Search all AHRQ sites
Menu
SHARE:
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.
Results
1 to 25 of 383 Research Studies DisplayedMeille G, Post B
The effects of the Medicaid expansion on hospital utilization, employment, and capital.
This AHRQ-authored paper describes the effect of the Affordable Care Act Medicaid expansion on hospital utilization, employment, and capital. The authors conducted a difference-in-differences analysis that compared changes to hospital demand and supply in Medicaid expansion and nonexpansion states. They used 2010-2016 data from the American Hospital Association and the Healthcare Cost Report Information System to quantify changes to hospital utilization and characterize how hospitals adjusted labor and capital inputs. Medicaid expansion was associated with increases in emergency department visits and other outpatient hospital visits. They found strong evidence that hospitals met increases in demand by hiring nursing staff and weaker evidence that they increased hiring of technicians and investments in equipment. They found no evidence that hospitals adjusted hiring of physicians, support staff, or investments in other capital inputs.
AHRQ-authored.
Citation: Meille G, Post B .
The effects of the Medicaid expansion on hospital utilization, employment, and capital.
Med Care Res Rev 2023 Apr;80(2):165-74. doi: 10.1177/10775587221133165.
Keywords: Medicaid, Hospitals, Healthcare Utilization, Health Insurance, Policy, Access to Care, Uninsured
Reistetter TA, Dean JM, Haas AM
Development and evaluation of rehabilitation service areas for the United States.
The purpose of this study was to develop and characterize post-acute care Rehabilitation Service Areas (RSAs) in the US that reflect rehabilitation use by Medicare beneficiaries. Data was accessed from Medicare claims 2013-2015 and included patient records across all diagnostic groups. RSAs were described by provider type, population, and traveling patterns among beneficiaries. The authors conclude that RSAs as a tool for measurement can provide policy makers, researchers, and administrators with small-area boundaries to assess access, resources, and understanding of financing to improve practice and policy for post-acute care.
AHRQ-funded; HS024711.
Citation: Reistetter TA, Dean JM, Haas AM .
Development and evaluation of rehabilitation service areas for the United States.
BMC Health Serv Res 2023 Mar 1;23(1):204. doi: 10.1186/s12913-023-09184-2.
Keywords: Rehabilitation, Access to Care
Wirth AN, Cushman NA, Reilley BA
Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021.
Researchers evaluated the extent to which Indian Country Extension for Community Healthcare Outcomes (ECHO) telehealth clinics increase access to hepatitis C virus (HCV) treatment and serve American Indians/Alaska Native (AI/AN) patients holistically. They conducted a retrospective descriptive analysis of Indian Country ECHO treatment recommendations from 2017 to 2021. Most patients received recommendations for HCV treatment by their primary care providers, along with recommendations beyond the scope of HCV. The researchers concluded that Indian Country ECHO telehealth clinic provided comprehensive recommendations to effectively integrate evidence-based HCV treatment with holistic care at the primary care level.
AHRQ-funded; HS026370.
Citation: Wirth AN, Cushman NA, Reilley BA .
Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021.
J Rural Health 2023 Mar;39(2):358-66. doi: 10.1111/jrh.12733.
Keywords: Hepatitis, Access to Care, Racial and Ethnic Minorities, Community-Based Practice, Telehealth, Health Information Technology (HIT), Chronic Conditions
Duncan MS, Robbins NN, Wernke SA
Geographic variation in access to cardiac rehabilitation.
Considerable regional disparities exist in the commencement of cardiac rehabilitation (CR), with only 10% to 40% of eligible patients at the state level participating. The potential factors contributing to these discrepancies, such as accessibility to CR facilities, remain insufficiently explored. The purpose of this study was to assess the impact of CR center availability on CR initiation among Medicare beneficiaries. The researchers utilized Medicare records to pinpoint CR-eligible Medicare beneficiaries and compute CR initiation rates at the hospital referral region (HRR) level. Linear regression was applied to evaluate the percentage variance in CR initiation explained by CR accessibility across HRRs. Geospatial hotspot analysis was performed to detect CR deserts, or counties where the patient-to-CR center ratio is notably high. The study found that between 2014 and 2017, 1,133,657 Medicare beneficiaries were eligible for CR, with 263,310 (23%) initiating CR. The West North Central Census Division exhibited the highest adjusted CR initiation rate (35.4%) and the greatest concentration of CR programs (6.58 per 1,000 CR-eligible Medicare beneficiaries). CR program density accounted for 21.2% of the regional variation in CR initiation at the HRR level. A total of 40 predominantly urban counties, encompassing 14% of the U.S. population aged ≥65 years, were identified as CR deserts due to limited CR access.
