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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.
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1 to 2 of 2 Research Studies DisplayedEscarce 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
Escarce JJ, Wozniak GD, Tsipas S
Effects of the Affordable Care Act Medicaid expansion on the distribution of new general internists across states.
The objective of this study was to determine whether the Medicaid expansion influenced the states selected by physicians just completing graduate medical education for establishing their first practices. Thirty-three states and the District of Columbia expanded Medicaid by the end of the study period. Findings showed that physicians in one specialty group, general internal medicine, were increasingly likely to locate in expansion states after the expansion. The Medicaid expansion influenced the practice location choices of men and international medical graduates in general internal medicine, while women and United States medical graduates did not alter their pre-expansion location patterns. States that opted not to expand Medicaid under the Affordable Care Act lost general internists to expansion states, potentially affecting access to care for all of their residents regardless of insurance coverage.
AHRQ-funded; HS025750.
Citation: Escarce JJ, Wozniak GD, Tsipas S .
Effects of the Affordable Care Act Medicaid expansion on the distribution of new general internists across states.
Med Care 2021 Jul;59(7):653-60. doi: 10.1097/mlr.0000000000001523..
Keywords: Medicaid, Health Insurance, Provider: Physician, Workforce