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
51 to 75 of 360 Research Studies DisplayedSherry TB, Damberg CL, DeYoreo M
Is bigger better?: A closer look at small health systems in the United States.
The purpose of this study was to expand existing health systems research by comparing the features, cost, and quality of care in small U.S. health care systems with those of large U.S. health systems. In this retrospective study with a repeated cross-sectional analysis, the researchers evaluated between 468 and 479 large health systems and between 608 and 641 small health systems serving fee-for-service Medicare beneficiaries, yearly between the year of 2013 and 2017. The study found that small systems had a larger share of beneficiaries and practice sites in small towns or rural areas, performance quality was lower in small systems that in large systems, and there was no difference in total cost of care. The study concluded that the quality of care in small systems is lower than large systems, but small systems provide care for rural Medicare populations. The researchers recommended that future research should explore the reasons for why these differences exist in quality.
AHRQ-funded; HS024067.
Citation: Sherry TB, Damberg CL, DeYoreo M .
Is bigger better?: A closer look at small health systems in the United States.
Med Care 2022 Jul;60(7):504-11. doi: 10.1097/mlr.0000000000001727..
Keywords: Health Systems, Medicaid, Healthcare Delivery
Luo Q, Moghtaderi A, Markus A
Financial impacts of the Medicaid expansion on community health centers.
This study’s objective was to determine the impact of Medicaid expansion on community health centers. The authors combined data from the Uniform Data System, IRS nonprofit tax returns, and county-level characteristics from the Census Bureau. Their final dataset included 5841 center-year observations. They found a $2.08 million relative increase in Medicaid revenues, offset by a $0.44 million decrease in total grants among community health centers in expansion states compared with centers in non-expansion states. They found a large but not statistically significant $0.98 million relative increase in total expenditures among expansion state centers. Uncompensated care for health centers in expansion states decreased by $1.19 million relative to their counterparts in non-expansion states.
AHRQ-funded; HS026816.
Citation: Luo Q, Moghtaderi A, Markus A .
Financial impacts of the Medicaid expansion on community health centers.
Health Serv Res 2022 Jun;57(3):634-43. doi: 10.1111/1475-6773.13897..
Keywords: Medicaid, Community-Based Practice, Healthcare Costs
Meiselbach MK, Drake C, Saloner B
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
This study examined variation in access to in-network buprenorphine-prescribing primary care providers that can treat opioid use disorder among Medicaid managed care enrollees. Approximately 32.2% of Medicaid enrollees had fewer than one in-network network buprenorphine-prescribing primary care providers per 100,000 county residents. There was on average a greater number of in-network buprenorphine-prescribing primary care providers in states with higher compared with lower overdose death rates, but most enrollees lived in areas with a shortage of these providers. The authors found that a 25 percent higher network participation rate by prescribers compared with nonprescribers could improve the probability that enrollees see a prescriber by approximately 25 percent.
AHRQ-funded; HS000029.
Citation: Meiselbach MK, Drake C, Saloner B .
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
Health Aff 2022 Jun;41(6):901-10. doi: 10.1377/hlthaff.2021.01719..
Keywords: Medicaid, Primary Care, Access to Care, Medication, Care Management, Opioids, Substance Abuse, Behavioral Health
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
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
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.
AHRQ-funded; HS025750.
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
Olin SS, Freed GL, Scholle SH
Aligning to improve pediatric health care quality.
The authors presented a population health framework for collaboration and coordination across the delivery system to improve care quality, with quality measures as key tools for monitoring and incentivizing collaboration and alignment of efforts across levels, based on each entity's sphere of influence within the Applegate Alignment Framework.
AHRQ-funded; HS025296; HS025292.
Citation: Olin SS, Freed GL, Scholle SH .
Aligning to improve pediatric health care quality.
Acad Pediatr 2022 Apr;22(3s):S115-s18. doi: 10.1016/j.acap.2021.08.021..
Keywords: Children/Adolescents, Quality Improvement, Quality Measures, Quality Indicators (QIs), Quality of Care, Medicaid
Taylor K, Diaz A, Nuliyalu U
Association of dual Medicare and Medicaid eligibility with outcomes and spending for cancer surgery in high-quality hospitals.
