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 (2)
- Cancer (1)
- Cardiovascular Conditions (1)
- Community-Based Practice (1)
- Disparities (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (5)
- Healthcare Utilization (3)
- Health Insurance (14)
- Heart Disease and Health (1)
- Hospitals (2)
- Human Immunodeficiency Virus (HIV) (1)
- Low-Income (5)
- Medicaid (4)
- Medical Expenditure Panel Survey (MEPS) (5)
- Medicare (2)
- Medication (1)
- Payment (1)
- Policy (5)
- Prevention (1)
- Primary Care (1)
- Racial and Ethnic Minorities (1)
- Surgery (1)
- (-) Uninsured (20)
- 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 20 of 20 Research Studies DisplayedJacobs PD
AHRQ Author: Jacobs PD
Mandating health insurance coverage for high-income individuals.
In this study, the author describes the effect of the Affordable Care Act’s (ACA’s) individual mandate for health coverage by focusing on higher-income non-elderly adults and exploiting state differences in the rules governing premium setting and coverage issuance in the non-group market prior to 2014.
AHRQ-authored.
Citation: Jacobs PD .
Mandating health insurance coverage for high-income individuals.
National Tax Journal 2018 Dec;71(4):807-28. doi: 10.17310/ntj.2018.4.10..
Keywords: Health Insurance, Policy, Uninsured
Bradley CJ, Neumark D, Walker LS
The effect of primary care visits on other health care utilization: a randomized controlled trial of cash incentives offered to low income, uninsured adults in Virginia.
Investigators recruited low-income uninsured adults in Virginia to determine whether cash incentives would encourage primary care provider (PCP) visits as opposed to going to the hospital emergency room. This randomized, controlled trial determined that PCP visits did increase but no reductions in overall costs occurred there was an offset from increased outpatient utilization.
AHRQ-funded; HS022534.
Citation: Bradley CJ, Neumark D, Walker LS .
The effect of primary care visits on other health care utilization: a randomized controlled trial of cash incentives offered to low income, uninsured adults in Virginia.
J Health Econ 2018 Nov;62:121-33. doi: 10.1016/j.jhealeco.2018.07.006..
Keywords: Healthcare Utilization, Health Insurance, Low-Income, Primary Care, Uninsured, Vulnerable Populations
Keenan PS, Jacobs PD, Miller GE
AHRQ Author: Kennan PS, Jacobs PD, Miller GE
Despite coverage gains, one-third of people in small-firm low-income families were uninsured in 2014-15.
Using data from the Medical Expenditure Panel Survey, the investigators examined health insurance coverage for workers at small firms and the self-employed and found that the overall uninsurance rate for these workers and their families declined by 5 percentage points over the past decade, but one-third of those with lower incomes remained uninsured in 2014-15.
AHRQ-authored.
Citation: Keenan PS, Jacobs PD, Miller GE .
Despite coverage gains, one-third of people in small-firm low-income families were uninsured in 2014-15.
Health Aff 2018 Oct;37(10):1673-77. doi: 10.1377/hlthaff.2018.0479..
Keywords: Health Insurance, Low-Income, Medical Expenditure Panel Survey (MEPS), Uninsured
Berdahl TA, Moriya AS
AHRQ Author: Berdahl TA, Moriya AS
Difference in uninsurance rates between full- and part-time workers declined in 2014.
This study examined uninsurance rates between full and part time workers using data from 2010-2015. The authors found that uninsurance declined more for part-time workers, with pathways to coverage varying by state Medicaid expansion status.
AHRQ-authored.
Citation: Berdahl TA, Moriya AS .
Difference in uninsurance rates between full- and part-time workers declined in 2014.
Health Aff 2018 Oct;37(10):1669-72. doi: 10.1377/hlthaff.2018.0345.
.
.
Keywords: Health Insurance, Medicaid, Medical Expenditure Panel Survey (MEPS), Uninsured
Nguyen KH, Trivedi AN, Shireman TI
Lesbian, gay, and bisexual adults report continued problems affording care despite coverage gains.
