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Topics
- Access to Care (2)
- Asthma (1)
- Behavioral Health (1)
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- (-) Medicaid (15)
- Medicare (3)
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- Risk (1)
- Screening (1)
- (-) Social Determinants of Health (15)
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- Vulnerable Populations (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 15 of 15 Research Studies DisplayedMiller-Rosales C, McCloskey J, Uratsu CS
Associations between different self-reported social risks and neighborhood-level resources in Medicaid patients.
Investigators sought improved understanding of how social risk factors interact with each other and with neighborhood characteristics in order to inform efforts to reduce health disparities. They found that among 5 commonly associated social risk factors, Medicaid patients in a large Northern California health system typically reported only a single factor and that these factors did not correlate strongly with each other. They found only modestly greater social risk reported by patients in the least resourced neighborhoods. They concluded that their results suggested that individual-level interventions should be targeted to specific needs whereas community-level interventions may be similarly important across diverse neighborhoods.
AHRQ-funded; HS027343.
Citation: Miller-Rosales C, McCloskey J, Uratsu CS .
Associations between different self-reported social risks and neighborhood-level resources in Medicaid patients.
Med Care 2022 Aug;60(8):563-69. doi: 10.1097/mlr.0000000000001735..
Keywords: Medicaid, Social Determinants of Health
McQueen A, Kreuter MW, Herrick CJ
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
The purpose of this study was to determine the number and types of social needs experienced by Medicaid beneficiaries with type 2 diabetes and how these social needs are associated with key health indicators. Findings showed that having more social needs was associated with a wide range of indicators of poor health and well-being. Study participants with the greatest social need burden were most open to intervention.
AHRQ-funded; HS019455.
Citation: McQueen A, Kreuter MW, Herrick CJ .
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
Health Soc Care Community 2022 May;30(3):1035-44. doi: 10.1111/hsc.13296..
Keywords: Diabetes, Chronic Conditions, Medicaid, Social Determinants of Health
Dennett JM, Baicker K
Medicaid, health, and the moderating role of neighborhood characteristics.
The purpose of this study was to evaluate whether the characteristics of different neighborhoods have an impact on the interaction between local environment and the effect of health insurance on health. The researchers utilized existing data from the Oregon Health Insurance Experiment and combined it with new, expanded data on neighborhood characteristics to assess whether those characteristics impacted the relationship between getting health insurance and health outcomes. The study found that the multiple domains of neighborhood characteristics did not affect the correlation between insurance and health outcomes, and concluded that Medicaid expansions do not differ greatly in effectiveness across neighborhoods.
AHRQ-funded; HS000055.
Citation: Dennett JM, Baicker K .
Medicaid, health, and the moderating role of neighborhood characteristics.
J Urban Health 2022 Feb;99(1):116-33. doi: 10.1007/s11524-021-00579-2..
Keywords: Medicaid, Social Determinants of Health, Health Insurance
Malhotra NA, Nevar A, Yearby R
Medicaid's EPSDT benefit: an opportunity to improve pediatric screening for social determinants of health.
This paper discusses the Early and Periodic Screening, Diagnostic, and Treatment (EPDST) benefit which is a key component of Medicaid policy intended to define an essential set of services provided to patients age 21 and younger. This qualitative review examines the extent to which EPSDT might be used to implement structured screening to identify environmental and social factors affecting children’s health. Semistructured interviews conducted in 2017 were triangulated with a review of the recent literature to describe how states currently consider the EPSDT benefit with respect to social determinants of health (SDOH) screening. Findings suggest that with sufficient stakeholder advocacy given the evidence supporting social determinants of health as “medically necessary”, EPSDT benefits could be considered as a funding source to incentivize the incorporation of SDOH screening into the basic package of well-child care.
AHRQ-funded; 233201600221A.
Citation: Malhotra NA, Nevar A, Yearby R .
Medicaid's EPSDT benefit: an opportunity to improve pediatric screening for social determinants of health.
Med Care Res Rev 2021 Apr;78(2):87-102. doi: 10.1177/1077558719874211..
Keywords: Children/Adolescents, Medicaid, Social Determinants of Health, Screening, Disparities, Policy
Byhoff E, Taylor LA
Massachusetts community-based organization perspectives on Medicaid redesign.
The purpose of the study was to investigate how community-based organizations perceive Medicaid policy changes to address the social determinants of health. Forty-six key informant interviews were conducted, representing 44 community-based organizations across Massachusetts. Findings showed that changes to Medicaid policy can catalyze interest in partnership between healthcare organizations and community-based organizations. Recommendations included having policymakers and healthcare leadership ensure that community-based organizations are part of strategy development and social service program implementation.
AHRQ-funded; HS026664.
Citation: Byhoff E, Taylor LA .