The purpose of this study was to assess whether treatment at high-quality hospitals mitigates dual-eligibility-associated disparities in outcomes and spending for cancer surgery. Medicare beneficiaries 65 years or older who underwent colectomy, rectal resection, lung resection, or pancreatectomy were evaluated. The findings indicate that, even among the highest-quality hospitals, dual-eligibility patients had poorer outcomes and higher spending. Dually eligible patients were more likely to be discharged to a facility and thus incurred higher post-acute care costs. Although treatment at high-quality hospitals is associated with reduced differences in outcomes, dual-eligibility patients remain at high risk for adverse post-operative outcomes as well as increased readmissions and post-acute care use.
AHRQ-funded; HS024763.
Citation: Taylor K, Diaz A, Nuliyalu U .
Association of dual Medicare and Medicaid eligibility with outcomes and spending for cancer surgery in high-quality hospitals.
JAMA Surg 2022 Apr;157(4):e217586. doi: 10.1001/jamasurg.2021.7586..
Keywords: Cancer, Surgery, Medicare, Medicaid, Outcomes, Hospitals
McBain RK, Cantor JH, Kofner A
Brief report: Medicaid expansion and growth in the workforce for autism spectrum disorder.
This study examined the role that state Medicaid expansion has played in utilization of child psychiatrists, board-certified behavioral analysts (BCBAs) and pediatricians for children with autism spectrum disorder (ASD). Health workforce data from HRSA was used to examine workforce growth from 2008-2017. State Medicaid expansion was associated with a 9% increase in BCBAs per 100,000 children one year after enactment, and a 5% increase in child psychiatrists, but no association with growth in pediatrician utilization.
AHRQ-funded; HS025750.
Citation: McBain RK, Cantor JH, Kofner A .
Brief report: Medicaid expansion and growth in the workforce for autism spectrum disorder.
J Autism Dev Disord 2022 Apr;52(4):1881-89. doi: 10.1007/s10803-021-05044-2..
Keywords: Children/Adolescents, Autism, Medicaid, Workforce, Behavioral Health
Mistry KB, Sagatov RDF, Schur C
AHRQ Author: Mistry KB, Sagatov RDF
Design and implementation of the Pediatric Quality Measures Program 2.0.
This AHRQ-authored research discusses the design and implementation of the Pediatric Quality Measures Program (PQMP) 2.0. The PQMP was established in response to the Children’s Health Insurance Program Reauthorization Act of 2009. AHRQ and CMS awarded 6 grants to Centers of Excellence (COEs) and a contract to facilitate collaboration and learning across the COEs. The COEs partnered with stakeholders from multiple levels to field test real-world implementation and refinement of pediatric quality measures and quality improvement initiatives. A PQMP Learning Collaborative (PQMP-LC) consisting of AHRQ, CMS, the 6 COEs, and L&M Policy Research, LLC was created to complete literature reviews, conduct key informant interviews, and collect data to develop reports to address the Research Foci. It also aided with development of measure implementation and quality improvement toolkits; conceptualized an implementation science framework, analysis, and roadmap; and facilitated dissemination of learnings and products. The various products created are intended to support the uptake of PQMP measures and inform future pediatric measurement and improvement work.
AHRQ-authored.
Citation: Mistry KB, Sagatov RDF, Schur C .
Design and implementation of the Pediatric Quality Measures Program 2.0.
Acad Pediatr 2022 Apr;22(3s):S59-S64. doi: 10.1016/j.acap.2021.12.021..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Forrest CB, Simpson L, Mistry KB
AHRQ Author: Mistry KB
PQMP Phase 2: implementation and dissemination.
The authors provide an overview of the articles in this supplement concerning the Children’s Health Insurance Program Reauthorization Act Pediatric Quality Measures Program (PQMP). The articles examine the opportunities and challenges associated with the PQMP 2.0 work of the Centers for Excellence and how findings may advance the science for pediatric quality measurement and improvement, and, ultimately, child health outcomes.
