National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedMaclean JC, McClellan C, Pesko MF
AHRQ Author: McClellan C
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, 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
Fung V, McCarthy S, Price M
Payment discrepancies and access to primary care physicians for dual-eligible Medicare-Medicaid beneficiaries.
This study examined whether the Affordable Care Act (ACA) primary care fee bump for dual-eligible Medicare-Medicaid beneficiaries impacted primary care physicians (PCP) acceptance of duals. The authors assessed differences in the likelihood that PCPs had dual caseloads of ≥10% or 20% in states with lower versus full dual reimbursement using linear probability models adjusted for physician and area-level traits. The proportion of PCPs with dual caseloads of ≥10% or 20% decreased significantly between 2012 and 2017. The fee bump was not consistently associated with increases in dual caseloads.
AHRQ-funded; HS024725.
Citation: Fung V, McCarthy S, Price M .
Payment discrepancies and access to primary care physicians for dual-eligible Medicare-Medicaid beneficiaries.
Med Care 2021 Jun;59(6):487-94. doi: 10.1097/mlr.0000000000001525..
Keywords: Primary Care, Medicaid, Medicare, Health Insurance, Payment, Access to Care
Mroz TM, Patterson DG, Frogner BK
The impact of Medicare's rural add-on payments on supply of home health agencies serving rural counties.
This analysis looked at the impact of Medicare’s rural add-on payments on supply of home health agencies serving rural counties. The authors used data from Home Health Compare. The results suggest that while supply changes are similar in rural counties adjacent to urban areas and urban counties regardless of add-on payments, only higher add-payments of 5 to 10 percent to rural counties keep them on pace with those in urban counties.
AHRQ-funded; HS024777.
Citation: Mroz TM, Patterson DG, Frogner BK .
The impact of Medicare's rural add-on payments on supply of home health agencies serving rural counties.
Health Aff 2020 Jun;39(6):949-57. doi: 10.1377/hlthaff.2019.00952..
Keywords: Elderly, Medicare, Home Healthcare, Rural Health, Payment, Access to Care
Ouayogode MH, Meara E, Chang CH
Forgotten patients: ACO attribution omits those with low service use and the dying.
Alternative payment models, such as accountable care organizations, hold provider groups accountable for an assigned patient population, but little is known about unassigned patients. This study compared clinical and utilization profiles of patients attributable to a provider group with those of patients not attributable to any provider group. The study concluded that attribution approaches that more fully capture unattributable patients with low service use and patients near the end of life should be considered to reward population health efforts and improve end-of-life care.
AHRQ-funded; HS024075.
Citation: Ouayogode MH, Meara E, Chang CH .
Forgotten patients: ACO attribution omits those with low service use and the dying.
Am J Manag Care 2018 Jul;24(7):e207-e15..
Keywords: Access to Care, Patient-Centered Outcomes Research, Payment, Vulnerable Populations
Gowrisankaran G, Lucarelli C, Schmidt-Dengler P
Can amputation save the hospital? The impact of the Medicare Rural Flexibility Program on demand and welfare.
This paper sought to understand the impact of the Medicare Rural Hospital Flexibility (Flex) Program on hospital choice and consumer welfare for rural residents. The Flex Program created a new class of hospital, the Critical Access Hospital (CAH), which received more generous Medicare reimbursements in return for limits on capacity and length of stay. The investigators found that conversion to CAH status resulted in a 4.7 percent drop in inpatient admissions to participating hospitals, almost all of which was driven by factors other than capacity constraints.
AHRQ-funded; HS018424.
Citation: Gowrisankaran G, Lucarelli C, Schmidt-Dengler P .
Can amputation save the hospital? The impact of the Medicare Rural Flexibility Program on demand and welfare.
J Health Econ 2018 Mar;58:110-22. doi: 10.1016/j.jhealeco.2018.01.004..
Keywords: Rural Health, Access to Care, Hospitals, Medicare, Payment