Massachusetts community-based organization perspectives on Medicaid redesign.
Am J Prev Med 2019 Dec;57(6 Suppl 1):S74-s81. doi: 10.1016/j.amepre.2019.07.017..
Keywords: Medicaid, Social Determinants of Health, Policy, Health Insurance
Roberts ET, Mellor JM, McInerney M
State variation in the characteristics of Medicare-Medicaid dual enrollees: Implications for risk adjustment.
The purpose of this study was to examine between-state differences in the socioeconomic and health characteristics of Medicare beneficiaries dually enrolled in Medicaid, focusing on characteristics not observable to or used by policy makers for risk adjustment. The investigators concluded that characteristics of dual enrollees differed substantially across states, reflecting differences in states' low-income Medicare populations and Medicaid policies.
AHRQ-funded; HS026727; HS025422.
Citation: Roberts ET, Mellor JM, McInerney M .
State variation in the characteristics of Medicare-Medicaid dual enrollees: Implications for risk adjustment.
Health Serv Res 2019 Dec;54(6):1233-45. doi: 10.1111/1475-6773.13205..
Keywords: Medicare, Medicaid, Social Determinants of Health
Fleming MD, Guo C, Knox M
Impact of social needs case management on use of medical and behavioral health services: secondary analysis of a randomized controlled trial.
This research letter describes a secondary analysis that was conducted of a randomized encouragement study that assigned Medicaid beneficiaries with high risk for acute care use to social needs case management or to be administratively observed in the control group from August 2017 through December 2018. These services connect patients to resources such as food assistance, housing, transportation, or income benefits in addition to facilitating access to health care and behavioral health services. The study group included adults 18 years or older, who are residents of Contra Costa County in California, and enrolled in full-scope Medicaid. The case management enrollees were assigned to a case manager who assessed their needs, created a patient-centered care plan, and provided ongoing support including community resource referrals, coordination with primary care providers, and collaboration on applications for public benefits. Case managers had diverse backgrounds and included public health nurses, social workers, substance misuse counselors, mental health clinicians, homeless service specialists, and community health workers. Case management was offered either in-person or by remote telephonic services for 1 year. About 40% (n = 8577) of enrolled patients used the services. There were 21,422 intervention group enrollments and 22,839 in the weighted control group. The intervention group had significantly higher rates of primary care visits compared with the control group. No differences were found between the treatment groups for specialty care visits, behavioral health visits, psychiatric emergency visits, or jail intakes.
AHRQ-funded; HS027648.
Citation: Fleming MD, Guo C, Knox M .
Impact of social needs case management on use of medical and behavioral health services: secondary analysis of a randomized controlled trial.
Ann Intern Med 2023 Aug; 176(8):1139-41. doi: 10.7326/m23-0876..
Keywords: Medicaid, Vulnerable Populations, Social Determinants of Health, Care Management, Care Coordination
Raven MC, Guzman D, Chen AH
Out-of-network emergency department use among managed Medicaid beneficiaries.
The researchers examined factors associated with out-of-network ED use among Medicaid beneficiaries. They concluded that there are a number of factors related to out-of-network ED use, including the proximity and density of out-of-network EDs, race and ethnicity, a prior history of out-of-network ED use, and individuals' connection to primary care.
AHRQ-funded; HS021700.
Citation: Raven MC, Guzman D, Chen AH .
Out-of-network emergency department use among managed Medicaid beneficiaries.
Health Serv Res 2017 Dec;52(6):2156-74. doi: 10.1111/1475-6773.12604.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Medicaid, Primary Care, Social Determinants of Health
Davis MM, Renfro S, Pham R
Geographic and population-level disparities in colorectal cancer testing: a multilevel analysis of Medicaid and commercial claims data.
This study used Medicaid and commercial claims data to examine individual and geographic factors associated with colorectal cancer testing rates in Oregon. CRC testing in newly age-eligible Medicaid and commercial members remains markedly low. Disparities exist by gender, geographic residence, insurance coverage, and access to primary care.
AHRQ-funded; HS022981.
Citation: Davis MM, Renfro S, Pham R .
Geographic and population-level disparities in colorectal cancer testing: a multilevel analysis of Medicaid and commercial claims data.
Prev Med 2017 Aug;101:44-52. doi: 10.1016/j.ypmed.2017.05.001.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Disparities, Medicaid, Social Determinants of Health
Gao YN, Nocon RS, Sharma R
What factors are associated with Medicaid patients' use of health centers?.
This study identified patient and neighborhood factors associated with health center (HC) use. Dually eligible patients and those with high chronic disease burden had lower odds of HC use. Temporary Assistance for Needy Families participants and Hispanic beneficiaries had higher odds. Local HC presence predicted higher HC use.
AHRQ-funded; HS000084.
Citation: Gao YN, Nocon RS, Sharma R .
