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Medicaid expansion

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https://www.readbyqxmd.com/read/29148341/the-affordable-care-act-appears-to-have-narrowed-racial-and-ethnic-disparities-in-insurance-coverage-and-access-to-care-among-young-adults
#1
Brandy J Lipton, Sandra L Decker, Benjamin D Sommers
Prior to the Affordable Care Act, one in three young adults aged 19 to 25 years were uninsured, with substantial racial/ethnic disparities in coverage. We analyzed the separate and cumulative changes in racial/ethnic disparities in coverage and access to care among young adults after implementation of the Affordable Care Act's 2010 dependent coverage provision and 2014 Medicaid and Marketplace expansions. We find that the dependent coverage provision was associated with similar gains across racial/ethnic groups, but the 2014 expansion was associated with larger gains in coverage among Hispanics and Blacks relative to Whites...
April 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148335/geographic-variation-in-medicaid-acceptance-across-michigan-primary-care-practices-in-the-era-of-the-affordable-care-act
#2
Renuka Tipirneni, Karin V Rhodes, Rodney A Hayward, Richard L Lichtenstein, HwaJung Choi, Emily K Arntson, Jessica M Landgraf, Matthew M Davis
Coverage and access have improved under the Affordable Care Act, yet it is unclear whether recent gains have reached those regions within states that were most in need of improved access to care. We examined geographic variation in Medicaid acceptance among Michigan primary care practices before and after Medicaid expansion in the state, using data from a simulated patient study of primary care practices. We used logistic regression analysis with time indicators to assess regional changes in Medicaid acceptance over time...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148334/evidence-of-pent-up-demand-for-care-after-medicaid-expansion
#3
Angela R Fertig, Caroline S Carlin, Scott Ode, Sharon K Long
We compared new Medicaid enrollees with similar ongoing enrollees for evidence of pent-up demand using claims data following Minnesota's 2014 Medicaid expansion. We hypothesized that if new enrollees had pent-up demand, utilization would decline over time as testing and disease management plans are put in place. Consistent with pent-up demand among new enrollees, the probability of an office visit, a new patient office visit, and an emergency department visit declines over time for new enrollees relative to ongoing Medicaid enrollees...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148324/the-impacts-of-medicaid-expansion-on-rural-low-income-adults-lessons-from-the-oregon-health-insurance-experiment
#4
Heidi Allen, Bill Wright, Lauren Broffman
Medicaid expansions through the Affordable Care Act began in January 2014, but we have little information about what is happening in rural areas where provider access and patient resources might be more limited. In 2008, Oregon held a lottery for restricted access to its Medicaid program for uninsured low-income adults not otherwise eligible for public coverage. The Oregon Health Insurance Experiment used this opportunity to conduct the first randomized controlled study of a public insurance expansion. This analysis builds off of previous work by comparing rural and urban survey outcomes and adds qualitative interviews with 86 rural study participants for context...
January 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29142907/social-effects-of-health-care-reform-medicaid-expansion-under-the-affordable-care-act-and-changes-in-volunteering
#5
Heeju Sohn, Stefan Timmermans
Do public health policy interventions result in pro-social behaviors? The Affordable Care Act (ACA)'s Medicaid expansions were responsible for the largest gains in public insurance coverage since its inception in 1965. These gains were concentrated in states that opted to expand Medicaid eligibility and provide a unique opportunity to study not just medical but also social consequences of increased public health coverage. This article examines the association between Medicaid and volunteer work. Volunteerism is implicated in individuals' health and well-being yet it is highly correlated with a person's existing socioeconomic resources...
January 2017: Socius
https://www.readbyqxmd.com/read/29137555/impact-of-aca-health-reforms-for-people-with-mental-health-conditions
#6
Kathleen C Thomas, Adele Shartzer, Noelle K Kurth, Jean P Hall
OBJECTIVE: This brief report explores the impact of health reform for people with mental illness. METHODS: The Health Reform Monitoring Survey was used to examine health insurance, access to care, and employment for 1,550 people with mental health conditions pre- and postimplementation of the Affordable Care Act (ACA) and by state Medicaid expansion status. Multivariate logistic regressions with predictive margins were used. RESULTS: Post-ACA reforms, people with mental health conditions were less likely to be uninsured (5% versus 13%; t=-6...
