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https://www.readbyqxmd.com/read/28102652/changing-rural-and-urban-enrollment-in-state-medicaid-programs
#1
Abigail R Barker, Kelsey Huntzberry, Timothy D McBride, Keith J Mueller
Purpose. From October 2013—before implementation of the Affordable Care Act (ACA)—to November 2016, Medicaid enrollment grew by 27 percent. However, very little attention has been paid to date to how changes in Medicaid enrollment vary within states across the rural-urban continuum. This brief reports and analyzes changes in enrollment in metropolitan, micropolitan, and rural (noncore) areas in both expansion states (those that used ACA funding to expand Medicaid coverage) and nonexpansion states (those that did not use ACA funding to expand Medicaid coverage)...
2017: Rural Policy Brief
https://www.readbyqxmd.com/read/28102648/2016-rural-enrollment-in-health-insurance-marketplaces-by-state
#2
Abigail R Barker, Kelsey A Huntzberry, Timothy D McBride, Leah M Kemper, Keith J Mueller
Purpose. In this brief, cumulative county-level enrollment in Health Insurance Marketplaces (HIMs) through March 2016 is presented for state HIMs operated as Federally Facilitated Marketplaces (FFMs) and for those operated as Federally Supported State-Based Marketplaces (FS-SBMs). Enrollment rates in metropolitan and non-metropolitan areas of each state, defined as the percentage of “potential market” participants selecting plans, are presented. Monitoring annual enrollment rates provides a gauge of how well state outreach and enrollment efforts are proceeding and helps identify states with strong non-metropolitan enrollment as models for other states to emulate...
2017: Rural Policy Brief
https://www.readbyqxmd.com/read/28094189/medicaid-payer-status-is-linked-to-increased-rates-of-complications-after-treatment-of-proximal-humerus-fractures
#3
Vani J Sabesan, Graysen Petersen-Fitts, Daniel Lombardo, Daniel Briggs, James Whaley
BACKGROUND: Low socioeconomic status and Medicaid insurance as a primary payer have been associated with major disparities in resource utilization and risk-adjusted outcomes for patients undergoing total joint arthroplasty. With the expansion of Medicaid through the Affordable Care Act in 2014, examination of these disparities has become increasingly relevant for the treatment of proximal humerus fracture (PHF). METHODS: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample database was used to identify patients who were treated for PHF from 2002 to 2012...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28093059/insurance-coverage-and-treatment-use-under-the-affordable-care-act-among-adults-with-mental-and-substance-use-disorders
#4
Brendan Saloner, Sachini Bandara, Marcus Bachhuber, Colleen L Barry
OBJECTIVE: Many adults who have mental or substance use disorders or both experience insurance-related barriers to care, contributing to low treatment utilization. Expanded insurance under the Affordable Care Act (ACA) could improve coverage and access. The study identified changes in coverage and treatment use following 2014 ACA insurance expansions. METHODS: Data from the National Survey on Drug Use and Health were used to identify individuals ages 18-64 screening positive for any mental disorder (N=29,962) or substance use disorder (N=19,243) for two periods: 2011-2013 and 2014...
January 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28080012/medicaid-s-future-what-might-aca-repeal-mean
#5
Sara Rosenbaum, Sara Rothenberg, Rachel Gunsalus, Sara Schmucker
Issue: Republicans in Congress are expected to repeal portions of the Affordable Care Act (ACA) using a fast-track process known as budget reconciliation. Goals: This issue brief examines how repeal legislation could affect Medicaid, the nation’s health care safety net, which insured 70 million people in 2016. Findings and Conclusions: Partial-repeal legislation that passed Congress but was vetoed by President Obama in 2016 offers some insight but new legislation could go further. It could repeal the ACA’s Medicaid eligibility expansions for adults and children but also roll back other provisions, such as simplified enrollment and improvements in long-term services and supports for beneficiaries with disabilities...
2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28075695/lessons-from-launching-the-diabetes-prevention-program-in-a-large-integrated-health-care-delivery-system-a-case-study
#6
Colin D Rehm, Melinda E Marquez, Elizabeth Spurrell-Huss, Nicole Hollingsworth, Amanda S Parsons
There is urgent need for health systems to prevent diabetes. To date, few health systems have implemented the evidence-based Diabetes Prevention Program (DPP), and the few that have mostly partnered with community-based organizations to implement the program. Given the recent decision by the Centers for Medicare & Medicaid Services to reimburse for diabetes prevention, there is likely much interest in how such programs can be implemented within large health systems or how community partnerships can be expanded to support DPP implementation...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28072508/repealing-federal-health-reform-economic-and-employment-consequences-for-states
#7
Leighton Ku, Erika Steinmetz, Erin Brantley, Brian Bruen
Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans. Goal: To determine the state-by-state effect of repeal on employment and economic activity...
