Search All Research Studies
AHRQ Research Studies Date
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 405 Research Studies Displayed
Mackie TI, Schaefer AJ, Palatucci JS
The role of formal policy to promote informed consent of psychotropic medications for youth in child welfare custody: a national examination.
The purpose of this sequential multi-method study was to propose a classification for the procedural elements of informed consent policies based upon existing child welfare policies and then explored whether formal state policies across the United States authorized these elements. The researchers conducted interviews with 58 key informants primarily from state child welfare agencies to identify a classification of procedural elements for informed consent of psychotropic medications. A legislative review of the 50 states and D.C. was then conducted to characterize whether formal policies endorsed each procedural element. Key informants reported five procedural elements in policy, and 23 states endorsed relevant legislation. Only two states specified all five procedural elements, and the content of any procedural elements varied considerably across policies.
AHRQ-funded; HS02198501; HS026001
Citation: Mackie TI, Schaefer AJ, Palatucci JS . The role of formal policy to promote informed consent of psychotropic medications for youth in child welfare custody: a national examination. Adm Policy Ment Health 2022 Nov;49(6):986-1003. doi: 10.1007/s10488-022-01212-3..
Keywords: Children/Adolescents, Vulnerable Populations, Medication, Behavioral Health, Policy
Li J, Wu B, Flory J
Impact of the Affordable Care Act's Physician Payments Sunshine Act on branded statin prescribing.
The purpose of this study was to assess the impact of the Affordable Care Act's Physician Payments Sunshine Act (PPSA) and its mandate of disclosing pharmaceutical and medical industry payments to physicians for prescribing branded statins. The study found that the PPSA contributed to a 7% decrease in monthly new prescriptions of brand-name statins over the study period. There was no significant change in generic prescribing. The reduction was concentrated among physicians with the highest tercile of drug spending prior to the enactment of the PPSA, with a decrease of 15% in new branded statin prescriptions. The researchers concluded that the PPSA mandate reduced the prescribing of branded statin prescriptions in the time period following its announcement, especially in physicians who were taking part in excessive prescribing of the branded statins.
Citation: Li J, Wu B, Flory J . Impact of the Affordable Care Act's Physician Payments Sunshine Act on branded statin prescribing. Health Serv Res 2022 Oct;57(5):1145-53. doi: 10.1111/1475-6773.14024..
Keywords: Payment, Policy, Medicare, Health Insurance
Donohue JM, Cole ES, James CV
The US Medicaid program: coverage, financing, reforms, and implications for health equity.
This article is a literature review of the Medicaid program focusing on Medicaid eligibility, enrollment, and spending and examined areas of Medicaid policy, including managed care, payment, and delivery system reforms; Medicaid expansion; racial and ethnic health disparities; and the potential to achieve health equity. The authors included peer-reviewed articles and reports published between January 2003 and February 2022. Medicaid covered approximately 80.6 million people per month in 2022, representing 16.3% of US health spending. Managed care plans run by states enrolled 69.5% of Medicaid beneficiaries in 2019 and adopted 139 delivery system reforms from 2003 to 2019. Over half (56.4%) of Medicaid beneficiaries were from racial and ethnic minority groups in 2019, and disparities in access, quality, and outcomes are common among these groups within Medicaid. The authors felt that additional Medicaid reforms are needed to reduce health disparities by race and ethnicity and to achieve equity in access, quality, and outcomes.
Citation: Donohue JM, Cole ES, James CV . The US Medicaid program: coverage, financing, reforms, and implications for health equity. JAMA 2022 Sep 20;328(11):1085-99. doi: 10.1001/jama.2022.14791..
Keywords: Medicaid, Healthcare Costs, Policy, Health Insurance
Lipton BJ, Decker SL, Stitt B
AHRQ Author: Decker SL Manski RJ
Association between Medicaid dental payment policies and children's dental visits, oral health, and school absences.