November 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29135661/reconsidering-the-affordable-care-act-s-restrictions-on-physician-owned-hospitals-analysis-of-cms-data-on-total-hip-and-knee-arthroplasty
#7
P Maxwell Courtney, Brian Darrith, Daniel D Bohl, Nicholas B Frisch, Craig J Della Valle
BACKGROUND: Concerns about financial incentives and increased costs prompted legislation limiting the expansion of physician-owned hospitals in 2010. Supporters of physician-owned hospitals argue that they improve the value of care by improving quality and reducing costs. The purpose of the present study was to determine whether physician-owned and non-physician-owned hospitals differ in terms of costs, outcomes, and patient satisfaction in the setting of total hip arthroplasty (THA) and total knee arthroplasty (TKA)...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29133576/spillover-effects-of-adult-medicaid-expansions-on-children-s-use-of-preventive-services
#8
Maya Venkataramani, Craig Evan Pollack, Eric T Roberts
BACKGROUND: Since the passage of the Affordable Care Act, Medicaid enrollment has increased by ∼17 million adults, including many low-income parents. One potentially important, but little studied, consequence of expanding health insurance for parents is its effect on children's receipt of preventive services. METHODS: By using state Medicaid eligibility thresholds linked to the 2001-2013 Medical Expenditure Panel Surveys, we assessed the relationship between changes in adult Medicaid eligibility and children's likelihood of receiving annual well-child visits (WCVs)...
November 13, 2017: Pediatrics
https://www.readbyqxmd.com/read/29114883/the-impact-of-the-affordable-care-act-s-medicaid-expansion-on-dental-care-use-through-2016
#9
Kamyar Nasseh, Marko Vujicic
OBJECTIVE: To examine the impact of the Affordable Care Act on dental care use among low-income adults ages 21-64. METHODS: Our analysis uses national survey data from the 2010-2016 Gallup Wellbeing-Index. We use a differences-in-differences analysis to assess changes since the end of 2013 in dental care use among low-income adults. We compare changes in states that expanded Medicaid and offer adult Medicaid dental benefits versus changes in other states. RESULTS: Relative to the pre-reform period and other states, in Medicaid expansion states with adult dental benefits, dental care use increased 3-6 percentage points in 2016...
November 8, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/29105809/us-health-care-reform-and-rural-america-results-from-the-aca-s-medicaid-expansions
#10
Joseph A Benitez, Eric E Seiber
PURPOSE: Medicaid expansions, prompted by the Affordable Care Act, generated generally positive effects on coverage and alleviated much of the financial burden associated with seeking health care. We do not know if these shifts also extend to the nation's rural populations. METHODS: Using 2011-2015 Behavioral Risk Factor Surveillance System data, this study compares trend changes for coverage, access to care, and health care utilization in response to Medicaid expansion among urban and rural residents using a difference-in-differences regression approach...
November 6, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/29084350/prostate-cancer-outcomes-for-men-aged-younger-than-65-years-with-medicaid-versus-private-insurance
#11
Amandeep R Mahal, Brandon A Mahal, Paul L Nguyen, James B Yu
BACKGROUND: In the current national debate regarding private insurance versus Medicaid expansion, understanding how insurance is associated with racial disparities in prostate cancer (CaP) outcomes has broad policy implications. In the current study, the authors examined the association between insurance status, race, and CaP outcomes. METHODS: The Surveillance, Epidemiology, and End Results program identified 155,524 men aged < 65 years who were diagnosed with CaP from 2007 through 2014...
October 30, 2017: Cancer
https://www.readbyqxmd.com/read/29072894/medicaid-payment-and-delivery-system-reform-early-insights-from-10-medicaid-expansion-states
#12
Sara Rosenbaum, Sara Schmucker, Sara Rothenberg, Rachel Gunsalus, J Zoe Beckerman
Issue: Expanded Medicaid enrollment under the Affordable Care Act has heightened the importance of states’ roles as principal purchasers of health care for low-income and medically vulnerable populations. Concurrently, the federal government has augmented states’ purchasing tools. Goal: To examine the evolution of payment and delivery system reform in 10 ACA Medicaid expansion states. Methods: Analysis of state managed care policies, including a detailed review of purchasing documents as well as interviews with senior agency officials in 10 states...
October 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29068908/medicaid-coverage-expansions-and-cigarette-smoking-cessation-among-low-income-adults
#13
Jonathan W Koma, Julie M Donohue, Colleen L Barry, Haiden A Huskamp, Marian Jarlenski
INTRODUCTION: Expanding Medicaid coverage to low-income adults may have increased smoking cessation through improved access to evidence-based treatments. Our study sought to determine if states' decisions to expand Medicaid increased recent smoking cessation. METHODS: Using pooled cross-sectional data from the Behavioral Risk Factor Surveillance Survey for the years 2011-2015, we examined the association between state Medicaid coverage and the probability of recent smoking cessation among low-income adults without dependent children who were current or former smokers (n=36,083)...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29057152/modeling-dr-dynasaur-2-0-coverage-and-finance-proposals-effects-of-the-expansion-of-vermont-s-dr-dynasaur-program-to-all-individuals-through-age-25
#14
Andrew W Dick, Carter C Price, Dulani Woods, Deborah Anne Freund, Martin McNamara, Steven P Schramm, Elrycc Berkman, Tom Dehner
The authors assessed an expansion of Vermont's Dr. Dynasaur program that would cover all residents age 25 and younger. The current Dr. Dynasaur program combines Vermont's Medicaid program and Child Health Insurance Program for children ages 0 through 18 to provide a seamless insurance program for those with family incomes below 317 percent of the federal poverty level. The authors used RAND's COMPARE-VT microsimulation model with Vermont-specific demographic, economic, and actuarial data to estimate the effects on health insurance coverage, costs, and premiums...