AHRQ-funded; HS022990
Citation: Duncan MS, Robbins NN, Wernke SA .
Geographic variation in access to cardiac rehabilitation.
J Am Coll Cardiol 2023 Mar 21;81(11):1049-60. doi: 10.1016/j.jacc.2023.01.016.
Keywords: Rehabilitation, Access to Care, Cardiovascular Conditions
Kirby JB, Nogueira LM, Zhao J
Past disruptions in health insurance coverage and access to care among insured adults.
This AHRQ-authored study investigated whether disruptions in health insurance coverage continued to be associated with poor access even after coverage was regained. The study used a nationally representative cohort of insured adults aged 18-64 years (N=39,904). The authors estimated the association between past disruptions in coverage (occurring at least 1 year before) and the risks of lacking a usual source of care provider and having unmet medical need. Among insured nonelderly adults, the risk of being without a usual source of care provider was between 18% and 75% higher than for those with continuous coverage and the risk of having unmet medical needs was between 41% and 66% higher.
AHRQ-authored.
Citation: Kirby JB, Nogueira LM, Zhao J .
Past disruptions in health insurance coverage and access to care among insured adults.
Am J Prev Med 2023 Mar; 64(3):405-13. doi: 10.1016/j.amepre.2022.10.005..
Keywords: Health Insurance, Access to Care
Logan CD, Feinglass J, Halverson AL
Rural-urban disparities in receipt of surgery for potentially resectable non-small cell lung cancer.
This study examined the reasons there are lower rates of surgical treatment for potentially resectable non-small cell lung cancer (NSCLC) for patients living in rural areas than in urban areas. The National Cancer Database was used to identify patients with clinical stage I-IIIA NSCLC between 2004 and 2018. Reasons for nonreceipt of surgery was evaluated for rural and urban area patients. The study included 328,785 patients with NSCLC with 13% from rural areas. Overall, 62.4% of patients from urban areas and 58.8% of patients from rural areas underwent surgery. Patients from rural areas had increased odds of (1) being recommended primary nonsurgical management, (2) surgery being deemed contraindicated due to risk, (3) surgery being recommended but not performed, and (4) overall failure to receive surgery.
AHRQ-funded; HS026385.
Citation: Logan CD, Feinglass J, Halverson AL .
Rural-urban disparities in receipt of surgery for potentially resectable non-small cell lung cancer.
J Surg Res 2023 Mar;283:1053-63. doi: 10.1016/j.jss.2022.10.097.
Keywords: Cancer: Lung Cancer, Cancer, Disparities, Surgery, Rural Health, Access to Care
Steenland MW, Trivedi AN
Association of Medicaid expansion with postpartum depression treatment in Arkansas.
This study examined the association of Medicaid expansion in Arkansas with postpartum antidepressant prescription fills and antidepressant continuation and supply during the first 6 months postpartum. This cohort study used data comparing persons with Medicaid and commercially financed childbirth using Arkansas' All-Payer Claims Database (2013-2016). A total of 60,990 births were included, with 72% of births paid for by Medicaid and 28% paid by a commercial payer. Before expansion, 4.2% of people with a Medicaid-paid birth filled an antidepressant prescription in the later postpartum period. Medicaid expansion was associated with a 4.6 percentage point increase in the likelihood, or a relative change of 110%, in this outcome. Among people with early postpartum depression, Medicaid expansion increased the continuity of antidepressant treatment by 20.5 percentage points and the number of days with antidepressant supply in the later postpartum period by 14.1 days.
AHRQ-funded; HS027464.
Citation: Steenland MW, Trivedi AN .
Association of Medicaid expansion with postpartum depression treatment in Arkansas.
JAMA Health Forum 2023 Feb; 4(2):e225603. doi: 10.1001/jamahealthforum.2022.5603..
