National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (11)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (2)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Behavioral Health (3)
- Blood Pressure (1)
- Cancer (2)
- Cancer: Breast Cancer (2)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (1)
- Children's Health Insurance Program (CHIP) (2)
- Children/Adolescents (7)
- Chronic Conditions (1)
- Dental and Oral Health (1)
- Diabetes (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (4)
- Healthcare Delivery (1)
- Healthcare Utilization (6)
- Health Information Technology (HIT) (1)
- Health Insurance (17)
- Health Services Research (HSR) (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (2)
- Labor and Delivery (1)
- Long-Term Care (1)
- Low-Income (1)
- Maternal Care (1)
- (-) Medicaid (29)
- Medical Expenditure Panel Survey (MEPS) (3)
- Medicare (4)
- Medication (7)
- Newborns/Infants (1)
- Nursing Homes (1)
- Opioids (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (2)
- Payment (4)
- Policy (15)
- Practice Patterns (1)
- Pregnancy (2)
- Primary Care (3)
- Primary Care: Models of Care (1)
- Sexual Health (1)
- Sickle Cell Disease (1)
- Substance Abuse (4)
- Surgery (1)
- Tobacco Use (1)
- Tobacco Use: Smoking Cessation (1)
- Uninsured (5)
- Vulnerable Populations (1)
- Women (4)
- Young Adults (1)
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 25 of 29 Research Studies DisplayedHenke RM, Karaca Z, Gibson TB
Medicaid Accountable Care Organizations and childbirth outcomes.
This study examined the impact of Accountable Care Organizations (ACOs) to childbirth outcomes. States that use Medicaid ACOs were compared with states that had not adopted ACO. Using HCUP data, the relationship between Medicaid ACO adoption and neonatal and maternal outcomes, and cost per birth was examined. Medicaid ACO implementation was associated with a moderate reduction in hospital costs per birth and decreased cesarean section rates with results varying by state. There was no association with other birth outcomes, including infant inpatient mortality, low birthweight, neonatal intensive care unit utilization and severe maternal morbidity.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Henke RM, Karaca Z, Gibson TB .
Medicaid Accountable Care Organizations and childbirth outcomes.
Med Care Res Rev 2020 Dec;77(6):559-73. doi: 10.1177/1077558718823132..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Health Insurance, Healthcare Costs, Labor and Delivery, Pregnancy, Women, Outcomes
Konetzka RT, Jung DH, Gorges RJ
Outcomes of Medicaid home- and community-based long-term services relative to nursing home care among dual eligibles.
This study measured the outcomes of dual-eligible recipients of Medicaid home- and community-based long-term services (HCBS) compared to nursing home residents. The authors used the 2005 and 2012 Medicaid Analytic eXtract (MAX) database, a national compilation of Medicaid claims which merges Medicare claims to identify hospital admissions. A cohort of 1,312,498 older adults dually enrolled in Medicaid and Medicare and using long-term care was tracked. HCBS users were found to have 10 percent points higher annual rates of hospitalization than their nursing home counterparts when selection bias is addressed. The differences persisted across races, dementia status, and intensity of HCBS spending.
AHRQ-funded; HS000084.
Citation: Konetzka RT, Jung DH, Gorges RJ .
Outcomes of Medicaid home- and community-based long-term services relative to nursing home care among dual eligibles.
Health Serv Res 2020 Dec;55(6):973-82. doi: 10.1111/1475-6773.13573..
Keywords: Elderly, Long-Term Care, Nursing Homes, Medicaid, Medicare, Outcomes
Larson AE, Hoopes M, Angier H
Private/marketplace insurance in community health centers 5 years post-affordable care act in Medicaid expansion and non-expansion states.
This study compared differences in private/marketplace insurance in community health centers (CHCs) 5 years post-Affordable Care Act (ACA) in Medicaid expansion and non-expansion states. Electronic health record data from 702,663 patients in clinics across 20 states was used to explore trends in private/market insurance post-expansion and whether CHC patients retain private/marketplace insurance. The authors found that patients in non-expansion state CHCs relied more heavily on private/marketplace insurance than patients in expansive states and had increased visits from 2014 through 2018. There was a more pronounced seasonal variation in private/marketplace-insured visits too. A greater percentage of those who in non-expansion states did not retain private/marketplace insurance become uninsured, while those in expansion states gained other types of health insurance.
