National Healthcare Quality and Disparities Report
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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
26 to 50 of 98 Research Studies DisplayedGreenberg JK, Brown DS, Olsen MA
Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care.
This study's goal was to evaluate the impact of Medicaid expansion under the Affordable Care Act on the volume and payer mix of elective spine surgery in the United States. The authors evaluated elective spinal surgeries performed in the U.S. from 2011 to 2016 and included 10 states with expanded Medicaid access and 4 states that did not. They identified 218,648 surgical procedures performed in 10 Medicaid expansion states and 118,693 procedures performed in 4 nonexpansion states. Medicaid expansion was associated with a 17% increase in mean hospital spine surgical volume and a 23% increase in Medicaid volume. Privately insured surgical volumes did not change significantly. This increase indicated improved access to care.
AHRQ-funded; HS027075.
Citation: Greenberg JK, Brown DS, Olsen MA .
Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care.
J Neurosurg Spine 2022 Feb;36(2):336–44. doi: 10.3171/2021.3.Spine2122..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Access to Care, Surgery
Gordon SH, Hoagland A, Admon LK
Extended postpartum Medicaid eligibility is associated with improved continuity of coverage in the postpartum year.
The purpose of this study was to explore whether states that adopt the American Rescue Plan Act 0f 2021 option to provide eligibility for pregnancy-related benefits for a full year after birth are likely to improve continuity of postpartum insurance coverage. The researchers utilized linked birth records, income, and all-payer claims data for Medicaid-paid births in Colorado during the period 2014-19. Continuity of coverage during one year postpartum among people eligible for low-income adult Medicaid as compared with those ineligible for Medicaid. The study found that retention of Medicaid coverage as a low-income adult was associated with 1.5 additional months of postpartum insurance enrollment and a 12-percentage-point increase in the probability of continuous insurance coverage during the first year after birth. The study concluded that states adopting the American Rescue Plan Act’s option to extend pregnancy-related benefits for a year after birth are likely to increase continuity of postpartum insurance coverage.
AHRQ-funded; HS027640.
Citation: Gordon SH, Hoagland A, Admon LK .
Extended postpartum Medicaid eligibility is associated with improved continuity of coverage in the postpartum year.
Health Aff 2022 Jan;41(1):69-78. doi: 10.1377/hlthaff.2021.00730..
Keywords: Maternal Care, Medicaid, Women, Pregnancy, Access to Care, Policy
Steenland MW, Wilson IB, Matteson KA
Association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities.
This study’s objective was to measure the association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities. A total of 60,990 childbirths were reviewed from January 1, 2014 on with a total of 72.3% paid for by Medicaid and 27.7% paid for by a commercial payer. The mean age of the birthing person was 27; with 67% White, 22% Black, and 7% Hispanic. Medicaid expansion in Arkansas was associated with a 27.8 percentage point increase in continuous insurance coverage and an increase in outpatient visits of 0.9 during the first 6 months postpartum, representing relative increases of 54.9% and 75.0%, respectively. Racial disparities in postpartum coverage decreased from 6.3 percentage points before expansion to -2.0 after. However, disparities in outpatient care after expansion persisted between Black and White individuals.
AHRQ-funded; HS027464.
Citation: Steenland MW, Wilson IB, Matteson KA .
Association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities.
JAMA Health Forum 2021 Dec;2(12):e214167. doi: 10.1001/jamahealthforum.2021.4167..
Keywords: Medicaid, Maternal Care, Pregnancy, Racial and Ethnic Minorities, Disparities, Policy, Women, Access to Care
Lipton BJ, Finlayson TL
AHRQ Author: Decker SL
The association between Medicaid adult dental coverage and children's oral health.
This study examined the association of Medicaid adult dental coverage and children’s oral health as Medicaid-eligible children are more likely to experience tooth decay than children in higher-income families. Data from the 1996-2016 National Health and Nutrition Examination Survey and the 2003, 2007, and 2011-12 waves of the National Survey of Children’s Health was used. Adult dental coverage was associated with a 5-percentage-point reduction in the prevalence of untreated caries among children after Medicaid-enrolled adults had access to dental coverage for at least one year. Children under twelve years of age were the most affected.