What factors are associated with Medicaid patients' use of health centers?.
J Prim Care Community Health 2017 Jul;8(3):141-46. doi: 10.1177/2150131916687919.
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Keywords: Community-Based Practice, Healthcare Utilization, Medicaid, Primary Care, Social Determinants of Health
Keohane LM, Rahman M, Mor V
Reforming access: trends in Medicaid enrollment for new Medicare beneficiaries, 2008-2011.
This study evaluated whether aligning the Part D low-income subsidy and Medicaid program enrollment pathways in 2010 increased Medicaid participation among new Medicare beneficiaries. It found that the percentage of beneficiaries enrolling in limited Medicaid at the start of Medicare coverage increased in 2010 by 0.3 percentage points for individuals aging into Medicare and by 1.3 percentage points for those qualifying due to disability.
AHRQ-funded; HS000011.
Citation: Keohane LM, Rahman M, Mor V .
Reforming access: trends in Medicaid enrollment for new Medicare beneficiaries, 2008-2011.
Health Serv Res 2016 Apr;51(2):550-69. doi: 10.1111/1475-6773.12349.
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Keywords: Medicare, Medicaid, Policy, Access to Care, Social Determinants of Health
Jiang HJ, Boutwell AE, Maxwell J
AHRQ Author: Jiang HJ
Understanding patient, provider, and system factors related to Medicaid readmissions.
This study was undertaken to understand the complexity of Medicaid readmission issues at the patient, provider, and system levels. It found that significant risk factors for Medicaid readmissions included financial stress, high prevalence of mental health and substance abuse disorders, medication nonadherence, and housing instability. Lacking awareness on Medicaid patients' high risk, a sufficient business case, and proven strategies for reducing readmissions were primary barriers for providers.
AHRQ-authored; AHRQ-funded; 290201000034I; 290201000030I.
Citation: Jiang HJ, Boutwell AE, Maxwell J .
Understanding patient, provider, and system factors related to Medicaid readmissions.
Jt Comm J Qual Patient Saf 2016 Mar;42(3):115-21.
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Keywords: Medicaid, Hospital Readmissions, Access to Care, Social Determinants of Health, Risk
Wright KD, Pepper GA, Caserta M
Factors that influence physical function and emotional well-being among Medicare-Medicaid enrollees.
The researchers examined the associations between race, gender, age, neighborhood poverty, education, and health behaviors (i.e., smoking, exercise, and physical activity) with physical function and emotional well-being in Medicare-Medicaid enrollees. They determined that race, neighborhood poverty, education, and income did not influence physical function or emotional well-being; however, physical activity was associated both with an increased self-report of physical function and emotional well-being.
AHRQ-funded; HS014539.
Citation: Wright KD, Pepper GA, Caserta M .
Factors that influence physical function and emotional well-being among Medicare-Medicaid enrollees.
Geriatr Nurs 2015 Mar-Apr;36(2 Suppl):S16-20. doi: 10.1016/j.gerinurse.2015.02.022..
Keywords: Social Determinants of Health, Medicare, Medicaid, Lifestyle Changes, Health Status
Malhotra K, Baltrus P P, Zhang S
Geographic and racial variation in asthma prevalence and emergency department use among Medicaid-enrolled children in 14 southern states.
Using 2007 Medicaid claims data from 556 counties in 14 southern states, the researchers described the local area variation in 1-year asthma prevalence rates, emergency department visit rates, and racial disparity rate ratios. They found much local area variation in asthma prevalence and asthma ED visit rates among Medicaid-enrolled children. Between black and white children, more counties had higher prevalence of asthma and higher ED visit rates among blacks.
AHRQ-funded; HS022444; HS019470
Citation: Malhotra K, Baltrus P P, Zhang S .
Geographic and racial variation in asthma prevalence and emergency department use among Medicaid-enrolled children in 14 southern states.
J Asthma. 2014 Nov;51(9):913-21. doi: 10.3109/02770903.2014.930479..
Keywords: Asthma, Medicaid, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Regenstein M, Andres E
Reducing hospital readmissions among Medicaid patients: a review of the literature.
This review aims to identify factors related to readmissions that are unique to Medicaid populations to inform efforts to reduce Medicaid readmissions. It concluded that much of the Medicaid readmissions literature focuses on patients with mental health or substance abuse issues, who are often high utilizers of health care within the Medicaid population.
AHRQ-funded; 290202010000301.
Citation: Regenstein M, Andres E .
Reducing hospital readmissions among Medicaid patients: a review of the literature.
Qual Manag Health Care 2014 Oct-Dec;23(4):203-25. doi: 10.1097/qmh.0000000000000043..
Keywords: Hospital Readmissions, Medicaid, Behavioral Health, Substance Abuse, Social Determinants of Health