This study’s investigators used data from three waves of the Behavioral Risk Factor Surveillance System to examine access to a personal doctor, affordability of care, type of health insurance coverage, and self-reported health in LGB adults in the period January 2014-February 2017 in thirty-one states that implemented the Affordable Care Act system's sexual orientation module.
AHRQ-funded; HS000011.
Citation: Nguyen KH, Trivedi AN, Shireman TI .
Lesbian, gay, and bisexual adults report continued problems affording care despite coverage gains.
Health Aff 2018 Aug;37(8):1306-12. doi: 10.1377/hlthaff.2018.0281.
.
.
Keywords: Access to Care, Healthcare Costs, Health Insurance, Uninsured, Vulnerable Populations
Decker SL, Moriya AS, Soni A
AHRQ Author: AHRQ authors - Decker and Moriya
Coverage for self-employed and others without employer offers increased after 2014.
This study examined how the Affordable Care Act might have differentially affected insurance coverage for self-employed workers, wage earners with and without offers of employer-sponsored insurance, and people not employed.
AHRQ-authored.
Citation: Decker SL, Moriya AS, Soni A .
Coverage for self-employed and others without employer offers increased after 2014.
Health Aff 2018 Aug;37(8):1238-42. doi: 10.1377/hlthaff.2017.1663..
Keywords: Health Insurance, Policy, Uninsured
Vistnes JP, Cohen JW
AHRQ Author: Vistnes JP, Cohen JW
Duration of uninsured spells for nonelderly adults declined after 2014.
Using MEPS data, the authors found that nonelderly respondents in 2014-15, following implementation of ACA coverage provisions, experienced shorter periods of being uninsured than did respondents in 2012-13 and 2013-14, especially for people with preexisting health conditions.
AHRQ-authored.
Citation: Vistnes JP, Cohen JW .
Duration of uninsured spells for nonelderly adults declined after 2014.
Health Aff 2018 Jun;37(6):951-55. doi: 10.1377/hlthaff.2017.1638.
.
.
Keywords: Health Insurance, Policy, Medical Expenditure Panel Survey (MEPS), Uninsured
Fingar KR, Coffey RM, Mulcahy AW
AHRQ Author: Andrews RM, Stocks C
Shifts in Medicaid and uninsured payer mix at safety-net and non-safety-net hospitals during the Great Recession.
The authors examined payer mix at safety-net hospitals (SNHs) and non-SNHs during a period covering the Great Recession using data from 38 states. The number of privately insured stays decreased at both SNHs and non-SNHs. Non-SNHs increasingly served Medicaid-enrolled and uninsured patients; in SNHs, the number of Medicaid stays decreased and uninsured stays remained stable.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Fingar KR, Coffey RM, Mulcahy AW .
Shifts in Medicaid and uninsured payer mix at safety-net and non-safety-net hospitals during the Great Recession.
J Healthc Manag 2018 May-Jun;63(3):156-72. doi: 10.1097/jhm-d-16-00024.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitals, Medicaid, Uninsured
Abdus S, Decker SL
AHRQ Author: Abdus S, Decker SL
The long-term uninsured were less likely than the short-term uninsured to gain insurance in 2014.
This study assessed the probability of having insurance in at least 1 month of 2014 for a sample of US citizens aged 19–63 who were uninsured in December 2013. It found that among those uninsured at the end of 2013, 2014 insurance take-up was lower the longer a person had been uninsured.
AHRQ-authored.
Citation: Abdus S, Decker SL .
The long-term uninsured were less likely than the short-term uninsured to gain insurance in 2014.
J Gen Intern Med 2018 May;33(5):593-95. doi: 10.1007/s11606-018-4365-2.
.
.
Keywords: Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS), Uninsured
Kirby JB, Cohen JW
AHRQ Author: Kirby JB, Cohen JW
Do people with health insurance coverage who live in areas with high uninsurance rates pay more for emergency department visits?