AHRQ-funded; HS024270.
Citation: Larson AE, Hoopes M, Angier H .
Private/marketplace insurance in community health centers 5 years post-affordable care act in Medicaid expansion and non-expansion states.
Prev Med 2020 Dec;141:106271. doi: 10.1016/j.ypmed.2020.106271..
Keywords: Medicaid, Health Insurance, Access to Care, Policy
Hudson JL, Moriya AS
AHRQ Author: Hudson JL
The role of marketplace policy on welcome mat effects for children eligible for Medicaid or the Children's Health Insurance Program.
This study examined the role of marketplace policy on “welcome mat” effects for children eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Data from the American Community Survey from 2013-2018 was used to estimate the relationship between Marketplace policy and increases in Medicaid/CHIP coverage among pre-ACA eligible children after the implementation of the Affordable Care Act (ACA). The sample included non-disabled citizen children ages 0-18 at 139-250% federal poverty level who were Medicaid/CHIP-eligible before and after implementation of the ACA. Marketplace policies and enrollment were compared in expansion states versus non-expansion states. Public coverage did increase more in states that empowered their Marketplace to enroll publicly-eligible applicants directly into Medicaid/CHIP. This was driven by enrollment policy, not by choice of state-based versus federal-based Marketplaces. Welcome mats were largest in expansion states and increases ranged from 9 to 13 percentage points in enrollment.
AHRQ-authored.
Citation: Hudson JL, Moriya AS .
The role of marketplace policy on welcome mat effects for children eligible for Medicaid or the Children's Health Insurance Program.
Inquiry 2020 Jan-Dec;57:46958020952920. doi: 10.1177/0046958020952920..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Medicaid, Health Insurance, Policy, Uninsured, Access to Care
Khouja T, Burgette JM, Donohue JM
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Researchers examined whether low-income children's use of preventive dental services is linked to variation in state Medicaid policies that affect parents' access to dental care in Medicaid. Using MEPS data along with Area Health Resources File and Medicaid adult dental coverage policies, they found no change in children's receipt of preventive dental care associated with Medicaid expansions in states that covered vs did not cover preventive dental services for adults. They concluded that factors other than parental access to dental benefits through Medicaid may be more salient determinants of preventive dental care use among low-income children.
AHRQ-funded; HS026727.
Citation: Khouja T, Burgette JM, Donohue JM .
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Health Serv Res 2020 Oct;55(5):642-50. doi: 10.1111/1475-6773.13324..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Dental and Oral Health, Medicaid, Health Insurance, Low-Income, Access to Care, Policy
Roberts ET, Nimgaonkar A, Aarons J
New evidence of state variation in Medicaid payment policies for dual Medicare-Medicaid enrollees.
The authors developed the first longitudinal database of state Medicaid policies for paying the cost sharing in Medicare Part B for services provided to dual Medicare-Medicaid enrollees (duals), and an index summarizing the impact of these policies on payments for physician office services. Information from 2004-2018 was consolidated from online Medicaid policy documents, state laws, and policy data reported to them by state Medicaid programs. The database showed that in 2018 42 states had policies to limit Medicaid payments of Medicare cost sharing when Medicaid’s fee schedule was lower than Medicare’s. This was an increase from 36 such states in 2004. In most states, combined Medicare and Medicare payments for evaluation and management services provided to duals averaged 78% of the Medicare allowed amount for these services.
AHRQ-funded; HS026727.
Citation: Roberts ET, Nimgaonkar A, Aarons J .
New evidence of state variation in Medicaid payment policies for dual Medicare-Medicaid enrollees.
Health Serv Res 2020 Oct;55(5):701-09. doi: 10.1111/1475-6773.13545..
Keywords: Medicaid, Medicare, Payment, Policy, Healthcare Costs, Health Insurance
Encinosa WE
AHRQ Author: Encinosa WE
Is it time for ACOs to start tackling the high costs of surgery?
This article discusses an article appearing in the same issue revisiting the impact of Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) on surgery expenditures. The author suggests that, in order to engage even more surgeons, it is likely that MSSP ACOs will have to work with surgeons in the various Medicare bundled payment programs for surgery. He concludes that the next stage is to examine how these different programs can work together to produce even more savings in surgical care.
AHRQ-authored.
Citation: Encinosa WE .
Is it time for ACOs to start tackling the high costs of surgery?
