare, Health Insurance
Allaire BT, Raghavan R, Brown DS
Morbid obesity and use of second generation antipsychotics among adolescents in foster care: evidence from Medicaid.
The researchers examined the association between receiving a morbid obesity diagnosis and second generation antipsychotics (SGAs) prescriptions among adolescents in foster care. They found that the risk increases with age. Quetiapine and clozapine increased the risk of a morbid obesity diagnosis more than 2.5 times, and two or more psychotropic drugs (polypharmacy) increased the risk fivefold.
AHRQ-funded; HS020269.
Citation: Allaire BT, Raghavan R, Brown DS .
Morbid obesity and use of second generation antipsychotics among adolescents in foster care: evidence from Medicaid.
Child Youth Serv Rev 2016 Aug;67:27-31. doi: 10.1016/j.childyouth.2016.05.019.
.
.
Keywords: Medicaid, Obesity, Medication, Children/Adolescents, Risk
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.
.
.
Keywords: Healthcare Costs, Health Insurance, Policy, Health Status, Medicaid
Creedon TB, Cook BL
Access to mental health care increased but not for substance use, while disparities remain.
The researchers assessed whether early implementation of Affordable Care Act (ACA) Medicaid expansion and state health insurance exchanges increased access to mental health and substance use treatment among those in need and whether these changes differed by racial/ethnic group. They found that mental health treatment rates increased significantly but found no evidence of a reduction in the wide racial/ethnic disparities in mental health treatment that preceded ACA expansion from 2005 to 2013.
AHRQ-funded; HS021486.
Citation: Creedon TB, Cook BL .
Access to mental health care increased but not for substance use, while disparities remain.
Health Aff 2016 Jun;35(6):1017-21. doi: 10.1377/hlthaff.2016.0098.
.
.
Keywords: Access to Care, Disparities, Health Insurance, Policy, Medicaid, Behavioral Health, Substance Abuse
Sommers BD, Chua KP, Kenney GM
California's early coverage expansion under the Affordable Care Act: a county-level analysis.
The researchers assessed the coverage effects of California's 2011 Low-Income Health Program (LIHP), enacted as an "early expansion" under the Affordable Care Act (ACA), and to demonstrate the feasibility of using Census data to measure county-level coverage changes. They concluded that California's 2011 expansion produced significant increases in public coverage for low-income individuals, particularly Latinos.
AHRQ-funded; HS021291.
Citation: Sommers BD, Chua KP, Kenney GM .
California's early coverage expansion under the Affordable Care Act: a county-level analysis.
Health Serv Res 2016 Jun;51(3):825-45. doi: 10.1111/1475-6773.12397.
.
.
Keywords: Medicaid, Uninsured, Policy, Health Insurance, Racial and Ethnic Minorities
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.
.
.
Keywords: Children/Adolescents, Family Health and History, Medicaid, Uninsured, Vulnerable Populations
McManus KA, McGonigle KM, Engelhard CL
PPACA and low-income people living with HIV: 2014 qualified health plan enrollment in a Medicaid nonexpansion state.
This review examined qualified heallth plan enrollment of AIDS Drug Assistance Programs clients in Virginia, a Medicaid nonexpansion state, and explored some issues that affect people living with HIV in other Medicaid nonexpansion states. The authors recommend that as healthcare delivery models shift, the effects on patients and health outcomes achieved should be monitored, particularly for chronic diseases such as HIV.
AHRQ-funded; HS024196.
Citation: McManus KA, McGonigle KM, Engelhard CL .
PPACA and low-income people living with HIV: 2014 qualified health plan enrollment in a Medicaid nonexpansion state.
South Med J 2016 Jun;109(6):371-7. doi: 10.14423/smj.0000000000000469.
.
.
Keywords: Medicaid, Low-Income, Human Immunodeficiency Virus (HIV), Health Insurance, Policy