Keywords: Depression, Behavioral Health, Medicaid, Pregnancy, Women, Access to Care
Maclean JC, McClellan C, Pesko MF
Medicaid reimbursement rates for primary care services and behavioral health outcomes.
This AHRQ-authored research studied the effects of changing Medicaid reimbursement rates for primary care services on behavioral health outcomes-defined here as mental illness and substance use disorders. The authors applied two-way fixed-effects regressions to survey data specifically designed to measure behavioral health outcomes over the period 2010-2016. They found that higher primary care reimbursement rates reduce mental illness and substance use disorders among non-elderly adult Medicaid enrollees, although they interpreted findings for substance use disorders with some caution as they may be vulnerable to differential pre-trends. Overall, their findings suggest positive spillovers from a policy designed to target primary care services to behavioral health outcomes.
AHRQ-authored.
Citation: Maclean JC, McClellan C, Pesko MF .
Medicaid reimbursement rates for primary care services and behavioral health outcomes.
Health Econ 2023 Jan 6;32(4):873-909. doi: 10.1002/hec.4646.
Keywords: Medicaid, Payment, Primary Care, Behavioral Health, Outcomes, Access to Care, Substance Abuse, Health Insurance
Auty SG, Aswani MS, Wahbi RN
Changes in health care access by race, income, and Medicaid expansion during the COVID-19 pandemic.
This study examined changes in access to care during the COVID-19 pandemic, stratified by race/ethnicity, household income, and state Medicaid expansion status. Data were extracted for all adults (N = 1,731,699) aged 18-64 surveyed in the 2015-2020 Behavioral Risk Factor Surveillance System from all 50 states and the District of Columbia. The pandemic was associated with a 1.2 percentage point decline in uninsurance for Medicaid expansion states, with reductions concentrated among respondents who were Black, multiracial, or low income. Rates of uninsurance were generally stable in nonexpansion states. Rates of avoided care because of cost fell by 3.5 percentage points in Medicaid expansion states, and by 3.6 percentage points in nonexpansion states. These declines were also concentrated among minority or low-income respondents.
AHRQ-funded; HS026395.
Citation: Auty SG, Aswani MS, Wahbi RN .
Changes in health care access by race, income, and Medicaid expansion during the COVID-19 pandemic.
Med Care 2023 Jan;61(1):45-49. doi: 10.1097/mlr.0000000000001788..
Keywords: COVID-19, Access to Care, Medicaid, Public Health, Racial and Ethnic Minorities, Low-Income
Steenland MW, Wherry LR
Medicaid expansion led to reductions in postpartum hospitalizations.
The purpose of this study was to assess whether the Medicaid expansions of the Affordable Care Act (ACA) affected rates of postpartum hospitalization. The researchers compared states that did and did not expand Medicaid under the ACA as they related to changes in hospitalizations among birthing people with a Medicaid-financed delivery. The study found a 17% reduction in hospitalizations during the first 60 days postpartum associated with the Medicaid expansions, and evidence of a lesser decrease in hospitalizations between 61 days and 6 months postpartum. The researchers concluded that Medicaid coverage expansion under the ACA resulted in improved postpartum health for low-income birthing people.
AHRQ-funded; HS027464.
Citation: Steenland MW, Wherry LR .
Medicaid expansion led to reductions in postpartum hospitalizations.
Health Aff 2023 Jan; 42(1):18-25. doi: 10.1377/hlthaff.2022.00819..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Hospitalization, Maternal Care, Women, Health Insurance, Access to Care
Moriya AS, Chakravarty S
Racial and ethnic disparities in preventable hospitalizations and ED visits five years after ACA Medicaid expansions,.
This AHRQ-authored paper examined whether the 2014 Affordable Care Act (ACA) Medicaid expansions mitigated existing racial or ethnic disparities in preventable hospitalizations and emergency department (ED) visits. The authors used inpatient data from twenty-nine states and ED data from twenty-six states for the period 2011 to 2018. They found that Medicaid expansions decreased disparities in preventable hospitalizations and ED visits between non-Hispanic Black and White nonelderly adults by 10 percent or more. There were no significant effects on disparities between Hispanic and non-Hispanic White nonelderly adults. Their findings highlight sustained improvements in community-level care for non-Hispanic Black populations, but also suggest access barriers experienced by Hispanic adults that need to be addressed beyond Medicaid eligibility expansion.