Am J Accountable Care 2020 Sep 15;8(3):26-27..
Keywords: Surgery, Healthcare Costs, Medicaid, Health Insurance, Payment
Cha P, Brindis CD
Early Affordable Care Act Medicaid: coverage effects for low- and moderate-income young adults.
This study examined the effects of early Medicaid expansions on low- and moderate-income young adults. They used the American Community Survey 2008-2013 to study three early expansion states: California, Connecticut and Minnesota. Results shows that Medicaid expansion reduced uninsurance in all three states and increased public insurance in California and Minnesota. Young men benefitted more than young women, who historically tend to be uninsured.
AHRQ-funded; HS022241.
Citation: Cha P, Brindis CD .
Early Affordable Care Act Medicaid: coverage effects for low- and moderate-income young adults.
J Adolesc Health 2020 Sep;67(3):425-31. doi: 10.1016/j.jadohealth.2020.05.029..
Keywords: Young Adults, Policy, Medicaid, Uninsured, Access to Care
Apathy NC, Everson J
High rates of partial participation in the first year of the merit-based incentive payment system.
This article discusses concerns over the implementation of the Merit-based Incentive Payment System (MIPS) for clinicians, which was authorized with the Medicare Access and CHIP Reauthorization Act of 2015. Data was analyzed from 2017, the first implementation year of MIPS. The authors found that although 90% of participating clinicians reported performance equal to or better than the lower performance threshold of 3 out of 100, almost half of clinicians did not participate in at least one of the three program categories. Even with the low participation rate, 74% of clinicians who only partially participated in the program received positive payment adjustments. The findings underline concerns that the design may have been too flexible to effectively incentivize clinicians to make incremental progress across all targeted aspects of the program (quality, advancing care information, and improvement activities).
AHRQ-funded; K12 HS026395.
Citation: Apathy NC, Everson J .
High rates of partial participation in the first year of the merit-based incentive payment system.
Health Aff 2020 Sep;39(9):1513-21. doi: 10.1377/hlthaff.2019.01648..
Keywords: Payment, Medicare, Medicaid, Children's Health Insurance Program (CHIP), Health Insurance
McClellan C, Maclean JC, Saloner B
AHRQ Author: McClellan C
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
This study provided the first population-level evidence on the effects of Medicaid health homes (HH) on behavioral health care service use. As of 2016, 16 states had adopted an HH for enrollees with serious mental illness and/or substance use disorder. Using data from the National Survey on Drug Use and Health, the authors found that HH adoption increased service use among enrollees and enrollee self-reported health improved post-HH.
AHRQ-authored.
Citation: McClellan C, Maclean JC, Saloner B .
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
Health Econ 2020 Sep;29(9):1086-97. doi: 10.1002/hec.4027..
Keywords: Behavioral Health, Medicaid, Substance Abuse, Primary Care: Models of Care, Primary Care, Ambulatory Care and Surgery, Patient-Centered Outcomes Research
Zuvekas SH, McClellan CB, Ali MM
AHRQ Author: Zuvekas SH, McClellan CB
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
AHRQ-authored.
Citation: Zuvekas SH, McClellan CB, Ali MM .
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
J Ment Health Policy Econ 2020 Sep 1;23(3):151-82..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Medicaid, Health Insurance, Access to Care, Healthcare Utilization, Policy, Uninsured
Akincigil A, Mackie TI, Cook S
Effectiveness of mandatory peer review to reduce antipsychotic prescriptions for Medicaid-insured children.
This retrospective observation study examined the effectiveness of mandatory peer review to reduce antipsychotic prescriptions for Medicaid-insured children. Data was analyzed from Medicaid Analytical eXtracts (MAX) with administrative claims from 2006-2011 in Washington State. Within two years of policy implementation, prescription prevalence decreased from 6.17 to 4.04 while the synthetic control group remained stable at 6.47. The results show the effectiveness of the peer review program.
AHRQ-funded; HS026001.
Citation: Akincigil A, Mackie TI, Cook S .
Effectiveness of mandatory peer review to reduce antipsychotic prescriptions for Medicaid-insured children.
Health Serv Res 2020 Aug;55(4):596-603. doi: 10.1111/1475-6773.13297..
Keywords: Children/Adolescents, Medication, Medicaid, Policy
Bucholz EM,, Schuster MA, Toomey SL
Trends in 30-day readmission for Medicaid and privately insured pediatric patients: 2010-2017.
