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AHRQ Research Studies
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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results
1 to 25 of 150 Research Studies Displayed
Cha P, Escarce JJ
The Affordable Care Act Medicaid expansion: a difference-in-differences study of spillover participation in SNAP.
Medicaid expansion through the Affordable Care Act increased access to insurance coverage to adults under 138% of the federal poverty level and connected individuals to SNAP (the Supplemental Nutrition Assistance Food Program – formerly the Food Stamp Program). The purpose of this study was to estimate the effect of Medicaid expansion on SNAP participation among 414,000 individuals across the U.S. The study found that there was a 2.9% increase in SNAP participation produced by Medicaid expansion among individuals living under 138% of the federal poverty level. In subgroup analyses the researchers discovered a 5% increase in households without children below 75% of the federal poverty level, and an increase in SNAP households with zero dollars in income. The study concluded that the impact of the Medicaid expansion on access to SNAP participation was the greatest in very-low-income individuals, and that the impact of Medicaid expansion reaches beyond healthcare by increasing access to other supports like food which is a social determinant of health.
AHRQ-funded; HS000046.
Citation:
Cha P, Escarce JJ .
The Affordable Care Act Medicaid expansion: a difference-in-differences study of spillover participation in SNAP.
PLoS One 2022 May 4;17(5):e0267244. doi: 10.1371/journal.pone.0267244..
Keywords:
Medicaid, Nutrition, Low-Income, Health Insurance
Chang L, Rees CA, Michelson KA
Association of socioeconomic characteristics with where children receive emergency care.
This study’s objective was to characterize national associations of neighborhood income and insurance type for children with the characteristics of emergency departments (EDs) from which they receive care. The authors conducted a cross-sectional study of ED visits by children from 2014 to 2017 using the Nationwide Emergency Department Sample. Emergency department characteristics were characterized by pediatric volume category. There was a total of 107.6 million ED visits from 2014 to 2017. Children outside of the wealthiest neighborhood income quartile had lower proportions of visits to high-volume pediatric EDs and greater proportions of visits to low-volume pediatric EDs than children in the wealthiest quartile. Publicly insured children were modestly more likely to visit higher-volume pediatric EDs than privately insurance and uninsured children. This association appears to be principally driven by urban-rural differences in access to pediatric emergency care.
AHRQ-funded; HS026503.
Citation:
Chang L, Rees CA, Michelson KA .
Association of socioeconomic characteristics with where children receive emergency care.
Pediatr Emerg Care 2022 Jan;38(1):e264-e67. doi: 10.1097/pec.0000000000002244..
Keywords:
Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Health Insurance, Uninsured, Low-Income
Bastani R, Glenn BA, Singhal R
Increasing HPV vaccination among low-income, ethnic minority adolescents: effects of a multicomponent system intervention through a county health department hotline.
The human papillomavirus (HPV) vaccine has cancer prevention benefits, yet low uptake. The purpose of the study was to evaluate an intervention intended to improve vaccine uptake in low-income, ethnic minority adolescents using a telephone hotline to seek county health department services. The researchers recruited participants through randomization of health department hotline callers who were caregivers of never-vaccinated adolescents aged 11-17. The intervention included multi-lingual print and telephone education and personalized referral to a low cost or free provider of vaccines. Participants completed baseline, 3-month, and 9-month telephone surveys. The study found that by the end of the 9-month follow up period, the HPV vaccination rates had increased, however there were no differences between the intervention (45%) and control (42%) groups. The researchers also observed significant improvements in perceived HPV knowledge, perceived HPV risk, and barriers to vaccination. The study concluded that the county hotline intervention did not produce a greater increase in HPV vaccine rates in the intervention group than the group without the intervention. The study authors recommend that future studies should evaluate interventions which are more intensive and address accessing and using services in complex, safety net settings. The authors also noted that because 44% of unvaccinated adolescents in both the intervention and control groups received at least one dose of the vaccine during the study period, investigators of future studies should be aware of the potential priming effects of participation in the study, which may impact the results of interventions.
AHRQ-funded; HS000046.
Citation:
Bastani R, Glenn BA, Singhal R .
Increasing HPV vaccination among low-income, ethnic minority adolescents: effects of a multicomponent system intervention through a county health department hotline.