This study investigated the relationship between the percent uninsured in a county and expenditures associated with the typical emergency department visit. Among those with private insurance, it found that an increase of 1 percentage point in the county uninsurance rate is associated with a $20 increase in the mean emergency department payment. No such association was observed among visits covered by other insurance types.
AHRQ-authored.
Citation: Kirby JB, Cohen JW .
Do people with health insurance coverage who live in areas with high uninsurance rates pay more for emergency department visits?
Health Serv Res 2018 Apr;53(2):768-86. doi: 10.1111/1475-6773.12659.
.
.
Keywords: Emergency Department, Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS), Uninsured
Likosky DS, Sukul D, Seth M
Association between Medicaid expansion and cardiovascular interventions in Michigan.
This study evaluated Michigan’s Medicaid expansion as it relates to access and outcomes for 7,558 coronary artery bypass grafting operations at 33 hospitals and 45,183 percutaneous coronary interventions at 47 hospitals. Most of the change in access to revascularization occurred within the first quarter following expansion. Michigan’s Medicaid expansion was associated with changes in the demographic of those using specialty cardiovascular services (i.e., reduction in uninsured patients undergoing coronary rrevascularization).
AHRQ-funded; HS022535.
Citation: Likosky DS, Sukul D, Seth M .
Association between Medicaid expansion and cardiovascular interventions in Michigan.
J Am Coll Cardiol 2018 Mar 6;71(9):1050-51. doi: 10.1016/j.jacc.2017.12.044.
.
.
Keywords: Access to Care, Cardiovascular Conditions, Heart Disease and Health, Surgery, Uninsured
Soni A, Sabik LM, Simon K
Changes in insurance coverage among cancer patients under the Affordable Care Act.
Uninsurance among patients with newly diagnosed cancer fell by one-third in the ACA’s first year. Coverage gains were significant across numerous common cancers, multiple demographic groups, and early-stage and late-stage disease. Large gains among Hispanic individuals were consistent with findings of other ACA studies and may indicate narrowing disparities.
AHRQ-funded; HS021291.
Citation: Soni A, Sabik LM, Simon K .
Changes in insurance coverage among cancer patients under the Affordable Care Act.
JAMA Oncol 2018 Jan;4(1):122-24. doi: 10.1001/jamaoncol.2017.3176.
.
.
Keywords: Cancer, Health Insurance, Policy, Uninsured
Hsuan C, Horwitz JR, Ponce NA
Complying with the Emergency Medical Treatment and Labor Act (EMTALA): challenges and solutions.
EMTALA, which requires Medicare-participating hospitals to provide emergency care to patients regardless of their ability to pay, plays an important role in protecting the uninsured. Yet many hospitals do not comply. This study examines the reasons for noncompliance and proposes solutions. Respondents identified 5 main causes of noncompliance as well as suggesting methods to improve compliance.
AHRQ-funded; HS024247.
Citation: Hsuan C, Horwitz JR, Ponce NA .
Complying with the Emergency Medical Treatment and Labor Act (EMTALA): challenges and solutions.
J Healthc Risk Manag 2018 Jan;37(3):31-41. doi: 10.1002/jhrm.21288.
.
.
Keywords: Emergency Medical Services (EMS), Payment, Hospitals, Medicare, Uninsured
Vargas Bustamante A, Chen J
The great recession and health spending among uninsured U.S. immigrants: implications for the Affordable Care Act implementation.
This study of the association between the timing of the Great Recession (GR) and health spending among uninsured U.S. immigrants found that the probability of any spending diminished for recent immigrants compared to citizens during the GR. For those with any spending, recent immigrants reported 27 percent higher spending during the GR.
AHRQ-funded; HS022634
Citation: Vargas Bustamante A, Chen J .
The great recession and health spending among uninsured U.S. immigrants: implications for the Affordable Care Act implementation.
Health Serv Res. 2014 Dec;49(6):1900-24. doi: 10.1111/1475-6773.12193..