This study examined trends in 30-day readmission rates for Medicaid and privately insured pediatric patients from 2010 to 2017. The HCUP Nationwide Readmissions Database was used to compare hospital-level risk-adjusted readmission rates. Higher readmission rates were found for Medicaid beneficiaires compared to privately insured pediatric patients during the time period.
AHRQ-funded; HS020513; HS025299.
Citation: Bucholz EM,, Schuster MA, Toomey SL .
Trends in 30-day readmission for Medicaid and privately insured pediatric patients: 2010-2017.
Pediatrics 2020 Aug;146(2). doi: 10.1542/peds.2020-0270..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospital Readmissions, Health Insurance, Medicaid, Hospitals
Myers CD, Gordon HG, Kim HM
Does group deliberation mobilize? The effect of public deliberation on willingness to participate in politics.
Proponents of public deliberation suggest that engaging in deliberation increases deliberators' subsequent participation in other forms of politics. In this paper, the authors evaluate this "deliberative participation hypothesis" using data drawn from a deliberative field experiment in which members of medically underserved communities in Michigan deliberated in small groups about the design of that state's Medicaid program.
AHRQ-funded; HS023566.
Citation: Myers CD, Gordon HG, Kim HM .
Does group deliberation mobilize? The effect of public deliberation on willingness to participate in politics.
Polit Behav 2020 Jun;42(2):557-80. doi: 10.1007/s11109-018-9507-z..
Keywords: Policy, Medicaid
Darney BG, Jacob RL, Hoopes M
Evaluation of Medicaid expansion under the Affordable Care Act and contraceptive care in US community health centers.
This study examined whether Medicaid expansion under the Affordable Care Act increased contraceptive use for women who are underserved in the US health care safety net. The authors used electronic health record (EHR) data from a clinical research network of community health centers across 24 states. The sample included all female patients ages 15 to 44 years at risk for pregnancy with an ambulatory care visit. The study compared receipt of contraception before (2013) vs immediately after (2014) and then in 2016 after a longer period of Medicaid expansion. The sample included 310,132 women from expansion states and 234,508 women from nonexpansion states. There was an associated increase in long-acting reversible contraceptive method prescriptions among women in the expansion states, with adolescents having the largest increase.
AHRQ-funded; HS025155.
Citation: Darney BG, Jacob RL, Hoopes M .
Evaluation of Medicaid expansion under the Affordable Care Act and contraceptive care in US community health centers.
JAMA Netw Open 2020 Jun;3(6):e206874. doi: 10.1001/jamanetworkopen.2020.6874..
Keywords: Medicaid, Women, Policy, Sexual Health
Taylor WM, Lu Y, Wang S
Long-term healthcare utilization by Medicaid enrolled children with neonatal abstinence syndrome.
The purpose of this study was to evaluate healthcare utilization in Medicaid enrolled children with neonatal abstinence syndrome (NAS) in the first 2 years of life. The investigators concluded that a diagnosis of NAS did not appear to be an independent predictor of increased healthcare utilization in the first 2 years of life. They indicated that their results differed from some other published studies.
AHRQ-funded; HS022941.
Citation: Taylor WM, Lu Y, Wang S .
Long-term healthcare utilization by Medicaid enrolled children with neonatal abstinence syndrome.
J Pediatr 2020 Jun;221:55-63.e6. doi: 10.1016/j.jpeds.2020.02.077..
Keywords: Children/Adolescents, Healthcare Utilization, Medicaid, Newborns/Infants, Substance Abuse
Maclean JC, Halpern MT, Hill SC
AHRQ Author: Hill SC
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
The purpose of this study was to quantify the effects of the Affordable Care Act Medicaid expansion on prescriptions for effective breast cancer hormonal therapies (tamoxifen and aromatase inhibitors) among Medicaid enrollees. Data from the Medicaid State Drug Utilization Database was used. Findings showed that Medicaid expansion may have had a meaningful impact on the ability of lower-income women to access effective hormonal therapies used to treat breast cancer.
AHRQ-authored.
Citation: Maclean JC, Halpern MT, Hill SC .
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
Health Serv Res 2020 Jun;55(3):399-410. doi: 10.1111/1475-6773.13289..