Cancer Epidemiol Biomarkers Prev 2022 Jan;31(1):175-82. doi: 10.1158/1055-9965.Epi-20-1578..
Keywords:
Children/Adolescents, Vaccination, Low-Income, Racial / Ethnic Minorities, Sexual Health, Prevention
Cornelio N, McInerney MP, Mellor JM
Increasing Medicaid's stagnant asset test for people eligible for Medicare and Medicaid will help vulnerable seniors.
Researchers examined states' income and asset tests for full-benefit Medicaid during the period 2006-18 and examined how alternative asset tests would affect eligibility for community-dwelling Medicare beneficiaries ages sixty-five and older. They found that increasing asset limits would lessen restrictions on Medicaid eligibility that arise from stagnant asset tests, broadening eligibility for certain low-income Medicare beneficiaries and allowing them to retain higher, yet still modest, savings.
AHRQ-funded; HS025422; HS026727; HS027698.
Citation:
Cornelio N, McInerney MP, Mellor JM .
Increasing Medicaid's stagnant asset test for people eligible for Medicare and Medicaid will help vulnerable seniors.
Health Affairs 2021 Dec;40(12):1943-52. doi: 10.1377/hlthaff.2021.00841..
Keywords:
Elderly, Medicaid, Medicare, Low-Income, Vulnerable Populations
Heller CG, Rehm CD, Parsons AH
The association between social needs and chronic conditions in a large, urban primary care population.
This study sought to understand the association between social needs and chronic health conditions using a screening tool and clinical data from Electronic Health Records. From April 2018 to December 2019, 33,550 adult patients completed a 10-item social needs screening tool during primary visits in Bronx and Westchester Counties, NY. A positive, cumulative association between social needs and each of the eight outcomes asked about was found. The relationship was strongest for elevated PHQ-2 (depression screening), alcohol/drug use disorder, and smoking. Those with 3 or greater social needs were 3.9 times more likely to have an elevated PHQ-2 than those without needs. Healthcare transportation challenges was associated with each condition and was the most strongly associated need with half of conditions in the fully-adjusted models. Examples included those with an alcohol/drug use disorder (84% more likely), and smokers (41% more likely).
AHRQ-funded; HS026396.
Citation:
Heller CG, Rehm CD, Parsons AH .
The association between social needs and chronic conditions in a large, urban primary care population.
Prev Med 2021 Dec;153:106752. doi: 10.1016/j.ypmed.2021.106752..
Keywords:
Chronic Conditions, Urban Health, Primary Care, Low-Income, Social Determinants of Health, Screening
McInerney M, Mellor JM, Sabik LM. M, Mellor JM, Sabik LM
Welcome mats and on-ramps for older adults: the impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid.
The authors examined whether Medicaid participation by low-income adults age 65 and up increased as a result of Medicaid expansions to working-age adults under the Affordable Care Act (ACA). Using American Community Survey data and state variation in ACA Medicaid expansions, they found that Medicaid expansions to working-age adults increased Medicaid participation among low-income older adults by 4.4 percent. They also found evidence of an “on-ramp” effect, which is an important mechanism behind welcome mat effects among some older adults.
AHRQ-funded; HS025422.
Citation:
McInerney M, Mellor JM, Sabik LM. M, Mellor JM, Sabik LM .
Welcome mats and on-ramps for older adults: the impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid.
J Policy Anal Manage 2021 Win;40(1):12-41. doi: 10.1002/pam.22259..
Keywords:
Elderly, Medicaid, Medicare, Low-Income, Health Insurance, Policy
Fleming MD, Shim JK, Yen I
Managing the "hot spots": health care, policing, and the governance of poverty in the US.
This research looked at a form of surveillance and intervention by health care systems known as “hot spotting”, which targets high-cost patients who are super-utilizers of emergency departments with intensive health and social services. An ethnographic investigation of hot spotting’s modes of distribution and its workings in the lives of patients and providers found that it targets the same individuals and neighborhoods as the police, who maintain longer-standing practices of hot spotting in zones of racialized urban poverty. The boundaries between them are shifting as a financialized logic of governance has come to dominate both the health and criminal justice systems.
AHRQ-funded; HS027648.
Citation:
Fleming MD, Shim JK, Yen I .