AHRQ-authored.
Citation: Forrest CB, Simpson L, Mistry KB .
PQMP Phase 2: implementation and dissemination.
Acad Pediatr 2022 Apr;22(3s):S55-S58. doi: 10.1016/j.acap.2022.01.012..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Schur C, Johnson M, Doherty J
AHRQ Author: Mistry KB
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
This AHRQ-authored paper describes key stakeholder insights focused on measure implementation and increasing the uptake of Pediatric Quality Measures (PQM). The PQMP Learning Collaborative conducted semistructured interviews with 9 key informants (KIs) presenting states, health plans, and other potential end users. The interviews focused on obtaining KIs’ perspectives on 6 research questions focused on assessing the feasibility and usability of PQM and strengthening the connection between measurement and improvement. The KIs uniformly acknowledged the complexity of the issues raised and pinpointed multiple unresolved issues.
AHRQ-authored; AHRQ-funded; 290201400003I.
Citation: Schur C, Johnson M, Doherty J .
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
Acad Pediatr 2022 Apr;22(3S):S76-S80. doi: 10.1016/j.acap.2021.04.007..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Shenkman E, Mistry KB, Davis D
AHRQ Author: Mistry KB
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
The University of Florida Child Health Quality (CHeQ) initiative, funded by the Agency for Health Care Research and Quality (AHRQ)/Centers for Medicare and Medicaid Services (CMS) Pediatric Quality Measurement Program, examined measures that states use to evaluate quality of oral health care for children in Medicaid and the Children’s Health Insurance Program (CHIP). This paper discusses stakeholder engagement in bridging research and policy to improve measurement and dental care for children in Medicaid.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Shenkman E, Mistry KB, Davis D .
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
Acad Pediatr 2022 Apr;22(3S):S65-S67. doi: 10.1016/j.acap.2021.08.012..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care
Sivaraman JC, Greene SB, Naumann RB
Association between medical diagnoses and suicide in a Medicaid beneficiary population, North Carolina 2014-2017.
This study investigated the impact of various medical diagnoses on firearm and nonfirearm suicide. The authors used a case-control design including 691 North Carolina Medicaid beneficiaries who died from suicide between 2014 and 2017 as cases. They selected 68,682 controls. They linked Medicaid claims to the North Carolina Violent Death Reporting System to ascertain suicide and means (firearm or nonfirearm). They matched cases and controls on number of months covered by Medicaid over the past 36 months They adjusted for sex, race, Supplemental Security Income state, the Charlson Comorbidity Index, and frequency of health care encounters. The case-control odds ratios for any mental health disorder were 4.2 for nonfirearm suicide and 2.2 for firearm suicide. Behavioral health diagnoses were more strongly associated with nonfirearm suicides than firearm suicides in men but not in women. There was a weaker association of mental health and substance use diagnoses with suicides in Blacks, although estimates were imprecise.
AHRQ-funded; HS000032.
Citation: Sivaraman JC, Greene SB, Naumann RB .
Association between medical diagnoses and suicide in a Medicaid beneficiary population, North Carolina 2014-2017.
Epidemiology 2022 Mar 1; 33(2):237-45. doi: 10.1097/ede.0000000000001439..
Keywords: Behavioral Health, Medicaid
Auty SG, Griffith KN
Medicaid expansion and drug overdose mortality during the COVID-19 pandemic in the United States.
This study examined trends in overdose mortality nationally and by state Medicaid expansion status from 2013 to 2020. Using data from the CDC’s WONDER database, findings showed that the increase in drug or opioid overdose deaths experienced during the first year of the COVID-19 pandemic was similar in states with and without Medicaid expansion.
AHRQ-funded; HS026395.
Citation: Auty SG, Griffith KN .
Medicaid expansion and drug overdose mortality during the COVID-19 pandemic in the United States.
Drug Alcohol Depend 2022 Mar 1;232:109340. doi: 10.1016/j.drugalcdep.2022.109340..
