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
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 7 of 7 Research Studies DisplayedGrove LR, Rao N, Domino ME
Are North Carolina clinicians delivering opioid use disorder treatment to Medicaid beneficiaries?
This study’s goal was to inform efforts to increase prescriptions of medications for opioid use disorder (MOUD) among Medicaid beneficiaries. A retrospective study of North Carolina licensed physicians, physician assistants, and nurse practitioners was conducted to estimate Medicaid participation prevalence among clinicians authorized to prescribe buprenorphine and to estimate the association between clinician characteristics and OUD care delivery to Medicaid beneficiaries. Outcomes looked for were indicators of any Medicaid professional claims and Medicaid claims data for buprenorphine and naltrexone. Licensure data from 2018 was merged with 2019 US Drug Enforcement Administration to identify clinicians who used the DEA waiver required to prescribe buprenorphine (n = 1714). Services by waivered clinicians to Medicare beneficiaries ranged from 67% of behavioral health clinicians to 82.9% of specialist physicians. Prevalence of prescribing buprenorphine to Medicaid beneficiaries ranged from 30.3% among specialist physicians to 51.6% among behavioral health clinicians.
AHRQ-funded; HS000032.
Citation: Grove LR, Rao N, Domino ME .
Are North Carolina clinicians delivering opioid use disorder treatment to Medicaid beneficiaries?
Addiction 2022 Nov;117(11):2855-63. doi: 10.1111/add.15854..
Keywords: Opioids, Substance Abuse, Behavioral Health, Vulnerable Populations, Medication, Access to Care, Medicaid
Newton H, Beetham T, Busch SH
Association of access to crisis intervention teams with county sociodemographic characteristics and state Medicaid policies and Its implications for a new mental health crisis lifeline.
This study’s objective was to assess county-level access to crisis intervention teams (CIS) for acute mental health issues in 2015 and 2020 and its association with area characteristics and state policies in 2020. This cross-sectional study included 10,430 facilities from the 2015 National Directory of Mental Health Treatment Facilities and 10,591 facilities from the 2020 National Directory of Mental Health Treatment Facilities, from 3142 US counties. Area measures included suicide, drug-related overdose mortality, rurality, and demographic characteristics. State-level policies included enactment of 5 Medicaid policies prior to 2020 and 2 recent policies intended to assist implementation of the 988 telephone lifeline. Most US residents (88%) lived in a county that had at least 1 facility offering CIT, although half of all US counties had no CIT facility. Counties without vs those with CIT access were less likely to be in states that expanded Medicare and in states that allow Medicaid to pay for short-term stays in psychiatric hospitals. Residents of counties without CIT access were more likely to be older (>55 years) and uninsured and were more likely to be rural.
AHRQ-funded; HS017589.
Citation: Newton H, Beetham T, Busch SH .
Association of access to crisis intervention teams with county sociodemographic characteristics and state Medicaid policies and Its implications for a new mental health crisis lifeline.
JAMA Netw Open 2022 Jul;5(7):e2224803. doi: 10.1001/jamanetworkopen.2022.24803..
Keywords: Medicaid, Behavioral Health, Access to Care, Policy
Meiselbach MK, Drake C, Saloner B
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
This study examined variation in access to in-network buprenorphine-prescribing primary care providers that can treat opioid use disorder among Medicaid managed care enrollees. Approximately 32.2% of Medicaid enrollees had fewer than one in-network network buprenorphine-prescribing primary care providers per 100,000 county residents. There was on average a greater number of in-network buprenorphine-prescribing primary care providers in states with higher compared with lower overdose death rates, but most enrollees lived in areas with a shortage of these providers. The authors found that a 25 percent higher network participation rate by prescribers compared with nonprescribers could improve the probability that enrollees see a prescriber by approximately 25 percent.
AHRQ-funded; HS000029.
Citation: Meiselbach MK, Drake C, Saloner B .
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
Health Aff 2022 Jun;41(6):901-10. doi: 10.1377/hlthaff.2021.01719..
Keywords: Medicaid, Primary Care, Access to Care, Medication, Care Management, Opioids, Substance Abuse, Behavioral Health
McBain RK, Cantor JH, Kofner A
Brief report: Medicaid expansion and growth in the workforce for autism spectrum disorder.
This study examined the role that state Medicaid expansion has played in utilization of child psychiatrists, board-certified behavioral analysts (BCBAs) and pediatricians for children with autism spectrum disorder (ASD). Health workforce data from HRSA was used to examine workforce growth from 2008-2017. State Medicaid expansion was associated with a 9% increase in BCBAs per 100,000 children one year after enactment, and a 5% increase in child psychiatrists, but no association with growth in pediatrician utilization.