Managing the "hot spots": health care, policing, and the governance of poverty in the US.
Am Ethnol 2021 Nov;48(4):474-88. doi: 10.1111/amet.13032..
Keywords:
Low-Income, Social Determinants of Health, Vulnerable Populations
Roberts ET, Glynn A, Donohue JM
The relationship between take-up of prescription drug subsidies and Medicaid among low-income Medicare beneficiaries.
In this study, the investigators examined take-up of the Low-Income Subsidy (LIS) and Medicaid among Medicare beneficiaries who qualified for both programs. They went beyond prior analyses that reported average enrollment by program by 1.) examining whether LIS take-up mirrored Medicaid enrollment at income levels where individuals qualified for limited Medicaid benefits that had low take-up rates and 2.) highlighting opportunities for policy reforms to increase participation in both programs.
AHRQ-funded; HS026727.
Citation:
Roberts ET, Glynn A, Donohue JM .
The relationship between take-up of prescription drug subsidies and Medicaid among low-income Medicare beneficiaries.
J Gen Intern Med 2021 Sep;36(9):2873-76. doi: 10.1007/s11606-020-06241-y..
Keywords:
Medicaid, Medicare, Medication, Low-Income, Health Insurance
Abdul-Chani MM, Moreno CP, Reeder JA
Perceived community disability stigma in multicultural, low-income populations: measure development and validation.
Investigators sought to develop and validate a brief bilingual (English/Spanish) perceived disability stigma measure, to compare perceived disability and autism stigma, and to examine perceived disability stigma by parent sociodemographic characteristics and disability familiarity. They found that perceived autism stigma was greater than perceived disability stigma, with Latino parents reporting less perceived disability stigma than white parents. They concluded that their perceived disability stigma scale demonstrated sound psychometric properties, with results suggesting differences in how stigma is perceived across sociodemographic characteristics and disability familiarity.
AHRQ-funded; HS000063.
Citation:
Abdul-Chani MM, Moreno CP, Reeder JA .
Perceived community disability stigma in multicultural, low-income populations: measure development and validation.
Res Dev Disabil 2021 Aug;115:103997. doi: 10.1016/j.ridd.2021.103997..
Keywords:
Disabilities, Low-Income, Vulnerable Populations, Social Stigma
Klawetter S, Glaze K, Sward A
Warm Connections: integration of infant mental health services into WIC.
Warm Connections is an innovative integrated behavioral health program delivered in the Special Supplemental Nutrition Program for Women, Infants, and Children and rooted in an infant and early childhood mental health framework. This exploratory study describes Warm Connections and provides evaluation results from its pilot implementation. Findings suggest Warm Connections may reduce distress and increase parenting efficacy among low-income mothers and support further research of this program's feasibility.
AHRQ-funded; HS026370.
Citation:
Klawetter S, Glaze K, Sward A .
Warm Connections: integration of infant mental health services into WIC.
Community Ment Health J 2021 Aug;57(6):1130-41. doi: 10.1007/s10597-020-00744-y..
Keywords:
Newborns/Infants, Maternal Care, Behavioral Health, Patient-Centered Healthcare, Low-Income, Vulnerable Populations
Berdahl TA, Moriya AS
AHRQ Author: Berdahl TA, Moriya AS
Insurance coverage for non-standard workers: experiences of temporary workers, freelancers, and part-time workers in the USA, 2010-2017.
This AHRQ-authored paper estimates insurance disparities across non-standard employment categories and determines how coverage disparities shifted following health reform in 2014. Data on working-age adults was analyzed from the 2010-2012 and 2015-2017 MEPS. Uninsurance decreased after health reform for all groups of nonstandard workers with a 10-14% point decline. Uninsurance remained high for all freelance workers at 30.8%, full-time temporary workers (25.1%) and part-time workers (17.9%) compared to full-time workers (11.9%). Lower uninsurance in a Medicaid expansion state was found for all categories of workers.
AHRQ-authored.
Citation:
Berdahl TA, Moriya AS .
Insurance coverage for non-standard workers: experiences of temporary workers, freelancers, and part-time workers in the USA, 2010-2017.
J Gen Intern Med 2021 Jul;36(7):1997-2003. doi: 10.1007/s11606-021-06700-0..