Keywords: COVID-19, Medicaid, Opioids, Substance Abuse, Behavioral Health, Mortality, Public Health
Caves Sivaraman JJ, Ranapurwala SI, Proescholdbell S
Suicide typologies among Medicaid beneficiaries, North Carolina 2014-2017.
Only ½ of suicide decedents are diagnosed with a mental health condition; population-based screening strategies are needed to help identify people who are at risk of suicide, and it may be necessary for providers to consider patient life circumstances that may place them at a higher risk. The purpose of this study was to identify suicide typologies among suicide decedents and describe the alignment between medical diagnoses and life circumstances. Decedent demographics, stressful life events, perceived and diagnosed/ health issues, suicidal behavior, and suicide method contributed to the typologies. In 2020 the researchers linked North Carolina Medicaid data with data from the North Carolina Violent Death reporting System (NC-VDRS) to analyze suicide decedents from 2014-2017, aged 25-54 years of age. Researchers analyzed 6 indicators of life circumstances from Medicaid claims and 12 indicators from the NC-VDRS and developed separate models for men and women. The study found that 88.3% of the suicide decedents were White, with a median age of 41 years, and more than 70% had experienced a health care visit in the 90 days prior to suicide. The study concluded that almost one-half of suicide decedents have a typology characterized by a low probability of diagnosis of mental health issues. The authors report that screenings for suicide could be improved by using improved indicators of lived experience and mental health.
AHRQ-funded; HS000032.
Citation: Caves Sivaraman JJ, Ranapurwala SI, Proescholdbell S .
Suicide typologies among Medicaid beneficiaries, North Carolina 2014-2017.
BMC Psychiatry 2022 Feb 10;22(1):104. doi: 10.1186/s12888-022-03741-5..
Keywords: Medicaid, Behavioral Health
Greenberg JK, Brown DS, Olsen MA
Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care.
This study's goal was to evaluate the impact of Medicaid expansion under the Affordable Care Act on the volume and payer mix of elective spine surgery in the United States. The authors evaluated elective spinal surgeries performed in the U.S. from 2011 to 2016 and included 10 states with expanded Medicaid access and 4 states that did not. They identified 218,648 surgical procedures performed in 10 Medicaid expansion states and 118,693 procedures performed in 4 nonexpansion states. Medicaid expansion was associated with a 17% increase in mean hospital spine surgical volume and a 23% increase in Medicaid volume. Privately insured surgical volumes did not change significantly. This increase indicated improved access to care.
AHRQ-funded; HS027075.
Citation: Greenberg JK, Brown DS, Olsen MA .
Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care.
J Neurosurg Spine 2022 Feb;36(2):336–44. doi: 10.3171/2021.3.Spine2122..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Access to Care, Surgery
Decker SL, Abdus S, Lipton BJ
AHRQ Author: Decker SL, Abdus S
Eligibility for and enrollment in Medicaid among nonelderly adults after implementation of the Affordable Care Act.
The authors used simulation modeling to examine Medicaid eligibility and participation during 2014 to 2017. They found that more than one in five adults were Medicaid-eligible in expansion states, while about one in 30 adults were Medicaid-eligible in non-expansion states. Further, while eligibility rates differed substantially by expansion status, participation rates among Medicaid-eligible adults were similar in both sets of states, indicating that differences in eligibility, rather than in participation rates, explained differences in enrollment between expansion and non-expansion states during the study period.
AHRQ-authored.
Citation: Decker SL, Abdus S, Lipton BJ .
Eligibility for and enrollment in Medicaid among nonelderly adults after implementation of the Affordable Care Act.
Med Care Res Rev 2022 Feb;79(1):125-32. doi: 10.1177/1077558721996851..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicaid, Health Insurance
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
Bronstein JM, Huang L, Shelley JP
Primary care visits and ambulatory care sensitive diabetes hospitalizations among adult Alabama Medicaid beneficiaries.