AHRQ-authored.
Citation: Moriya AS, Chakravarty S .
Racial and ethnic disparities in preventable hospitalizations and ED visits five years after ACA Medicaid expansions,.
Health Aff 2023 Jan; 42(1):26-34. doi: 10.1377/hlthaff.2022.00460..
Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Emergency Department, Hospitalization, Disparities, Medicaid, Health Insurance, Access to Care
Auty SG, Daw JR, Wallace J
State-level variation in supplemental maternity kick payments in Medicaid managed care.
The purpose of the cross-sectional study described in this research letter was to assesses the prevalence and magnitude of state-level delivery event–triggered kick payments to Medicaid managed care (MMC) plans for covering pregnant patients and the association of such payments with delivery costs. MMC kick payment rates were compared with average state Medicaid fee-for-service (FFS) payments for delivery hospitalizations and state kick payment rates compared with the Medicaid-Medicare fee index. The authors found “substantial and potentially unwarranted” state variation in delivery kick payment rates within MMC. They noted that if kick payment rates are set too low, plans may attempt to avoid pregnant enrollees by limiting coverage of certain services or restricting maternity care clinicians in their networks, with consequences for Black and Indigenous maternity patients.
AHRQ-funded; HS028754.
Citation: Auty SG, Daw JR, Wallace J .
State-level variation in supplemental maternity kick payments in Medicaid managed care.
JAMA Intern Med 2023 Jan; 183(1):80-82. doi: 10.1001/jamainternmed.2022.5146..
Keywords: Care Management, Health Insurance, Access to Care, Payment, Maternal Care
Coburn SB, Lang R, Zhang J
Statins utilization in adults with HIV: the treatment gap and predictors of statin initiation.
The purpose of this study was to describe trends in statin eligibility and subsequent statin initiation among people with HIV (PWH) from and identify the predictors of statin initiation. The researchers collected data from 12 United States cohorts between 2001 and 2017. The study found that among 16,409 PWH, 45% met statin eligibility criteria per guidelines for the time period from 2001 to 2017. Statin eligibility ranged from 22% to 25% from 2001 to 2013, and initiation increased from 13% to 45%. In 2014, 51% were statin-eligible, among whom 25% initiated statins, which increased to 32% by 2017. The researchers concluded that there is a substantial statin treatment gap, expanded by the 2013 ACC/AHA guidelines.
AHRQ-funded; 90047713.
Citation: Coburn SB, Lang R, Zhang J .
Statins utilization in adults with HIV: the treatment gap and predictors of statin initiation.
J Acquir Immune Defic Syndr 2022 Dec 15;91(5):469-78. doi: 10.1097/qai.0000000000003083..
Keywords: Medication, Human Immunodeficiency Virus (HIV), Access to Care, Practice Patterns, Cardiovascular Conditions
Herb J, Friedman H, Shrestha S
Prevalence and risk factors associated with readmission with acute kidney injury in patients receiving vancomycin outpatient parenteral antimicrobial therapy.
The purpose of this study was to understand barriers to early-stage lung cancer care at high-volume academic centers in the US. Researchers conducted semi-structured interviews with patients with suspected or diagnosed early-stage non-small cell lung cancer who had presented to a multidisciplinary clinic at academic institutions over a 6-month period; a qualitative content analysis was then performed using the framework method. Six themes relating to barriers and facilitators to lung-cancer care were identified, and the authors concluded that these factors must be addressed to improve quality of care among lung cancer patients.
AHRQ-funded; HS000032.
Citation: Herb J, Friedman H, Shrestha S .
Prevalence and risk factors associated with readmission with acute kidney injury in patients receiving vancomycin outpatient parenteral antimicrobial therapy.
Support Care Cancer 2022 Dec 14;31(1):21. doi: 10.1007/s00520-022-07465-w..