Keywords:
Medical Expenditure Panel Survey (MEPS), Health Insurance, Policy, Uninsured, Medicaid, Low-Income
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
Walter LA, Schoenfeld EM, Smith CH
Emergency department-based interventions affecting social determinants of health in the United States: a scoping review.
Emergency departments (EDs) function as the safety nets of the American health care system, caring for many vulnerable populations. ED-based interventions to assess social risk and mitigate social needs have been reported in the literature. However, the breadth and scope of these interventions have not been evaluated. As the field of social emergency medicine (SEM) expands, a mapping and categorization of previous interventions may help shape future research. In this study, the investigators sought to identify, summarize, and characterize ED-based interventions aimed at mitigating negative social determinants of health.
AHRQ-funded; HS025701; HS013852.
Citation:
Walter LA, Schoenfeld EM, Smith CH .
Emergency department-based interventions affecting social determinants of health in the United States: a scoping review.
Acad Emerg Med 2021 Jun;28(6):666-74. doi: 10.1111/acem.14201..
Keywords:
Emergency Department, Social Determinants of Health, Vulnerable Populations, Low-Income
Roberts ET, James AE, Sabik LM
Modernizing Medicaid coverage for Medicare beneficiaries with low income.
Medicaid serves as a supplemental insurer for eleven million low-income Medicare beneficiaries, known as duals. For these beneficiaries, Medicaid pays for Medicare’s out-of-pocket costs, including premiums, deductibles and coinsurance. This paper examined opportunities to close these gaps in Medicaid coverage and discussed how these reforms could complement other efforts to modernize Medicaid for low-income Medicare beneficiaries.
AHRQ-funded; HS026727.
Citation:
Roberts ET, James AE, Sabik LM .
Modernizing Medicaid coverage for Medicare beneficiaries with low income.
JAMA Health Forum 2021 Jun;2(6). doi: 10.1001/jamahealthforum.2021.0989..
Keywords:
Medicaid, Medicare, Low-Income, Health Insurance, Policy
Roberts ET, Glynn A, Cornelio N
Medicaid coverage 'cliff' increases expenses and decreases care for near-poor Medicare beneficiaries.
Cost sharing in traditional Medicare can consume a substantial portion of the income of beneficiaries who do not have supplemental insurance, resulting in a supplemental coverage cliff. The authors estimated that Medicaid beneficiaries affected by this cliff incurred an additional $2,288 in out-of-pocket spending over the course of two years, used 55 percent fewer outpatient evaluation and management services per year, and filled fewer prescriptions. They recommended expanding eligibility for Medicaid supplemental coverage and increasing take-up of Part D subsidies to lessen cost-related barriers to health care among near-poor Medicare beneficiaries.
AHRQ-funded; HS026727.
Citation:
Roberts ET, Glynn A, Cornelio N .
Medicaid coverage 'cliff' increases expenses and decreases care for near-poor Medicare beneficiaries.
Health Aff 2021 Apr;40(4):552-61. doi: 10.1377/hlthaff.2020.02272..
Keywords:
Medicaid, Medicare, Healthcare Costs, Low-Income, Health Insurance
Feinberg E, Kuhn J, Eilenberg JS
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
This study looked at impacts of a modification to a pilot program called Family Navigation to help low-income, minority children needing autism-related diagnostic services receive those services. An advisory group recommended modifications to recruitment criteria and study conditions. 40 parent-child dyad participants were randomized between the two pilots to receive usual care (UC) or modified FN. Participant enrollment, satisfaction with clinical care, and timely completion of the diagnostic assessment were compared. Recruitment improved significantly with the modified protocol (4.8% vs. 19.5%) and no participants were excluded from study enrollment compared to the first pilot (43.6%). Families in the second pilot were more likely to complete diagnostic assessment and report greater satisfaction with clinical care.
AHRQ-funded; HS022155; HS022242.
Citation:
Feinberg E, Kuhn J, Eilenberg JS .
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
Acad Pediatr 2021 Mar;21(2):265-71. doi: 10.1016/j.acap.2020.04.007..
Keywords:
Children/Adolescents, Autism, Patient-Centered Healthcare, Care Coordination, Racial / Ethnic Minorities, Low-Income, Patient and Family Engagement, Chronic Conditions
Hill LM, Lightfoot AF, Riggins L
Awareness of and attitudes toward pre-exposure prophylaxis among African American women living in low-income neighborhoods in a Southeastern city.