This retrospective cohort study described patterns of care use for Alabama Medicaid adult beneficiaries with diabetes and the association of primary care utilization and ambulatory care sensitive (ACS) diabetes hospitalizations. Alabama Medicaid claims data from January 2010 to April 2018 for 52, 549 covered adults aged 19-64 with diabetes was analyzed. Individuals were categorized by demographics, comorbidities, and health care use. Characteristics of the cohort with and without ACS hospitalization was reported. One third of the cohort had at least one ACS diabetes hospitalization over the observed periods. Hospital users tended to have multiple ACS hospitalizations as well as more comorbidities and pharmaceutical and other types of care use than those with no ACS hospitalizations. Having a primary care visit in one year was significantly associated with a reduced likelihood of ACS hospitalization in the following year.
AHRQ-funded; HS023009.
Citation: Bronstein JM, Huang L, Shelley JP .
Primary care visits and ambulatory care sensitive diabetes hospitalizations among adult Alabama Medicaid beneficiaries.
Prim Care Diabetes 2022 Feb;16(1):116-21. doi: 10.1016/j.pcd.2021.10.005..
Keywords: Diabetes, Hospitalization, Medicaid, Primary Care
Roman LA, Raffo JE, Strutz K
The impact of a population-based system of care intervention on enhanced prenatal care and service utilization among Medicaid-insured pregnant women.
Enhanced prenatal/postnatal care home visiting programs for Medicaid-insured women have significant positive impacts on care and health outcomes. However, enhanced prenatal care participation rates are typically low, enrolling <30% of eligible women. This study investigated the impacts of a population-based systems approach on timely enhanced prenatal care participation and other healthcare utilization. The investigators concluded that a population systems approach improved selected enhanced prenatal care participation and service utilization for Medicaid-insured women in a county population, those in practices with established clinical-community linkages, and Black women.
AHRQ-funded; HS020208.
Citation: Roman LA, Raffo JE, Strutz K .
The impact of a population-based system of care intervention on enhanced prenatal care and service utilization among Medicaid-insured pregnant women.
Am J Prev Med 2022 Feb;62(2):e117-e27. doi: 10.1016/j.amepre.2021.08.012..
Keywords: Maternal Care, Pregnancy, Medicaid, Women
Holland JE, Varni SE, Pulcini CD
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
This study investigated the association between adolescent and young adult (AYA) well-care visits and emergency department (ED) utilization. Vermont’s all-payer claims data for 2018 was used to evaluate visits for 49,089 AYAs (aged 12-21 years) with a health-care claim. Nearly half (49%) of AYAs who engaged with the health-care system did not have a well-care visit in 2018. Those AYAs had 24% greater odds of going to the ED at least once in 2018, controlling for age, sex, insurance type, and medical complexity. Late adolescents and young adults (aged 18-21) who did not attend a well-care visit had 47% greater odds of ED visits, middle adolescents (15-17 years) had 9% greater odds, and early adolescents (12-14 years) had 16% greater odds.
AHRQ-funded; HS024575.
Citation: Holland JE, Varni SE, Pulcini CD .
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
J Adolesc Health 2022 Jan;70(1):64-69. doi: 10.1016/j.jadohealth.2021.08.011..
Keywords: Children/Adolescents, Young Adults, Emergency Department, Healthcare Utilization, Medicaid, Prevention
Staiger B
Disruptions to the patient-provider relationship and patient utilization and outcomes: evidence from Medicaid managed care.
The patient-provider relationship is considered a cornerstone to delivering high-value healthcare. However, in Medicaid managed care settings, disruptions to this relationship are disproportionately common. In this paper, the researcher evaluated the impact of a primary provider's exit from a Medicaid managed care plan on adult beneficiary healthcare utilization and outcomes.
AHRQ-funded; HS026128.
Citation: Staiger B .
Disruptions to the patient-provider relationship and patient utilization and outcomes: evidence from Medicaid managed care.
J Health Econ 2022 Jan;81:102574. doi: 10.1016/j.jhealeco.2021.102574..
Keywords: Medicaid, Clinician-Patient Communication, Healthcare Delivery, Chronic Conditions
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.
AHRQ-funded; HS027640.
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
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.
AHRQ-funded; HS027464.
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 and Ethnic Minorities, Disparities, Policy, Women, Access to Care