Keywords: Cancer: Lung Cancer, Cancer, Access to Care
Lock LJ, Channa R, Brennan MB
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
The goal of this retrospective cohort study was to determine the role of level of disadvantage in diabetic eye screening to explain the effect of health systems on rural and urban disparities. Researchers used an all-payer, statewide claims database to include adult Wisconsin residents with diabetes who had claims billed throughout the baseline and measurement years. Results indicated that patients from urban underserved clinics were more likely to receive screening than those from rural underserved clinics; similar findings emerged for both Medicare and non-Medicare subgroups. The researchers concluded that health systems, especially those that serve urban underserved populations, have an opportunity to increase screening rates by leveraging health system-level interventions and supporting patients in overcoming barriers.
AHRQ-funded; HS026279.
Citation: Lock LJ, Channa R, Brennan MB .
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
BMJ Open Diabetes Res Care 2022 Dec;10(6):e003174. doi: 10.1136/bmjdrc-2022-003174..
Keywords: Rural Health, Access to Care, Screening, Diabetes, Eye Disease and Health, Disparities, Chronic Conditions, Health Systems
Creedon TB, Zuvekas SH, Hill SC
Effects of Medicaid expansion on insurance coverage and health services use among adults with disabilities newly eligible for Medicaid.
The purpose of this study was to explore the impact of Affordable Care Act (ACA) Medicaid expansion on insurance coverage and health services use for adults with disabilities newly eligible for Medicaid. The researchers utilized the 2008-2018 Medical Expenditure Panel Survey data and the Agency for Healthcare Research and Quality (AHRQ) PUBSIM model to identify adults between the ages of 26-64 years with disabilities who were newly Medicaid-eligible in expansion states or would have been eligible in non-expansion states if those states had opted in to ACA Medicaid expansion. The study found that among adults with disabilities who were newly eligible for Medicaid, Medicaid expansion was associated with significant increases in full-year Medicaid coverage, receipt of primary care, receipt of flu shots and a significant decrease in out-of-pocket spending. There were greater improvements for adults with disabilities compared to those without disabilities in full-year Medicaid coverage and receipt of flu shots. The researchers concluded that Medicaid expansion was associated with improvements in full-year insurance coverage, receipt of primary and preventive care, and out-of-pocket spending for adults with disabilities who were newly eligible for Medicaid, and there were greater improvements for adults with disabilities than for adults without disabilities.
AHRQ-authored.
Citation: Creedon TB, Zuvekas SH, Hill SC .
Effects of Medicaid expansion on insurance coverage and health services use among adults with disabilities newly eligible for Medicaid.
Health Serv Res 2022 Dec;57(suppl 2):183-94. doi: 10.1111/1475-6773.14034..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicaid, Health Insurance, Disabilities, Policy, Access to Care
Chu J, Roby DH, Boudreaux MH
Effects of the Children's Health Insurance Reauthorization Act on immigrant children's healthcare access.
The purpose of this study was to estimate the effects of the Children's Health Insurance Reauthorization Act (CHIPRA) on insurance coverage, access, utilization, and health outcomes among immigrant children. The researchers utilized the restricted use 2000-2016 National Health Interview Survey (NHIS)with a sample which included immigrant children between the ages of 0 and 18 born outside the United States, with family income below 300% of the Federal Poverty Level (FPL). The study found that CHIPRA was related with a decrease in uninsured rates and an increase in public insurance enrollment for immigrant children. The effects of CHIPRA became small and statistically not significant 3 years after adoption. The researchers found no significant changes in health care access and utilization, and health outcomes, overall and across subgroups due to CHIPRA. The researchers concluded that the eligibility expansion of CHIPRA was related with increases in public insurance coverage for low-income children. However, no effect of CHIPRA on access to care and health was found.
AHRQ-funded; HS028532.
Citation: Chu J, Roby DH, Boudreaux MH .
Effects of the Children's Health Insurance Reauthorization Act on immigrant children's healthcare access.
Health Serv Res 2022 Dec;57(suppl 2):315-25. doi: 10.1111/1475-6773.14061..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Access to Care, Vulnerable Populations, Uninsured
Auty SG, Griffith KN, Shafer PR
Improving access to high-value, high-cost medicines: the use of subscription models to treat hepatitis C using direct acting antivirals in the United States.
This paper discusses the use of state-sponsored subscription models to support increased access to high-value medications such as direct acting antivirals (DAAs) which can cure chronic Hepatitis C virus (HCV). The authors discuss the use of subscription models, a type of advanced purchase commitment (APC), to support increased access to high-value DAAs to treat HCV. They provide background information on HCV, its treatment, and state financing of prescription medications. They review the implementation of HCV subscription models in two states, Louisiana and Washington, and early evidence of their impact, as DAAs can cost upwards of $90,000 for treatment course.