The purpose of this cross-sectional study was to assess the relationship between the ratio of Medicaid payment rates to dentist charges and children's preventive dental visits, oral health, and school absences. The researchers conducted a difference-in-differences analysis of 15,738 Medicaid-enrolled children and a control group of 16 867 privately insured children aged 6 to 17 years who participated in the 2016-2019 National Survey of Children's Health. The study found that 87% and 48% of Medicaid-enrolled children had at least 1 and at least 2 past-year dental visits, respectively, and 29% had parent-reported excellent oral health. Increasing the fee ratio by was associated with increases in at least 1 and 2 visits and in excellent oral health. Increases in at least 2 visits were larger for Hispanic children than for White children. By weighted baseline estimates, 28% and 15% of Medicaid-enrolled children had at least 4 and at least 7 past-year school absences, respectively. The researchers concluded that Medicaid policies with higher payments were associated with modest increases in children's preventive dental visits and excellent oral health.
Citation: Lipton BJ, Decker SL, Stitt B . Association between Medicaid dental payment policies and children's dental visits, oral health, and school absences. JAMA Health Forum 2022 Sep 2;3(9):e223041. doi: 10.1001/jamahealthforum.2022.3041..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Payment, Policy
Eliason EL, A Spishak-Thomas, Steenland MW
Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy.
The purpose of this study was to assess the relationship of the Affordable Care Act (ACA) Medicaid expansion with postpartum contraception use and pregnancy. The researchers found that Medicaid expansion was associated with a 7.0 percentage point increase in postpartum use of the contraceptive implant and intrauterine device LARC, a 3.1 percentage point decrease in short-acting contraception, and a 3.9 percentage point decrease in non-prescription contraceptive use overall. Increases in LARC use were concentrated among non-Hispanic, White, and Black respondents. Medicaid expansion was associated with a decrease in early postpartum pregnancy only among non-Hispanic Black respondents. The researchers concluded that the ACA Medicaid expansion improved postpartum contraceptive access and led to shifts from methods with a lower upfront out-of-pocket cost for people without insurance towards methods with the higher upfront out-of-pocket cost for people without insurance. These changes suggest that Medicaid expansions increased access to the full range of contraceptive methods.
AHRQ-funded; HS027464; HS000011
Citation: Eliason EL, A Spishak-Thomas, Steenland MW . Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy. Contraception 2022 Sep;113:42-48. doi: 10.1016/j.contraception.2022.02.012..
Keywords: Sexual Health, Pregnancy, Maternal Care, Women, Medicaid, Access to Care, Policy
Encinosa W, Lane K, Cornelio N
AHRQ Author: Encinosa W
How state surprise billing protections increased ED visits, 2007-2018: potential implications for the No Surprises Act.
This article discusses the 2022 No Surprises Act whose goal was to prevent patients from receiving unexpected emergency department (ED) out-of-network physician bills and restrict out-of-network co-payments to in-network co-payment levels. Similar state bans were examined to determine whether the large reduction in out-of-pocket payments under bans will have an unintended consequence of an increase in ED visits and spending. The authors examined 16 million nonelderly, fully funded, privately insured health maintenance organization (HMO) enrollees between 2007 and 2018 from 15 states with balance billing bans for HMO ED visits and 16 states without bans as the control group. They found that the bans reduced spending per visit by 14% but spurred a demand response with an increase of 3 percentage points in ED visits which wiped away the cost savings. The authors predict that the federal ban will result in $5.1 billion in savings but 3.5 million more ED visits at $4.2 billion in extra spending per year, largely negating expected savings.
AHRQ-authored; AHRQ-funded; HS027698.
Citation: Encinosa W, Lane K, Cornelio N . How state surprise billing protections increased ED visits, 2007-2018: potential implications for the No Surprises Act. Am J Manag Care 2022 Sep;28(9):e333-e38. doi: 10.37765/ajmc.2022.89226..
Keywords: Healthcare Costs, Emergency Department, Policy, Healthcare Utilization
Rogstad TL, Gupta S, Connolly J
Social risk adjustment In the hospital readmissions reduction program: a systematic review and implications for policy.
Investigators reviewed fourteen studies of social risk adjustment in Medicare's Hospital Readmissions Reduction Program (HRRP). They concluded that their findings support the use of social risk adjustment to improve provider payment equity and highlight opportunities to enhance social risk adjustment in value-based payment programs.