The authors conducted a venue-based community survey with 53 African American women living in low-income neighborhoods of a Southeastern city in order to understand women's knowledge of and attitudes toward pre-exposure prophylaxis (PrEP). They found that awareness of PrEP was very low, with only 16% being aware that PrEP is used for HIV prevention. The vast majority reported that they would use or would consider using PrEP, most frequently citing a general interest in HIV prevention or a lack of awareness of their partners' HIV status as motivations for their interest. Some women expressed concerns about side effects or low perceived HIV risk as disincentives for PrEP use.
AHRQ-funded; HS000032.
Citation:
Hill LM, Lightfoot AF, Riggins L .
Awareness of and attitudes toward pre-exposure prophylaxis among African American women living in low-income neighborhoods in a Southeastern city.
AIDS Care 2021 Feb;33(2):239-43. doi: 10.1080/09540121.2020.1769834..
Keywords:
Human Immunodeficiency Virus (HIV), Racial / Ethnic Minorities, Women, Low-Income, Prevention, Medication
McCoy RG, Van Houten HK, Deng Y
Comparison of diabetes medications used by adults with commercial insurance vs Medicare Advantage, 2016 to 2019.
Investigators sought to compare trends in initiation of treatment with GLP-1RA, SGLT2i, and DPP-4i by older adults with type 2 diabetes insured by Medicare Advantage vs commercial health plans. They found that Medicare Advantage beneficiaries may be less likely than commercially insured beneficiaries to be treated with newer medications to lower glucose levels, with greater disparities among lower-income patients. They recommended further investigation of nonclinical factors contributing to treatment decisions and efforts to promote greater equity in diabetes management.
AHRQ-funded; HS025164.
Citation:
McCoy RG, Van Houten HK, Deng Y .
Comparison of diabetes medications used by adults with commercial insurance vs Medicare Advantage, 2016 to 2019.
JAMA Netw Open 2021 Feb;4(2):e2035792. doi: 10.1001/jamanetworkopen.2020.35792..
Keywords:
Elderly, Diabetes, Chronic Conditions, Medication, Medicare, Health Insurance, Disparities, Low-Income
Patel SA, Krasnow M, Long K
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Researchers examined whether neighborhood environment modifies the disparity in 30-day heart failure (HF) readmissions and mortality between Black and White patients in the Southeastern United States. They created a geocoded retrospective cohort of patients hospitalized for acute HF from 2010-2018 within Emory Healthcare. They found that excess 30-day HF readmissions and mortality were present among Black patients in every neighborhood strata and increased with progressive neighborhood socioeconomic deprivation.
AHRQ-funded; HS026081.
Citation:
Patel SA, Krasnow M, Long K .
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Circ Heart Fail 2020 Dec;13(12):e007947. doi: 10.1161/circheartfailure.120.007947..
Keywords:
Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Racial / Ethnic Minorities, Mortality, Social Determinants of Health, Low-Income, Disparities
Joyce NR, Pfeiffer MR, Zullo AR
Individual and geographic variation in driver's license suspensions: evidence of disparities by race, ethnicity and income.
Using data from the New Jersey Safety Health Outcomes data warehouse 2004-2018, the authors compared characteristics of suspended drivers, their residential census tract, as well as access to public transportation and jobs, by reason for the suspension. They found that 91% of license suspensions were for non-driving-related events, with the most common reason for a suspension being failure to pay a fine. Non-driving-related suspended drivers lived in census tracts with a lower household median income, higher proportion of black and Hispanic residents and higher unemployment rates, but also better walkability scores and better access to public transportation and jobs. They recommended additional work to determine what effect this has for the social and economic well-being of suspended drivers.
AHRQ-funded; HS022998.
Citation:
Joyce NR, Pfeiffer MR, Zullo AR .
Individual and geographic variation in driver's license suspensions: evidence of disparities by race, ethnicity and income.
J Transp Health 2020 Dec;19. doi: 10.1016/j.jth.2020.100933..
Keywords:
Racial / Ethnic Minorities, Disparities, Low-Income, Vulnerable Populations, Social Determinants of Health
Leifheit KM, Schwartz GL, Pollack CE
Severe housing insecurity during pregnancy: association with adverse birth and infant outcomes.