2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28069846/medicaid-expansion-and-grant-funding-increases-helped-improve-community-health-center-capacity
#8
Xinxin Han, Qian Luo, Leighton Ku
Through the expansion of Medicaid eligibility and increases in core federal grant funding, the Affordable Care Act (ACA) sought to increase the capacity of community health centers to provide primary care to low-income populations. We examined the effects of the ACA Medicaid expansion and changes in federal grant levels on the centers' numbers of patients, percentages of patients by type of insurance, and numbers of visits from 2012 to 2015. In the period after expansion (2014-15), health centers in expansion states had a 5 percent higher total patient volume, larger shares of Medicaid patients, smaller shares of uninsured patients, and increases in overall visits and mental health visits, compared to centers in nonexpansion states...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069845/at-federally-funded-health-centers-medicaid-expansion-was-associated-with-improved-quality-of-care
#9
Megan B Cole, Omar Galárraga, Ira B Wilson, Brad Wright, Amal N Trivedi
In 2014 many uninsured, low-income nonelderly adults gained access to health insurance in states that expanded Medicaid eligibility under the Affordable Care Act. Federally funded community health centers were likely to be particularly affected by this expansion because many of their patients were uninsured and low income. We used a difference-in-differences approach to compare changes among 1,057 such centers in expansion versus nonexpansion states from 2011 to 2014, in terms of their patients' insurance coverage, the number of patients they served, and the quality of care they provided...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069844/adults-are-more-likely-to-become-eligible-for-medicaid-during-future-recessions-if-their-state-expanded-medicaid
#10
Paul D Jacobs, Steven C Hill, Salam Abdus
Eligibility for and enrollment in Medicaid can vary with economic recessions, recoveries, and changes in personal income. Understanding how Medicaid responds to such forces is important to budget analysts and policy makers tasked with forecasting Medicaid enrollment. We simulated eligibility for Medicaid for the period 2005-14 in two scenarios: assuming that each state's eligibility rules in 2009, the year before passage of the Affordable Care Act (ACA), were in place during the entire study period; and assuming that the ACA's expanded eligibility rules were in place during the entire period for all states...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069842/most-newly-insured-people-in-2014-were-long-term-uninsured
#11
Sandra L Decker, Brandy J Lipton
In 2014-after the implementation of most of the Affordable Care Act provisions, including Medicaid expansions in some states and subsidies to purchase Marketplace coverage in all states-adults who had been uninsured for more than three years represented a larger share of the newly insured, compared to adults who had been insured for shorter periods of time.
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28051917/economic-effects-of-medicaid-expansion-in-michigan
#12
John Z Ayanian, Gabriel M Ehrlich, Donald R Grimes, Helen Levy
Under the Affordable Care Act, 31 U.S. states have opted to expand Medicaid coverage to nonelderly adults with annual incomes up to 138% of the federal poverty level (approximately $16,400 for a single adult in 2016). The federal government currently pays the full cost of Medicaid expansion in..
January 4, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28025774/-they-treat-you-a-different-way-public-insurance-stigma-and-the-challenge-to-quality-health-care
#13
Anna C Martinez-Hume, Allison M Baker, Hannah S Bell, Isabel Montemayor, Kristan Elwell, Linda M Hunt
Under the Affordable Care Act, Medicaid Expansion programs are extending Medicaid eligibility and increasing access to care. However, stigma associated with public insurance coverage may importantly affect the nature and content of the health care beneficiaries receive. In this paper, we examine the health care stigma experiences described by a group of low-income public insurance beneficiaries. They perceive stigma as manifest in poor quality care and negative interpersonal interactions in the health care setting...
December 26, 2016: Culture, Medicine and Psychiatry
https://www.readbyqxmd.com/read/28007801/rhetoric-and-reform-in-waiver-states
#14
Colleen M Grogan, Phillip M Singer, David K Jones
Seven states have used Section 1115 waivers to expand Medicaid as part of the Affordable Care Act (ACA). While each state pursued a unique plan, there are similarities in the types of changes each state desired to make. Equally important to how a state modified their Medicaid programs is how a state talked about Medicaid and reform. We investigate whether the rhetoric that emerged in waiver states is unique, analyze whether the rhetoric is associated with particular waiver reforms, and consider the implications of our findings for the future of Medicaid policy making...