AHRQ-authored.
Citation: Lipton BJ, Finlayson TL .
The association between Medicaid adult dental coverage and children's oral health.
Health Aff 2021 Nov;40(11):1731-39. doi: 10.1377/hlthaff.2021.01135..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Health Insurance, Access to Care
Lewis VA, Spivack S, Murray GF
FQHC designation and safety net patient revenue associated with primary care practice capabilities for access and quality.
Researchers assessed capabilities around access to and quality of care among primary care practices serving a high share of Medicaid and uninsured patients compared to practices serving a low share of these patients. Data from the National Survey of Healthcare Organizations and Systems was analyzed. They found that federally qualified health centers were more likely than other types of primary care practices (both safety net practices and other practices) to possess capabilities related to access and quality. However, safety net practices were less likely than non-safety net practices to possess health information technology capabilities.
AHRQ-funded; HS024075.
Citation: Lewis VA, Spivack S, Murray GF .
FQHC designation and safety net patient revenue associated with primary care practice capabilities for access and quality.
J Gen Intern Med 2021 Oct;36(10):2922-28. doi: 10.1007/s11606-021-06746-0..
Keywords: Vulnerable Populations, Primary Care, Access to Care, Uninsured, Medicaid, Quality of Care
Roberts ET, Desai SM
Does Medicaid coverage of Medicare cost sharing affect physician care for dual-eligible Medicare beneficiaries?
The objective of this paper was to assess changes in physicians' provision of care to duals (low-income individuals with Medicare and Medicaid) in response to a policy that required Medicaid to fully pay Medicare's cost sharing for office visits with these patients. This policy-a provision of the Affordable Care Act-effectively increased payments for office visits with duals by 0%-20%, depending on the state, in 2013 and 2014.
AHRQ-funded; HS026727; HS026980.
Citation: Roberts ET, Desai SM .
Does Medicaid coverage of Medicare cost sharing affect physician care for dual-eligible Medicare beneficiaries?
Health Serv Res 2021 Jun;56(3):528-39. doi: 10.1111/1475-6773.13650..
Keywords: Medicare, Medicaid, Health Insurance, Access to Care, Healthcare Costs, Low-Income
Chow JY, Nijhawan AE, Mathews WC
Hospitalization rates among persons with HIV who gained Medicaid or private insurance after the Affordable Care Act in 2014.
The purpose of this study was to investigate whether gaining inpatient healthcare coverage had an effect on hospitalization rates among persons with HIV following implementation of the Affordable Care Act in 2014. Hospitalization data from 2015 were obtained on adults receiving longitudinal care at HIV clinics; all patients were previously uninsured and supported by the Ryan White HIV/AIDS Program (RWHAP) in 2013. Findings showed that acquiring inpatient coverage was not associated with a change in hospitalization rates.
AHRQ-funded; 290201100007C.
Citation: Chow JY, Nijhawan AE, Mathews WC .
Hospitalization rates among persons with HIV who gained Medicaid or private insurance after the Affordable Care Act in 2014.
J Acquir Immune Defic Syndr 2021 Jun 1;87(2):776-80. doi: 10.1097/qai.0000000000002645..
Keywords: Human Immunodeficiency Virus (HIV), Hospitalization, Medicaid, Health Insurance, Access to Care, Policy
Fung V, McCarthy S, Price M
Payment discrepancies and access to primary care physicians for dual-eligible Medicare-Medicaid beneficiaries.
This study examined whether the Affordable Care Act (ACA) primary care fee bump for dual-eligible Medicare-Medicaid beneficiaries impacted primary care physicians (PCP) acceptance of duals. The authors assessed differences in the likelihood that PCPs had dual caseloads of ≥10% or 20% in states with lower versus full dual reimbursement using linear probability models adjusted for physician and area-level traits. The proportion of PCPs with dual caseloads of ≥10% or 20% decreased significantly between 2012 and 2017. The fee bump was not consistently associated with increases in dual caseloads.
