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
1 to 7 of 7 Research Studies DisplayedChatterjee P, Liao JM, Wang E
Characteristics, utilization, and concentration of outpatient care for dual-eligible Medicare beneficiaries.
The purpose of this study was to describe the distribution of outpatient care for dual-eligible Medicare beneficiaries ("duals") and characterize the intensity of outpatient care utilization of duals vs non-dual-eligible beneficiaries ("nonduals"). The researchers assessed the distribution of outpatient care across physician practices and compared the use of different outpatient services between duals and nonduals. The study found that nearly 80% of outpatient visits for duals were provided by 35% of practices. Compared with low-dual and no-dual practices, high-dual practices served more patients, with morhe comorbidities. Duals had 2 less outpatient visits per year compared with nonduals with substantially fewer subspecialty care visits despite having more comorbidities.
AHRQ-funded; HS027595.
Citation: Chatterjee P, Liao JM, Wang E .
Characteristics, utilization, and concentration of outpatient care for dual-eligible Medicare beneficiaries.
Am J Manag Care 2022 Oct;28(10):e370-e77. doi: 10.37765/ajmc.2022.89189..
Keywords: Ambulatory Care and Surgery, Medicare, Medicaid, Care Management, Healthcare Utilization
Nguyen JK, Sanghavi P
A national assessment of legacy versus new generation Medicaid data.
The purpose of the study was to review Medicaid legacy, Medicaid new generation, and Medicare claims across multiple states and compare performance on data analytic tasks. The researchers targeted the series of events that begins with a non-hospital-related medical emergency and ends with survival to discharge or death. Six data quality indicators were developed to evaluate the following: ambulance variables; code reporting for external cause of injury; linkage between claims; and death reporting on hospital discharge status codes. For death reporting on hospital discharge status codes the researchers estimated the severity of injuries and developed a model of its correlation with death in the Medicare population. The resulting model was utilized to compare reported versus expected deaths by level of injury severity in the Medicaid population. The study found that new generation Medicare claims had high performance across states and indicators, Medicaid legacy claims underperformed on multiple indicators in most states, and while new generation Medicaid claims outperformed Medicaid legacy claims on several indicators, conducting high-level analysis with that data will require substantial improvements.
AHRQ-funded; HS025720.
Citation: Nguyen JK, Sanghavi P .
A national assessment of legacy versus new generation Medicaid data.
Health Serv Res 2022 Aug;57(4):944-56. doi: 10.1111/1475-6773.13937..
Keywords: Medicaid, Medicare, Care Management
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
Fleming MD, Guo C, Knox M
Impact of social needs case management on use of medical and behavioral health services: secondary analysis of a randomized controlled trial.
This research letter describes a secondary analysis that was conducted of a randomized encouragement study that assigned Medicaid beneficiaries with high risk for acute care use to social needs case management or to be administratively observed in the control group from August 2017 through December 2018. These services connect patients to resources such as food assistance, housing, transportation, or income benefits in addition to facilitating access to health care and behavioral health services. The study group included adults 18 years or older, who are residents of Contra Costa County in California, and enrolled in full-scope Medicaid. The case management enrollees were assigned to a case manager who assessed their needs, created a patient-centered care plan, and provided ongoing support including community resource referrals, coordination with primary care providers, and collaboration on applications for public benefits. Case managers had diverse backgrounds and included public health nurses, social workers, substance misuse counselors, mental health clinicians, homeless service specialists, and community health workers. Case management was offered either in-person or by remote telephonic services for 1 year. About 40% (n = 8577) of enrolled patients used the services. There were 21,422 intervention group enrollments and 22,839 in the weighted control group. The intervention group had significantly higher rates of primary care visits compared with the control group. No differences were found between the treatment groups for specialty care visits, behavioral health visits, psychiatric emergency visits, or jail intakes.
AHRQ-funded; HS027648.
Citation: Fleming MD, Guo C, Knox M .
Impact of social needs case management on use of medical and behavioral health services: secondary analysis of a randomized controlled trial.
Ann Intern Med 2023 Aug; 176(8):1139-41. doi: 10.7326/m23-0876..
Keywords: Medicaid, Vulnerable Populations, Social Determinants of Health, Care Management, Care Coordination
Olesiuk WJ, Farley JF, Domino ME
Do medical homes offer improved diabetes care for Medicaid enrollees with co-occurring schizophrenia?
The purpose of this study was to determine whether Medicaid recipients with co-occurring diabetes and schizophrenia that are medical-home-enrolled are more likely to receive guideline-concordant diabetes care than those who are not medical-home-enrolled, controlling for confounders. The study concluded that medical-home enrollment is generally associated with greater likelihood of receiving guideline-concordant diabetes care for Medicaid enrollees with diabetes and schizophrenia.
AHRQ-funded; HS023099; HS019659; HS000032.
Citation: Olesiuk WJ, Farley JF, Domino ME .
Do medical homes offer improved diabetes care for Medicaid enrollees with co-occurring schizophrenia?
J Health Care Poor Underserved 2017;28(3):1030-41. doi: 10.1353/hpu.2017.0094..
Keywords: Care Management, Diabetes, Medicaid, Behavioral Health, Patient-Centered Healthcare
Jung HY, Trivedi AN, Grabowski DC
Integrated Medicare and Medicaid managed care and rehospitalization of dual eligibles.
The objective of this study was to conduct an early evaluation of an innovative program that coordinates benefits for elderly dual eligibles. The authors found no statistically significant effect of senior care options on rehospitalization. They concluded that coordinating the financing and delivery of services through an integrated managed program may not sufficiently address the problems of inefficiency and fragmentation in care for hospitalized dual eligible enrollees.
AHRQ-funded; HS020756.
Citation: Jung HY, Trivedi AN, Grabowski DC .
Integrated Medicare and Medicaid managed care and rehospitalization of dual eligibles.
Am J Manag Care 2015 Oct;21(10):711-7.
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Keywords: Healthcare Delivery, Care Management, Medicaid, Medicare, Hospital Readmissions
Snyder ME, Frail CK, Jaynes H
Predictors of medication-related problems among Medicaid patients participating in a pharmacist-provided telephonic medication therapy management program.
The objective of this study was to identify predictors of medication-related problems (MRPs) among Medicaid patients participating in a telephonic medication therapy management (MTM) program. The analysis of study results supports the relative importance of number of medications as a predictor of MRPs in the Medicaid population and identifies other predictors.
AHRQ-funded; HS022119.
Citation: Snyder ME, Frail CK, Jaynes H .
Predictors of medication-related problems among Medicaid patients participating in a pharmacist-provided telephonic medication therapy management program.
Pharmacotherapy 2014 Oct;34(10):1022-32. doi: 10.1002/phar.1462..
Keywords: Adverse Drug Events (ADE), Care Management, Community-Based Practice, Medicaid, Medication, Provider: Pharmacist