Keywords: Medicaid, Cancer: Breast Cancer, Cancer, Medication, Policy, Women, Healthcare Utilization, Access to Care, Health Insurance
Bailey SR, Marino M, Ezekiel-Herrera D
Tobacco cessation in Affordable Care Act Medicaid expansion states versus non-expansion states.
This study examined whether states that expanded Medicaid eligibility under the ACA had increased smoking quit rates, tobacco cessation medication orders, and greater health care utilization compared to patients in non-expansion states. The researchers used electronic health record (EHR) data from 219 community health centers (CHCs) in 10 states that expanded Medicaid as of January 2014. They identified patients aged 19-64 with tobacco use status in their records within six months prior to ACA Medicaid expansion and 1 or more visits. They found that patients in expansion states had increased adjusted odds of quitting, having a medication ordered and having follow-up visits compared to patients in non-expansion states.
AHRQ-funded; HS024270.
Citation: Bailey SR, Marino M, Ezekiel-Herrera D .
Tobacco cessation in Affordable Care Act Medicaid expansion states versus non-expansion states.
Nicotine Tob Res 2020 Jun;22(6):1016-22. doi: 10.1093/ntr/ntz087..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Substance Abuse, Medication, Medicaid, Policy, Healthcare Utilization, Access to Care, Health Insurance
Huguet N, Kaufmann J, O'Malley J
Using electronic health records in longitudinal studies: estimating patient attrition.
This study’s objective was to estimate overall and among adults with diabetes or hypertension: 1) patient attrition over a 3-year period at community health centers; and 2) the likelihood that patients with Medicaid switched their primary care source. Data was collected from the retrospective cohort study of 2012-2017 claims data Accelerating Data Value Across a National Community Health Center Network (ADVANCE) Clinical Data Research Network of community health centers. This study focused on Oregon Medicaid enrollees with a total of 232,891 patients aged 19-64 with a gap of 6 months or more following a claim for a visit billed to a primary care source. The authors theorized the reason was due to patients with Medicaid permanently changing their primary care source. They found that attrition over 3 years averaged 33.5% but patients with diabetes or hypertension was lower (25% or less). Among Medicaid patients the attrition rate 12% for community health center patients compared with 39% for single-provider practice patients.
AHRQ-funded; HS025962.
Citation: Huguet N, Kaufmann J, O'Malley J .
Using electronic health records in longitudinal studies: estimating patient attrition.
Med Care 2020 Jun;58(Suppl 1):S46-S52. doi: 10.1097/mlr.0000000000001298...
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Blood Pressure, Chronic Conditions, Primary Care, Medicaid
Samples H, Williams AR, Crystal S
Impact of long-term buprenorphine treatment on adverse health care outcomes In Medicaid.
The optimal, or even minimum, duration of medication treatment for opioid use disorder (OUD) needed to improve long-term outcomes has not been established empirically. As a result, health plans set potentially restrictive treatment standards to guide benefits and payment. To address this gap, the investigators used a National Quality Forum measure for OUD medication treatment duration (180 days) to examine the impact of longer treatment on health care outcomes within a key population of Medicaid enrollees.
AHRQ-funded; HS023258; HS021112.
Citation: Samples H, Williams AR, Crystal S .
Impact of long-term buprenorphine treatment on adverse health care outcomes In Medicaid.
Impact of long-term buprenorphine treatment on adverse health care outcomes In Medicaid..
Keywords: Medication, Substance Abuse, Opioids, Medicaid, Adverse Drug Events (ADE), Adverse Events, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Kayle M, Valle J, Paulukonis S
Impact of Medicaid expansion on access and healthcare among individuals with sickle cell disease.
The purpose of this study was to examine whether Medicaid expansion in California, increased Medicaid enrollment, increased hydroxyurea prescriptions filled, and decreased acute healthcare utilization in sickle cell disease (SCD). Findings showed that Medicaid expansion did not appear to have improved enrollment or acute healthcare utilization among individuals with SCD in California. Recommendations included future studies exploring whether individuals with SCD transitioned to other insurance plans or became uninsured post-expansion, the underlying reasons for low hydroxyurea utilization, and the lack of effect on hospital admissions despite a modest effect on emergency department visits.
AHRQ-funded; HS023011; HS025297.
Citation: Kayle M, Valle J, Paulukonis S .
Impact of Medicaid expansion on access and healthcare among individuals with sickle cell disease.
Pediatr Blood Cancer 2020 May;67(5):e28152. doi: 10.1002/pbc.28152..