AHRQ-funded; HS026395.
Citation: Auty SG, Griffith KN, Shafer PR .
Improving access to high-value, high-cost medicines: the use of subscription models to treat hepatitis C using direct acting antivirals in the United States.
J Health Polit Policy Law 2022 Dec 1;47(6):691-708. doi: 10.1215/03616878-10041121..
Keywords: Hepatitis, Medication, Chronic Conditions, Access to Care
Strauss AT, Sidoti CN, Purnell TS
Multicenter study of racial and ethnic inequities in liver transplantation evaluation: understanding mechanisms and identifying solutions.
This multicenter study examined racial and ethnic inequities in liver transplantation. The authors recruited participants from the liver transplantation (LT) teams including coordinators, advanced practice providers, physicians, social workers, dieticians, pharmacists, leadership at 2 major LT centers. They conducted 54 interviews and had 49 observation hours. They created a conceptual framework describing how transplant work system characteristics and other external factors may improve equity in the LT evaluation process. They proposed transplant center-level solutions (i.e., including but not limited to training of staff on health equity) to modifiable barriers in the clinical work system that could help patient navigation, reduce disparities, and improve access to care. Their findings call for an urgent need for transplant centers, national societies, and policy makers to focus efforts on improving equity (tailored, patient-centered resources) using the science of human factors and systems engineering.
AHRQ-funded; HS024600.
Citation: Strauss AT, Sidoti CN, Purnell TS .
Multicenter study of racial and ethnic inequities in liver transplantation evaluation: understanding mechanisms and identifying solutions.
Liver Transpl 2022 Dec;28(12):1841-56. doi: 10.1002/lt.26532..
Keywords: Racial and Ethnic Minorities, Transplantation, Disparities, Access to Care
Eliason EL, Daw JR
Presumptive eligibility for pregnancy Medicaid and timely prenatal care access.
The purpose of this study was to evaluate the relationship between the adoption of presumptive eligibility for pregnancy Medicaid in Kansas in 2016 and timely prenatal care access. The researchers utilized 2012-2019 National Center for Health Statistics natality files of all live births in adults aged 20 or older in Kansas, Idaho, Missouri, Nebraska, Tennessee, Utah, Wisconsin, and Wyoming, with outcomes of first-trimester prenatal care, the month of first prenatal visit, and adequate prenatal care. The study found no evidence that presumptive eligibility in Kansas resulted in changes in prenatal care use. Among individuals with high school education or less, presumptive eligibility was associated with an increase in first-trimester prenatal care, driven by earlier month of first prenatal care visit. The researchers concluded that in individuals with lower education, presumptive eligibility in Medicaid non-expansion states may lead to small improvements in early prenatal care.
AHRQ-funded; HS000011.
Citation: Eliason EL, Daw JR .
Presumptive eligibility for pregnancy Medicaid and timely prenatal care access.
Health Serv Res 2022 Dec;57(6):1288-94. doi: 10.1111/1475-6773.14035..
Keywords: Pregnancy, Maternal Care, Access to Care, Medicaid, Women
Grove LR, Rao N, Domino ME
Are North Carolina clinicians delivering opioid use disorder treatment to Medicaid beneficiaries?
This study’s goal was to inform efforts to increase prescriptions of medications for opioid use disorder (MOUD) among Medicaid beneficiaries. A retrospective study of North Carolina licensed physicians, physician assistants, and nurse practitioners was conducted to estimate Medicaid participation prevalence among clinicians authorized to prescribe buprenorphine and to estimate the association between clinician characteristics and OUD care delivery to Medicaid beneficiaries. Outcomes looked for were indicators of any Medicaid professional claims and Medicaid claims data for buprenorphine and naltrexone. Licensure data from 2018 was merged with 2019 US Drug Enforcement Administration to identify clinicians who used the DEA waiver required to prescribe buprenorphine (n = 1714). Services by waivered clinicians to Medicare beneficiaries ranged from 67% of behavioral health clinicians to 82.9% of specialist physicians. Prevalence of prescribing buprenorphine to Medicaid beneficiaries ranged from 30.3% among specialist physicians to 51.6% among behavioral health clinicians.