AHRQ-funded; HS024725.
Citation: Fung V, McCarthy S, Price M .
Payment discrepancies and access to primary care physicians for dual-eligible Medicare-Medicaid beneficiaries.
Med Care 2021 Jun;59(6):487-94. doi: 10.1097/mlr.0000000000001525..
Keywords: Primary Care, Medicaid, Medicare, Health Insurance, Payment, Access to Care
Dy CJ, Salter A, Barker A
Increased utilization of total joint arthroplasty after Medicaid expansion.
This study examined prior analyses that greater utilization of total hip arthroplasty (THA) and total knee arthroplasty (TKA) was to be expected after Medicaid expansion in 2014. Using 2012-2015 data from the HCUP Database, 9 expansion states (Arkansas, Arizona, Colorado, Iowa, Massachusetts, Maryland, Nevada, New York, and Vermont) were compared to 2 states that did not expand Medicaid (Florida and Missouri). After adjusting for community characteristics, THA and TKA increased 15% in 2014 and 23% in 2015 within expansion states compared to 2013. In non-expansion states, compared to 2013, there were significant decreases of 18% in 2014 and 11% in 2015.
AHRQ-funded; HS019455.
Citation: Dy CJ, Salter A, Barker A .
Increased utilization of total joint arthroplasty after Medicaid expansion.
J Bone Joint Surg Am 2021 Mar 17;103(6):524-31. doi: 10.2106/jbjs.20.00303..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Orthopedics, Surgery, Healthcare Utilization, Access to Care
Herrick CJ, Keller MR, Trolard AM
Factors associated with postpartum diabetes screening in women with gestational diabetes and Medicaid during pregnancy.
This study’s goal was to understand the factors associated with the receipt of postpartum diabetes screening for women with gestational diabetes in a state without Medicaid expansion. Findings showed that prenatal certified diabetes education and access to public transportation were associated with increased screening, the total number of prenatal visits, the use of diabetes medication during pregnancy, and a pregnancy-specific comorbidity index that incorporated age.
AHRQ-funded; HS019455.
Citation: Herrick CJ, Keller MR, Trolard AM .
Factors associated with postpartum diabetes screening in women with gestational diabetes and Medicaid during pregnancy.
Am J Prev Med 2021 Feb;60(2):222-31. doi: 10.1016/j.amepre.2020.08.028..
Keywords: Diabetes, Screening, Maternal Care, Pregnancy, Women, Medicaid, Access to Care
Hill SC, Abdus S
AHRQ Author: Hill SC Abdus S
The effects of Medicaid on access to care and adherence to recommended preventive services.
Using MEPS data, the authors sought to quantify the impact of Medicaid enrollment on access to care and adherence to recommended preventive services. They found that Medicaid enrollment decreased the probability of having unmet needs for medical care and of experiencing delays getting prescription drugs. Medicaid enrollment increased the probability of having a usual source of care, of having a routine checkup, and of having a flu shot in past year.
AHRQ-authored.
Citation: Hill SC, Abdus S .
The effects of Medicaid on access to care and adherence to recommended preventive services.
Health Serv Res 2021 Feb;56(1):84-94. doi: 10.1111/1475-6773.13603..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicaid, Access to Care, Prevention, Patient Adherence/Compliance
Fung V, Price M, Hull P
Assessment of the Patient Protection and Affordable Care Act's increase in fees for primary care and access to care for dual-eligible beneficiaries.
The purpose of this study was to examine the association between the Affordable Care Act (ACA) fee bump and primary care visits for dual-eligible Medicare and Medicaid beneficiaries. Medicare claims data from 2012 to 2016 was used. Findings showed that the ACA fee bump was not associated with increases in primary care visits for dual-eligible Medicare and Medicaid beneficiaries. Additionally, visits for dual-eligible beneficiaries with primary care physicians decreased after the ACA, a decrease that was partially offset by increases in visits with nonphysician clinicians.