December 22, 2016: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/28007795/the-future-of-health-care-reform-what-is-driving-enrollment
#15
Timothy H Callaghan, Lawrence R Jacobs
Against a backdrop of ongoing operational challenges, insurance market turbulence, and the ever present pull of partisanship, enrollment in the ACA's programs has soared and significant variations have developed across states in terms of their pace of coverage expansion. Our article explores why ACA enrollment has varied so dramatically across states. We explore the potential influence of party control, presidential cueing, administrative capacity, the reverberating effects of ACA policy decisions, affluence, and unemployment on enrollment...
December 22, 2016: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/28007793/policy-diffusion-across-disparate-disciplines-private-and-public-sector-dynamics-affecting-state-level-adoption-of-the-aca
#16
Rena M Conti, David K Jones
The ACA entails a number of provisions that are profoundly changing the way the states ensure access to medical care, including the expansion of Medicaid and the maintenance of health insurance exchanges. Here, we argue that while federal policy is the originating force of whether these provisions are adopted, individual state decisions are made within a larger ecosystem. This ecosystem has two main components: (1) complementary and competing state and federal policies; and (2) medical provision by a variety of suppliers...
December 22, 2016: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/28002205/the-role-of-public-and-private-insurance-expansions-and-premiums-for-low-income-parents-lessons-from-state-experiences
#17
Gery P Guy, Emily M Johnston, Patricia Ketsche, Peter Joski, E Kathleen Adams
BACKGROUND: Numerous states have implemented policies expanding public insurance eligibility or subsidizing private insurance for parents. OBJECTIVES: To assess the impact of parental health insurance expansions from 1999 to 2012 on the likelihood that parents are insured; their children are insured; both the parent and child within a family unit are insured; and the type of insurance. DESIGN: Cross-sectional analysis of the 2000-2013 March supplements to the Current Population Survey, with data from the Medical Expenditure Panel Survey-Insurance Component and the Area Resource File...
December 20, 2016: Medical Care
https://www.readbyqxmd.com/read/27997244/effect-of-medicaid-expansion-on-workforce-participation-for-people-with-disabilities
#18
Jean P Hall, Adele Shartzer, Noelle K Kurth, Kathleen C Thomas
OBJECTIVES: To use data from the Health Reform Monitoring Survey (HRMS) to examine differences in employment among community-living, working-age adults (aged 18-64 years) with disabilities who live in Medicaid expansion states and nonexpansion states. METHODS: Analyses used difference-in-differences to compare trends in pooled, cross-sectional estimates of employment by state expansion status for 2740 HRMS respondents reporting a disability, adjusting for individual and state characteristics...
February 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/27996379/the-affordable-care-act-and-health-insurance-coverage-for-lesbian-gay-and-bisexual-adults-analysis-of-the-behavioral-risk-factor-surveillance-system
#19
Gilbert Gonzales, Carrie Henning-Smith
PURPOSE: This study compares uninsurance rates for lesbian, gay, and bisexual (LGB) adults by state Medicaid expansion decisions under the Affordable Care Act. METHODS: Data come from nonelderly adults in the 2014 Behavioral Risk Factor Surveillance System. Prevalence estimates and logistic regression models identified LGB adults most likely to be uninsured. RESULTS: Approximately 15.7% of LGB adults lack health insurance, but the uninsurance rate is lower among LGB adults in Medicaid expansion states (12...
December 20, 2016: LGBT Health
https://www.readbyqxmd.com/read/27992930/insurance-expansion-and-hospital-emergency-department-access-evidence-from-the-affordable-care-act
#20
Craig Garthwaite, Tal Gross, Matthew Notowidigdo, John A Graves
Background: Little is known about whether insurance expansion affects the location and type of emergency department (ED) use. Understanding these changes can inform state-level decisions about the Medicaid expansion under the Patient Protection and Affordable Care Act (ACA). Objective: To investigate the effect of the 2014 ACA Medicaid expansion on the location, insurance status, and type of ED visits. Design: Quasi-experimental observational study from 2012 to 2014...
December 20, 2016: Annals of Internal Medicine
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