AHRQ-funded; HS000032.
Citation: Grove LR, Rao N, Domino ME .
Are North Carolina clinicians delivering opioid use disorder treatment to Medicaid beneficiaries?
Addiction 2022 Nov;117(11):2855-63. doi: 10.1111/add.15854..
Keywords: Opioids, Substance Abuse, Behavioral Health, Vulnerable Populations, Medication, Access to Care, Medicaid
Yabroff KR, Han X, Zhao J
Association of health insurance coverage disruptions with mortality risk among US working-age adults.
This cohort study assessed associations of a prior coverage disruption with mortality risk among large, nationally representative cohorts of working-age adults aged 18 to 64 with public or private health insurance coverage. Most research had previously been conducted among Medicaid enrollees, and little is known about insurance disruption among privately insured adults. The study used data from the 2000 to 2018 National Health Interview Survey (NIHS), specifically from the NHIS Linked Mortality files which contain data from the National Death Index. All data was deidentified and publicly available. The authors found that disruptions were associated with a higher mortality risk in either publicly or privately insured adults.
AHRQ-authored.
Citation: Yabroff KR, Han X, Zhao J .
Association of health insurance coverage disruptions with mortality risk among US working-age adults.
JAMA Health Forum 2022 Nov;3(11):e224258. doi: 10.1001/jamahealthforum.2022.4258..
Keywords: Health Insurance, Mortality, Risk, Access to Care
Semere W, Kaplan L, Valle K
Caregiving needs are unmet for many older homeless adults: findings from the Hope Home study.
Researchers described characteristics of older homeless-experienced adults with caregiving need and determined factors associated with having unmet need. Using data from the longitudinal study, Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME), they found that better self-rated health and being a man were associated with higher odds of unmet need. Moderate or high-risk substance use was associated with lower odds of unmet need. They recommended interventions that increase caregiving access for homeless-experienced individuals in order to avoid poor health outcomes and costly long-term-care needs due to untreated disabilities.
AHRQ-funded; HS027844.
Citation: Semere W, Kaplan L, Valle K .
Caregiving needs are unmet for many older homeless adults: findings from the Hope Home study.
J Gen Intern Med 2022 Nov;37(14):3611-19. doi: 10.1007/s11606-022-07438-z..
Keywords: Elderly, Vulnerable Populations, Caregiving, Access to Care
Eliason Gordon, Gordon SH
The association between postpartum insurance instability and access to postpartum mental health services: evidence from Colorado.
This study assessed the association between postpartum insurance instability and access to postpartum mental health services. The authors used data from the 2018-2019 Colorado Health eMoms survey, which sampled mothers from the 2018 birth certificate files at 3-6 months and 12-14 months postpartum. Respondents were classified at each time point as stably insured or unstable insured based on postpartum insurance status. Of respondents with public coverage at childbirth, 33.2% experienced postpartum insurance changes compared with 9.5% with private coverage. Respondents were more likely to experience unstable postpartum insurance if they were younger, had incomes of less than $50,000, and were of Hispanic ethnicity. Respondents who experienced postpartum insurance instability had lower odds of reporting that they discussed mental health at a postpartum check-up and received postpartum mental health services.
AHRQ-funded; HS000011.
Citation: Eliason Gordon, Gordon SH .
The association between postpartum insurance instability and access to postpartum mental health services: evidence from Colorado.
Womens Health Issues 2022 Nov-Dec;32(6):550-56. doi: 10.1016/j.whi.2022.06.010..
Keywords: Maternal Care, Access to Care, Women, Behavioral Health, Health Insurance
Abdus S, Selden TM
Well-child visit adherence.
This article presents updated evidence on well-child visit adherence, using MEPS data to conduct a cross-sectional study. The results indicate that average adherence increased between 2006-07 and 2016-17, but the authors note that large gaps remain in such areas as race and ethnicity, poverty level, insurance coverage, and geographic region.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Well-child visit adherence.
JAMA Pediatr 2022 Nov;176(11):1143-45. doi: 10.1001/jamapediatrics.2022.2954..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Healthcare Utilization, Access to Care