AHRQ-funded; HS024725; HS025378.
Citation: Fung V, Price M, Hull P .
Assessment of the Patient Protection and Affordable Care Act's increase in fees for primary care and access to care for dual-eligible beneficiaries.
JAMA Netw Open 2021 Jan;4(1):e2033424. doi: 10.1001/jamanetworkopen.2020.33424..
Keywords: Access to Care, Medicaid, Medicare, Health Insurance, Healthcare Costs, Policy
Hatch B, Hoopes M, Darney BG
Impacts of the Affordable Care Act on receipt of women's preventive services in Community Health Centers in Medicaid expansion and nonexpansion states.
Researchers assessed whether ACA implementation and Medicaid expansion were followed by greater receipt of recommended preventive services among women and girls in a large network of community health centers. Data was collected from electronic health records in 14 states. The researchers found that among female patients at community health centers, receipt of recommended preventive care improved after ACA implementation in both Medicaid expansion and non-expansion states, although the overall rates remained low. They recommended continued support to overcome barriers to preventive care in this population.
AHRQ-funded; HS025155.
Citation: Hatch B, Hoopes M, Darney BG .
Impacts of the Affordable Care Act on receipt of women's preventive services in Community Health Centers in Medicaid expansion and nonexpansion states.
Womens Health Issues 2021 Jan-Feb;31(1):9-16. doi: 10.1016/j.whi.2020.08.011..
Keywords: Cancer, Medicaid, Health Insurance, Uninsured, Access to Care, Policy, Cancer: Cervical Cancer, Prevention, Women, Healthcare Utilization
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
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
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
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
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
Gordon SH, Sommers BD, Wilson IB
Effects of Medicaid expansion on postpartum coverage and outpatient utilization.
Timely postpartum care is associated with lower maternal morbidity and mortality, yet fewer than half of Medicaid beneficiaries attend a postpartum visit. Using Medicaid claims data for 2013-2015 from Colorado, which expanded Medicaid under the Affordable Care Act, and Utah, which did not, the authors conclude that expansion may promote the stability of postpartum coverage and increase the use of postpartum outpatient care in the Medicaid program.
AHRQ-funded; HS025560.
Citation: Gordon SH, Sommers BD, Wilson IB .
Effects of Medicaid expansion on postpartum coverage and outpatient utilization.
Health Aff 2020 Jan;39(1):77-84. doi: 10.1377/hlthaff.2019.00547..
Keywords: Medicaid, Pregnancy, Women, Access to Care, Maternal Care, Ambulatory Care and Surgery, Policy, Healthcare Delivery
Hassmiller Lich K, O'Leary MC, Nambiar S
Estimating the impact of insurance expansion on colorectal cancer and related costs in North Carolina: a population-level simulation analysis.
Researchers used microsimulation to estimate the health and financial effects of insurance expansion and reduction scenarios in North Carolina (NC) for colorectal cancer screening (CRC). The full lifetime of a simulated population of residents age-eligible for CRC screening (aged 50-75) during a 5-year period were simulated. Findings indicate that the estimated cost savings--balancing increased CRC screening/testing costs against decreased cancer treatment costs--were approximately $30 M and $970 M for Medicaid expansion and Medicare-for-all scenarios, respectively, compared to status quo. The researchers concluded that insurance expansion will likely improve CRC screening both overall and in underserved populations while saving money, with the largest savings realized by Medicare.
AHRQ-funded; HS022981.
Citation: Hassmiller Lich K, O'Leary MC, Nambiar S .
Estimating the impact of insurance expansion on colorectal cancer and related costs in North Carolina: a population-level simulation analysis.
Prev Med 2019 Dec;129s:105847. doi: 10.1016/j.ypmed.2019.105847..
Keywords: Health Insurance, Cancer: Colorectal Cancer, Cancer, Healthcare Costs, Screening, Prevention, Medicaid, Medicare, Policy, Access to Care