AHRQ-funded; HS025750.
Citation: McBain RK, Cantor JH, Kofner A .
Brief report: Medicaid expansion and growth in the workforce for autism spectrum disorder.
J Autism Dev Disord 2022 Apr;52(4):1881-89. doi: 10.1007/s10803-021-05044-2..
Keywords: Children/Adolescents, Autism, Medicaid, Workforce, Behavioral Health
Sivaraman JC, Greene SB, Naumann RB
Association between medical diagnoses and suicide in a Medicaid beneficiary population, North Carolina 2014-2017.
This study investigated the impact of various medical diagnoses on firearm and nonfirearm suicide. The authors used a case-control design including 691 North Carolina Medicaid beneficiaries who died from suicide between 2014 and 2017 as cases. They selected 68,682 controls. They linked Medicaid claims to the North Carolina Violent Death Reporting System to ascertain suicide and means (firearm or nonfirearm). They matched cases and controls on number of months covered by Medicaid over the past 36 months They adjusted for sex, race, Supplemental Security Income state, the Charlson Comorbidity Index, and frequency of health care encounters. The case-control odds ratios for any mental health disorder were 4.2 for nonfirearm suicide and 2.2 for firearm suicide. Behavioral health diagnoses were more strongly associated with nonfirearm suicides than firearm suicides in men but not in women. There was a weaker association of mental health and substance use diagnoses with suicides in Blacks, although estimates were imprecise.
AHRQ-funded; HS000032.
Citation: Sivaraman JC, Greene SB, Naumann RB .
Association between medical diagnoses and suicide in a Medicaid beneficiary population, North Carolina 2014-2017.
Epidemiology 2022 Mar 1; 33(2):237-45. doi: 10.1097/ede.0000000000001439..
Keywords: Behavioral Health, Medicaid
Auty SG, Griffith KN
Medicaid expansion and drug overdose mortality during the COVID-19 pandemic in the United States.
This study examined trends in overdose mortality nationally and by state Medicaid expansion status from 2013 to 2020. Using data from the CDC’s WONDER database, findings showed that the increase in drug or opioid overdose deaths experienced during the first year of the COVID-19 pandemic was similar in states with and without Medicaid expansion.
AHRQ-funded; HS026395.
Citation: Auty SG, Griffith KN .
Medicaid expansion and drug overdose mortality during the COVID-19 pandemic in the United States.
Drug Alcohol Depend 2022 Mar 1;232:109340. doi: 10.1016/j.drugalcdep.2022.109340..
Keywords: COVID-19, Medicaid, Opioids, Substance Abuse, Behavioral Health, Mortality, Public Health
Caves Sivaraman JJ, Ranapurwala SI, Proescholdbell S
Suicide typologies among Medicaid beneficiaries, North Carolina 2014-2017.
Only ½ of suicide decedents are diagnosed with a mental health condition; population-based screening strategies are needed to help identify people who are at risk of suicide, and it may be necessary for providers to consider patient life circumstances that may place them at a higher risk. The purpose of this study was to identify suicide typologies among suicide decedents and describe the alignment between medical diagnoses and life circumstances. Decedent demographics, stressful life events, perceived and diagnosed/ health issues, suicidal behavior, and suicide method contributed to the typologies. In 2020 the researchers linked North Carolina Medicaid data with data from the North Carolina Violent Death reporting System (NC-VDRS) to analyze suicide decedents from 2014-2017, aged 25-54 years of age. Researchers analyzed 6 indicators of life circumstances from Medicaid claims and 12 indicators from the NC-VDRS and developed separate models for men and women. The study found that 88.3% of the suicide decedents were White, with a median age of 41 years, and more than 70% had experienced a health care visit in the 90 days prior to suicide. The study concluded that almost one-half of suicide decedents have a typology characterized by a low probability of diagnosis of mental health issues. The authors report that screenings for suicide could be improved by using improved indicators of lived experience and mental health.
AHRQ-funded; HS000032.
Citation: Caves Sivaraman JJ, Ranapurwala SI, Proescholdbell S .
Suicide typologies among Medicaid beneficiaries, North Carolina 2014-2017.
BMC Psychiatry 2022 Feb 10;22(1):104. doi: 10.1186/s12888-022-03741-5..
Keywords: Medicaid, Behavioral Health