Citation: Rogstad TL, Gupta S, Connolly J . Social risk adjustment In the hospital readmissions reduction program: a systematic review and implications for policy. Health Aff 2022 Sep;41(9):1307-15. doi: 10.1377/hlthaff.2022.00614..
Keywords: Social Determinants of Health, Hospital Readmissions, Risk, Policy
Guo W, Li Y, Temkin-Greener H
Coronavirus disease 2019 (COVID-19) in assisted living communities: neighborhood deprivation and state social distancing policies matter.
Investigators examined the association between COVID-19 cases in assisted living communities (ALCs) and the proportion of Medicare-Medicaid (dual) eligible minority residents, neighborhood area deprivation, and state COVID-19 policy stringency. They found that ALCs with higher proportions of dual-eligible minority residents were more likely to have COVID-19 outbreaks within their communities. Further, ALCs located in more socioeconomically deprived neighborhoods, and in states with less stringent state social distancing policies, tended to have more COVID-19 cases.
Citation: Guo W, Li Y, Temkin-Greener H . Coronavirus disease 2019 (COVID-19) in assisted living communities: neighborhood deprivation and state social distancing policies matter. Infect Control Hosp Epidemiol 2022 Aug;43(8):1004-09. doi: 10.1017/ice.2022.46..
Keywords: COVID-19, Elderly, Long-Term Care, Policy, Public Health
Koball H, Kirby J, Hartig S
AHRQ Author: Kirby J
The relationship between states' immigrant-related policies and access to health care among children of immigrants.
The purpose of this AHRQ-authored paper was to explore immigrants’ children’s access to preventive healthcare, and the impact of sanctuary policies (state policies that limit federal immigration enforcement involvement) and the provision of driver’s licenses for undocumented immigrants on that access. Primary outcomes included whether the child had a well child check-up, unmet medical needs, or a regular source for care. The 2008-2016 Medical Panel Expenditure Survey (MPES) merged with policy data at the state level were analyzed, with the researchers reporting that sanctuary policies and having a state driver’s license were both associated with having a regular source for care and less unmet medical needs among the children of immigrants. The researchers emphasized the importance of access to preventive care and concluded that sanctuary policies are related to increased access to preventive health care among the children of immigrants.
Citation: Koball H, Kirby J, Hartig S . The relationship between states' immigrant-related policies and access to health care among children of immigrants. J Immigr Minor Health 2022 Aug;24(4):834-41. doi: 10.1007/s10903-021-01282-9..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Policy, Access to Care
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.
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
Fung V, Yang Z, Cook BL
Changes in insurance coverage continuity after Affordable Care Act expansion of Medicaid eligibility for young adults with low income in Massachusetts.
The purpose of this cohort study was to describe changes in insurance coverage continuity for Medicaid enrollees who turned age 19 years before and after eligibility policy changes from the 2014 Medicaid expansion of the Patient Protection and Affordable Care Act. Between November 1, 2020, and May 12, 2022 the researchers analyzed data from the Massachusetts All-Payer Claims Database (2012 to 2016) to compare coverage for Medicaid beneficiaries turning age 19 years before and after Medicaid expansion. A total of 41,247 young adults turning age 18 to 19 years in the baseline year were included in the study. The researchers found that enrollees who turned age 19 after vs before the Medicaid eligibility expansion were less likely to have 3 or more uninsured months at18 to 19 years of age and 19 to 20 years of age and more likely to have continuous insurance coverage for 12 or more months. Differences in the likelihood of having 3 or more uninsured months decreased at 20 to 21 years of age, when both groups had access to Medicaid. The study concluded that among Medicaid enrollees entering adulthood, the expansion of Medicaid to lower-income adults through the 2014 Patient Protection and Affordable Care Act was associated with a decreased possibility of becoming uninsured.
Citation: Fung V, Yang Z, Cook BL . Changes in insurance coverage continuity after Affordable Care Act expansion of Medicaid eligibility for young adults with low income in Massachusetts. JAMA Health Forum 2022 Jul;3(7):e221996. doi: 10.1001/jamahealthforum.2022.1996..