This study measured the association of severe housing insecurity with adverse birth and infant outcomes. Data was analyzed from 3248 mother-infant dyads enrolled in the Fragile Families and Child Wellbeing Study. This prospective cohort study represented births in 20 large U.S. cities from 1998 to 2000. Severe housing insecurity was defined as threatened eviction or homelessness. Adverse outcomes included low birth weight and/or preterm birth, admission to a neonatal intensive care unit (NICU) or stepdown facility, extended hospitalization after delivery, and infant health and temperament. There were statistically significant associations found between severe housing insecurity during pregnancy and low birth weight and/or preterm births. Housing insecurity and infant fair or poor health and poor temperament were not found to have statistically significant associations. Population attributable fraction (PAF) estimates suggested that up to 3% of adverse birth and infant outcomes could be avoided by eliminating severe housing insecurity among low-income, pregnant women.
AHRQ-funded; HS000046.
Citation:
Leifheit KM, Schwartz GL, Pollack CE .
Severe housing insecurity during pregnancy: association with adverse birth and infant outcomes.
Int J Environ Res Public Health 2020 Nov 21;17(22):8659. doi: 10.3390/ijerph17228659..
Keywords:
Pregnancy, Labor and Delivery, Vulnerable Populations, Outcomes, Adverse Events, Women, Low-Income, Newborns/Infants
Roberts ET, McGarry BE, Glynn A
Cognition and take-up of the Medicare Savings Programs.
In this study, the investigators examined the association between cognition and Medicare Savings Program (MSP) enrollment among elderly Medicare beneficiaries who qualified for these programs. They also examined enrollment in the Low-Income Subsidy (LIS), a separate program that provides premium and cost-sharing assistance in Medicare Part D that Medicare beneficiaries automatically received if they are enrolled in an MSP.
AHRQ-funded; HS026727.
Citation:
Roberts ET, McGarry BE, Glynn A .
Cognition and take-up of the Medicare Savings Programs.
JAMA Intern Med 2020 Nov;180(11):1529-31. doi: 10.1001/jamainternmed.2020.2783..
Keywords:
Elderly, Medicare, Health Insurance, Healthcare Costs, Low-Income, Dementia, Neurological Disorders
Fung V, Price M, Nierenberg AA
Assessment of behavioral health services use among low-income Medicare beneficiaries after reductions in coinsurance fees.
This study looked at outcomes from reducing behavioral health care Medicare coinsurance from 50% to 20% from 2009 to 2013. The sample of patients looked at included some diagnosed with SMI (serious mental illness) including schizophrenia, bipolar, or major depressive disorder). Data analysis was performed on 793,275 beneficiaries with SMI in 2008 and compared them with costs in 2013. The mean adjusted out-of-pocket costs for outpatient behavioral care decreased from $132 annually to $64, but the number of visits only increased slightly. No association was found between cost-sharing reductions and changes in behavioral health care visits.
AHRQ-funded; HS024725.
Citation:
Fung V, Price M, Nierenberg AA .
Assessment of behavioral health services use among low-income Medicare beneficiaries after reductions in coinsurance fees.
JAMA Netw Open 2020 Oct;3(10):e2019854. doi: 10.1001/jamanetworkopen.2020.19854..
Keywords:
Medicare, Health Insurance, Depression, Behavioral Health, Low-Income, Healthcare Costs, Healthcare Utilization
Roberts ET, Mehrotra A
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
In this study, the investigators examined disparities in digital access (ie, access at home to technology that enables video telemedicine visits) among Medicare beneficiaries by socioeconomic and demographic characteristics. The investigators concluded that the proportion of beneficiaries who lacked digital access was higher among those with low socioeconomic status, those 85 years or older, and in communities of color.
AHRQ-funded; HS026727.
Citation:
Roberts ET, Mehrotra A .
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
JAMA Intern Med 2020 Oct;180(10):1386-89. doi: 10.1001/jamainternmed.2020.2666..
Keywords:
Elderly, Medicare, Telehealth, Health Information Technology (HIT), Disparities, Access to Care, Social Determinants of Health, Low-Income, Racial / Ethnic Minorities
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