January 2017: Rand Health Quarterly
https://www.readbyqxmd.com/read/29057151/a-comprehensive-assessment-of-four-options-for-financing-health-care-delivery-in-oregon
#15
Chapin White, Christine Eibner, Jodi L Liu, Carter C Price, Nora Leibowitz, Gretchen Morley, Jeanene Smith, Tina Edlund, Jack Meyer
This article describes four options for financing health care for residents of the state of Oregon and compares the projected impacts and feasibility of each option. The Single Payer option and the Health Care Ingenuity Plan would achieve universal coverage, while the Public Option would add a state-sponsored plan to the Affordable Care Act (ACA) Marketplace. Under the Status Quo option, Oregon would maintain its expansion of Medicaid and subsidies for nongroup coverage through the ACA Marketplace. The state could cover all residents under the Single Payer option with little change in overall health care costs, but doing so would require cuts to provider payment rates that could worsen access to care, and implementation hurdles may be insurmountable...
January 2017: Rand Health Quarterly
https://www.readbyqxmd.com/read/29053183/impact-of-recent-medicaid-expansions-on-office-based-primary-care-and-specialty-care-among-the-newly-eligible
#16
Adam I Biener, Samuel H Zuvekas, Steven C Hill
OBJECTIVE: To quantify the effect of Medicaid expansions on office-based care among the newly eligible. DATA SOURCE: 2008-2014 Medical Expenditure Panel Survey. STUDY DESIGN: The main sample is adults age 26-64 with incomes ≤138% of poverty who were not eligible for Medicaid prior to the Affordable Care Act. For this population, difference-in-differences linear probability models compare utilization between expansion and nonexpansion states and between 2008-2013 and 2014...
October 20, 2017: Health Services Research
https://www.readbyqxmd.com/read/29029585/refinement-of-the-affordable-care-act-a-progressive-perspective
#17
Olveen Carrasquillo, Michael Mueller
The Affordable Care Act (ACA) was the most significant expansion of health coverage since Medicare and Medicaid were enacted. The law resulted in approximately 13-20 million uninsured persons gaining coverage. Despite these gains, the ACA has numerous shortcomings. For progressives, the ACA was a unique opportunity to provide access to high-quality, comprehensive, equitable health coverage to all persons living in the United States. Using this perspective as our framework, in this review we highlight some of the limitations of the ACA and potential areas for refinement...
October 13, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/29021122/influencing-quality-of-outpatient-sud-care-implementation-of-alerts-and-incentives-in-washington-state
#18
Deborah W Garnick, Constance M Horgan, Andrea Acevedo, Margaret T Lee, Lee Panas, Grant A Ritter, Kevin Campbell, Jason Bean-Mortinson
Financial incentives for quality improvement and feedback on specific clients are two approaches to improving the quality of treatment for individuals with substance use disorders. We examined the impacts of these interventions in Washington State by randomizing outpatient substance use treatment agencies into intervention and control groups. From October 2013 through December 2015, agencies could earn financial incentives for meeting performance goals incorporating both achievement relative to a benchmark and improvement from agencies' own baselines...
November 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29019050/impacting-entry-into-evidence-based-supported-employment-a-population-based-empirical-analysis-of-a-statewide-public-mental-health-program-in-maryland
#19
David Salkever, Michael Abrams, Kevin Baier, Brent Gibbons
We use discrete-time survival regression to study two empirical issues relating to take-up of individual placement and support (IPS) supported employment (SE) services for persons with serious mental illness: (1) the influence of client characteristics on take-up probability, and (2) the possible impacts of a major recent initiative in one state (Maryland) to overcome barriers to IPS-SE expansion. Our longitudinal analysis of population-based Medicaid cohorts, during 2002-2010, provides tentative evidence of positive state initiative impacts on SE take-up rates, and evidence of effects on take-up for clients' diagnoses, prior work-history, health and demographic characteristics, and geographic accessibility to SE providers...
October 10, 2017: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/29016491/expanding-prenatal-care-to-unauthorized-immigrant-women-and-the-effects-on-infant-health
#20
Jonas J Swartz, Jens Hainmueller, Duncan Lawrence, Maria I Rodriguez
OBJECTIVE: To measure the effect of access to prenatal care on unauthorized and low-income, new legal permanent resident immigrant women and their offspring. METHODS: We used a difference-in-differences design that leverages the staggered rollout of Emergency Medicaid Plus by county from 2008 to 2013 as a natural experiment to estimate the effect on health service utilization for women and health outcomes for their infants. Regular Medicaid pregnancies were used as an additional control in a triple difference design...
November 2017: Obstetrics and Gynecology
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