Keywords: Young Adults, Health Insurance, Policy, Medicaid, Access to Care, Low-Income
Blanco C, Kato EU, Aklin WM
AHRQ Author: Kato EU, Tong ST, Bierman A, Meyers D
Research to move policy - using evidence to advance health equity for substance use disorders.
This paper discusses ways that evidence-based research can advance health equity for substance use disorder (SUD) treatment. Racial and ethnic disparities in treatment access and outcomes have widened, despite substantial efforts to address the epidemic of overdose-related deaths in the US. Overdose rates are rising faster in Black, Latinx, and American Indian and Alaska Native populations than in White populations. Possible opportunities to address these disparities include addressing social determinants of health, implementing prevention measures, and supporting data science. The steps to ensure that research reduces disparities are to: 1) include members of underrepresented groups in the development of preventive interventions and treatments, 2) adequately recruit members of historically represented groups and ensure that studies are large enough to measure differences in outcomes according to race and ethnic group, 3) establish equitable partnerships with people who currently have or have had SUDS and their families and engage these groups in evidence production, 4) diversify the scientific workforce, and 4) have investigators measure the effects of policies and interventions on equity.
Citation: Blanco C, Kato EU, Aklin WM . Research to move policy - using evidence to advance health equity for substance use disorders. N Engl J Med 2022 Jun 16;386(24):2253-55. doi: 10.1056/NEJMp2202740..
Keywords: Substance Abuse, Behavioral Health, Policy, Racial / Ethnic Minorities, Disparities, Social Determinants of Health
Haque W, Ahmadzada M, Janumpally S
Adherence to a federal hospital price transparency rule and associated financial and marketplace factors.
This research letter describes a study that evaluated adherence to the federal Hospital Price Transparency Rule 6 to 9 months after the final rule effective date (January 1, 2021). The rule’s aim is to increase health price transparency and facilitation patient price shopping online. Hospitals were required to post 5 price types: gross charges, discounted prices, payer-specific negotiated prices, minimum and maximum prices in a machine-readable file, and a separate accessible display or price estimator for at least 300 shoppable items. The authors used the Herfindahl-Hirschman Index (HHI) to measure inpatient hospital market concentration. The data was collected for 185 of 929 core-based statistical areas from 2019. HHI is divided into the following categories: unconcentrated, moderately concentrated, or highly or very concentrated. Results showed that out of 5239 total hospitals, 729 (13.9%) had an adherent machine-readable file but no shoppable display, 1542 (29.4%) had an adherent shoppable display but no machine-readable file, and 300 (5.7%) had both. The most adherent hospitals tended to be acute care hospitals with lesser revenue per patient-day, within unconcentrated health care markets, and in urban areas.
Citation: Haque W, Ahmadzada M, Janumpally S . Adherence to a federal hospital price transparency rule and associated financial and marketplace factors. JAMA 2022 Jun 7;327(21):2143-45. doi: 10.1001/jama.2022.5363..
Keywords: Policy, Hospitals, Healthcare Costs
Escarce JJ, Wozniak GD, Tsipas S
The Affordable Care Act Medicaid expansion, social disadvantage, and the practice location choices of new general internists.
This study’s objective was to examine the level of social disadvantage of the areas of Medicaid expansion states from the ACA that gained new physicians and the areas of nonexpansion states that lost them. The authors used American Community Survey data to classify commuting zones as high, medium, or low social disadvantage. The AMA Physician Masterfile data from 2009-2019 was used to compare where 32,102 new general internists located during the 6 years following the expansion to where they located during the 5 years preceding the expansion. They estimated that between 2014 and 2019 nonexpansion states lost 371 new general internists to expansion states. However, 62.5% of the physicians lost by nonexpansion states were lost from high disadvantage areas although those areas only account for 17.9% of the population of nonexpansion states. This potentially compromises access for all residents irrespective of insurance coverage.