Keywords: Sickle Cell Disease, Medicaid, Access to Care, Healthcare Utilization, Medication, Hospitalization, Health Insurance
Melnikow J, Evans E, Xing G
Primary care access to new patient appointments for California Medicaid enrollees: a simulated patient study.
Investigators evaluated variation in the availability of primary care new patient appointments for Medi-Cal (California Medicaid) enrollees in Northern California and its relationship to emergency department (ED) use after Medicaid expansion. Data from the California Health Interview Survey, Medi-Cal enrollment reports, and California hospital discharge records were used. The investigators found that access to primary care in Northern California was limited for new patient Medi-Cal enrollees and varied across counties, despite standard statewide reimbursement rates. Further, counties with more limited access to primary care new patient appointments had higher ED use by Medi-Cal enrollees.
AHRQ-funded; HS022236.
Citation: Melnikow J, Evans E, Xing G .
Primary care access to new patient appointments for California Medicaid enrollees: a simulated patient study.
Ann Fam Med 2020 May;18(3):210-17. doi: 10.1370/afm.2502..
Keywords: Primary Care, Access to Care, Medicaid, Health Insurance, Emergency Department, Healthcare Utilization
Tilhou AS, Huguet N, DeVoe J
The Affordable Care Act Medicaid Expansion positively impacted community health centers and their patients.
In this paper, the investigators summarized their results to-date as experts in investigating the impact of the Patient Protection and Affordable Care Act (ACA) Medicaid expansion on Community Health Centers (CHCs) and the patients they serve. They found the ACA Medicaid expansion increased access to care and preventive services, primarily in Medicaid expansion states. Rates of physical and mental health conditions rose substantially from pre- to post-ACA in expansion states, suggesting underdiagnosis pre-ACA.
AHRQ-funded; HS024270.
Citation: Tilhou AS, Huguet N, DeVoe J .
The Affordable Care Act Medicaid Expansion positively impacted community health centers and their patients.
J Gen Intern Med 2020 Apr;35(4):1292-95. doi: 10.1007/s11606-019-05571-w..
Keywords: Policy, Medicaid, Access to Care, Uninsured, Health Insurance
Takvorian SU, Oganisian A, Mamtani R
Association of Medicaid expansion under the Affordable Care Act with insurance status, cancer stage, and timely treatment among patients with breast, colon, and lung cancer.
The effect of the Patient Protection and Affordable Care Act's Medicaid expansion on cancer care delivery and outcomes is unknown. Patients with cancer are a high-risk group for whom treatment delays are particularly detrimental. The objective of this study was to examine the association between Medicaid expansion and changes in insurance status, stage at diagnosis, and timely treatment among patients with incident breast, colon, and non-small cell lung cancer.
AHRQ-funded; HS026116.
Citation: Takvorian SU, Oganisian A, Mamtani R .
Association of Medicaid expansion under the Affordable Care Act with insurance status, cancer stage, and timely treatment among patients with breast, colon, and lung cancer.
JAMA Netw Open 2020 Feb 5;3(2):e1921653. doi: 10.1001/jamanetworkopen.2019.21653.
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Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer, Health Insurance, Medicaid, Policy, Health Services Research (HSR)
Fischer MA, Mahesri M, Lii J
Non-Infection-related and non-visit-based antibiotic prescribing is common among Medicaid patients.
This study examined antibiotic prescribing by clinicians when there was no visit or without clear indications for use. The authors discuss the fact that current ambulatory antibiotic stewardship policies do not capture prescribing outside of clinician visits or clear indications for use. They measured the frequency for all filled antibiotic prescriptions in Medicaid patients in the period 2004-2013. They found that out of 298 million antibiotic fills for 53 million patients (62% for children), 55% were for clinician visits with an infection-related diagnosis, 17% were for visits without an infection-related diagnosis, and 28% were not associated with a visit.
AHRQ-funded; HS024930; HS023236; HS024651; HS026506; 2332015000201.
Citation: Fischer MA, Mahesri M, Lii J .
Non-Infection-related and non-visit-based antibiotic prescribing is common among Medicaid patients.
Health Aff 2020 Feb;39(2):280-88. doi: 10.1377/hlthaff.2019.00545..
Keywords: Antimicrobial Stewardship, Medicaid, Antibiotics, Medication, Practice Patterns, Children/Adolescents