Keywords: Healthcare Costs, Uninsured, Disparities
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
Heintzman J, Marino M, Hoopes M
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
This study used EHR data to compare the preventive service utilization of uninsured patients receiving care at Oregon community health centers (CHCs) in 2008 through 2011 with that of continuously insured patients at the same CHCs in the same period. The results showed that CHCs provided many preventive services to uninsured patients, but that uninsured patients were less likely than continuously insured patients to receive 5 of 11 preventive services. The authors concluded that lack of insurance is a barrier to preventive service utilization, even in patients who can access care at a CHC.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Hoopes M .
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
Prev Med 2014 Oct;67:306-10. doi: 10.1016/j.ypmed.2014.08.006.
.
.
Keywords: Community-Based Practice, Electronic Health Records (EHRs), Healthcare Utilization, Prevention, Uninsured
Yehia BR, Fleishman JA, Agwu AL
AHRQ Author: Fleishman JA
Health insurance coverage for persons in HIV care, 2006-2012.
The authors examined trends in health insurance coverage at 11 US HIV clinics between 2006 and 2012. They found that Medicaid coverage was more prevalent among women than men; blacks and Hispanics than whites; and individuals with injection drug use risk compared with other transmission risk factors, with Hispanics and younger age groups more likely to be uninsured than other racial/ethnic and older age groups, respectively.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, Fleishman JA, Agwu AL .
Health insurance coverage for persons in HIV care, 2006-2012.
J Acquir Immune Defic Syndr 2014 Sep 1;67(1):102-6. doi: 10.1097/qai.0000000000000251.
.
.
Keywords: Health Insurance, Human Immunodeficiency Virus (HIV), Medicare, Racial and Ethnic Minorities, Uninsured
Crisp GD, Roberts AW, Esserman DA
The University of North Carolina's Health Care Pharmacy Assistance Program.
This study examined a program providing financial assistance to uninsured residents of North Carolina who need prescription medications. It found that from 2009 to 2011, the program served 7,180 patients in 81 counties. These patients received a mean of 23 prescriptions at an average cost of $754 per recipient per year.
AHRQ-funded; HS000032
Citation: Crisp GD, Roberts AW, Esserman DA .
The University of North Carolina's Health Care Pharmacy Assistance Program.
N C Med J. 2014 Sep-Oct;75(5):303-9..
Keywords: Healthcare Costs, Uninsured, Medication, Healthcare Utilization
Politi MC, Kaphingst KA, Kreuter M
Knowledge of health insurance terminology and details among the uninsured.
This study examined currently uninsured individuals’ understanding of terminology and details in health care plans in a series of interviews of a small mostly low-income and African American population. It found that the cost of the premium and having fixed costs through co-payments rather than coinsurance were very important so that individuals could budget as best as possible.
AHRQ-funded; HS020309.
Citation: Politi MC, Kaphingst KA, Kreuter M .
Knowledge of health insurance terminology and details among the uninsured.
Med Care Res Rev 2014 Feb;71(1):85-98. doi: 10.1177/1077558713505327..
Keywords: Uninsured, Low-Income, Health Insurance
Sommers BD, Kenney GM, Epstein AM
New evidence on the Affordable Care Act: coverage impacts of early Medicaid expansions.
Since 2010 California, Connecticut, Minnesota, and Washington, D.C., have taken advantage of the Affordable Care Act’s option to expand coverage earlier to a portion of low-income childless adults. The researchers present new data on these expansions focusing on several questions including the extent to which childless adults’ new enrollment in Medicaid result from extending coverage to uninsured people as opposed to replacing private coverage.
AHRQ-funded; HS021291.
Citation: Sommers BD, Kenney GM, Epstein AM .
New evidence on the Affordable Care Act: coverage impacts of early Medicaid expansions.
Health Aff 2014 Jan;33(1):78-87. doi: 10.1377/hlthaff.2013.1087..
Keywords: Low-Income, Uninsured, Medicaid, Health Insurance