Citation: Escarce JJ, Wozniak GD, Tsipas S . The Affordable Care Act Medicaid expansion, social disadvantage, and the practice location choices of new general internists. Med Care 2022 May;60(5):342-50. doi: 10.1097/mlr.0000000000001703..
Keywords: Medicaid, Policy, Provider: Physician, Health Insurance
Tzeng HM, Raji MA, Chou LN
Impact of state nurse practitioner regulations on potentially inappropriate medication prescribing between physicians and nurse practitioners: a national study in the United States.
The American Geriatrics Society regularly updates the Beers Criteria for Potentially Inappropriate Medication (PIM) to improve prescribing safety. This study assessed the impact of nurse practitioner (NP) practices on PIM prescribing across states in the United States and compared the change in PIM prescribing rates between 2016 and 2018. The investigators found that the PIM prescription rate was lower in states with full NP practice and lower among NPs than among physicians; these rates for both physicians and NPs decreased from 2016 to 2018.
Citation: Tzeng HM, Raji MA, Chou LN . Impact of state nurse practitioner regulations on potentially inappropriate medication prescribing between physicians and nurse practitioners: a national study in the United States. J Nurs Care Qual 2022 Jan-Mar;37(1):6-13. doi: 10.1097/ncq.0000000000000595..
Keywords: Medication, Medication: Safety, Provider: Nurse, Adverse Drug Events (ADE), Adverse Events, Policy
Dorilas E, Hill SC, Pesko MF
AHRQ Author: Hill SC
Tobacco surcharges associated with reduced ACA marketplace enrollment.
Researchers used 2014-19 administrative data on enrollees in the federally facilitated Affordable Care Act Marketplace, HealthCare.gov, to examine the relationships among surcharge rates, total Marketplace enrollment, and enrollment by tobacco users. They found that the tobacco surcharge rate was associated with lower total enrollment as well as a reduced share of total enrollees who reported any tobacco use. Further, tobacco surcharges have a significantly larger effect on tobacco users' share of enrollment in rural areas than in urban areas, which may contribute to urban-rural health disparities.
Citation: Dorilas E, Hill SC, Pesko MF . Tobacco surcharges associated with reduced ACA marketplace enrollment. Health Aff 2022 Mar;41(3):398-405. doi: 10.1377/hlthaff.2021.01313..
Keywords: Tobacco Use, Policy, Health Insurance
Eliason EL, MacDougall H, Peterson L
Understanding the aggressive practices of nonprofit hospitals in pursuit of patient debt.
This study examined the prevalence of extraordinary collection actions (ECAs) and characteristics of nonprofit hospitals that reported this behavior from 2010 to 2016. The authors used Community Benefit Insight data to compare these hospitals with ones that did not report these practices. ECAs include reporting patient debt to credit and collection agencies, filing lawsuits, placing liens on residences, and issuing civil arrest. Hospitals that reported ECAs significantly differed in total revenue, system membership, bed size, urban location, financial assistance policy use, and use of poverty guidelines for discounted care. Lower total hospital revenue was a significant predictor of ECAs.
Citation: Eliason EL, MacDougall H, Peterson L . Understanding the aggressive practices of nonprofit hospitals in pursuit of patient debt. Health Soc Work 2022 Jan 31;47(1):36-44. doi: 10.1093/hsw/hlab034..
Keywords: Hospitals, Healthcare Costs, Policy
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.
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
Sood N, Yang Z, Huckfeldt P
Geographic variation in Medicare fee-for-service health care expenditures before and after the passage of the Affordable Care Act.
This cross-section study examined geographic variation in Medicare fee-for-service health care expenditures before and after the passage of the Affordable Care Act. The study included all fee-for-service Medicare enrollees aged 65 and older from 2007 to 2018 using data from the Medicare Geographic Variation Public Use File. Hospital referral regions (HRRs) were grouped in each year into deciles (10 equal groups) based on per-beneficiary total spending. Geographic variation was stable from 2007 to 2011 and declined steadily from 2012 through 2018. In specific spending categories, only home health had statistically significant reductions in geographic variation. The ratio of home health spending among HRRs in the top to bottom deciles of total Medicare spending fell from 5.14 in 2007 to 3.45 in 2018.
Citation: Sood N, Yang Z, Huckfeldt P . Geographic variation in Medicare fee-for-service health care expenditures before and after the passage of the Affordable Care Act. JAMA Health Forum 2021 Dec;2(12):e214122. doi: 10.1001/jamahealthforum.2021.4122..
Keywords: Medicare, Policy, Healthcare Costs, Payment
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.
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 / Ethnic Minorities, Disparities, Policy, Women, Access to Care
Pollack CE, Leifheit KM, McGinty EE
Public support for policies to increase housing stability during the COVID-19 pandemic.
The COVID-19 pandemic has exacerbated longstanding housing precarity. This study measured the public support for policies designed to increase housing stability and gauged whether support levels were associated with views about the role of evictions in COVID-19 transmission and the existence of racial inequities in the housing market. The investigators concluded that support for housing stability policies was strong among U.S. adults, particularly among those who agreed that preventing evictions slowed COVID-19 transmission and among those who acknowledged racial inequities in the housing market.
Citation: Pollack CE, Leifheit KM, McGinty EE . Public support for policies to increase housing stability during the COVID-19 pandemic. Am J Prev Med 2021 Dec;61(6):919-22. doi: 10.1016/j.amepre.2021.05.006..
Keywords: COVID-19, Policy, Public Health
Rao BR, Merchant FM, Howard DH
Shared decision-making for implantable cardioverter-defibrillators: policy goals, metrics, and challenges.
Researchers discussed shared decision-making for implantable cardioverter-defibrillators (ICDs), including the results from a case study implementing the shared decision-making mandate for ICDs, which involved providing patients with decision aids prior to or following the doctor consultation.
Citation: Rao BR, Merchant FM, Howard DH . Shared decision-making for implantable cardioverter-defibrillators: policy goals, metrics, and challenges. J Law Med Ethics 2021 Win;49(4):622-29. doi: 10.1017/jme.2021.85..
Keywords: Decision Making, Medical Devices, Policy, Cardiovascular Conditions
Cerda M, Wheeler-Martin K, Bruzelius E
Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths.
The authors investigated the impact of pain management clinic laws. They analyzed data on county-level, opioid overdose deaths via the National Vital Statistics System and patients filling long-duration or high-dose opioid prescriptions in the US 2010-2018. Their findings suggested that laws with criminal penalties were associated with intended reductions in high-risk opioid prescribing and some opioid overdoses but raised concerns regarding unintended consequences on heroin/synthetic overdoses.
Citation: Cerda M, Wheeler-Martin K, Bruzelius E . Spatiotemporal analysis of the association between pain management clinic laws and opioid prescribing and overdose deaths. Am J Epidemiol 2021 Dec;190(12):2592-603. doi: 10.1093/aje/kwab192..
Keywords: Opioids, Pain, Chronic Conditions, Medication, Practice Patterns, Policy
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.
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
Gigli KH, Rak KJ, Hershey TB
A roadmap for successful state sepsis regulations-lessons from New York.
This study looked at the reasons why New York State’s 2013 sepsis regulations were successful in improving mortality compared to less successful sepsis policies at the federal level. The authors recruited thirteen key stakeholders from three groups including four New Year State policymakers and seven clinicians and hospital association leaders involved in the creation and implementation of the 2013 New York State sepsis regulations, as well as two members of patient advocacy groups. The group identified themes related to participant perceptions of the sepsis policy, factors that influenced the policy’s perceived successes, and opportunities for improvement. A major factor that created early buy-in was engaging a diverse array of stakeholders in the development of the policy. Policymakers also worked to provide a balance between the desire for comprehensive reporting and the burden of data collection. The regulations also touched on all three major domains of sepsis quality: structure, process, and outcomes.
Citation: Gigli KH, Rak KJ, Hershey TB . A roadmap for successful state sepsis regulations-lessons from New York. Crit Care Explor 2021 Sep;3(9):e0521. doi: 10.1097/cce.0000000000000521..
Keywords: Sepsis, Policy