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https://www.readbyqxmd.com/read/28537963/out-of-pocket-spending-under-the-affordable-care-act-for-patients-with-cancer
#1
Matthew S Dixon, Ashley L Cole, Stacie B Dusetzina
The Patient Protection and Affordable Care Act (ACA) included several key provisions aimed at lowering the out-of-pocket cost burden for patients. In this review, we summarize the effect of 3 provisions under Medicaid, Medicare, and commercial insurance, respectively: expansion of Medicaid eligibility, closing the doughnut hole for Medicare Part D beneficiaries, and requiring an annual limit on out-of-pocket spending for commercially insured patients. Through this review, we find early evidence that these 3 ACA provisions have reduced the out-of-pocket burden or increased access to health insurance for many patients...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537962/effects-of-affordable-care-act-marketplaces-and-medicaid-eligibility-expansion-on-access-to-cancer-care
#2
John A Graves, Katherine Swartz
PURPOSE: The aim of this study was to inform oncologists about how repealing the Affordable Care Act (ACA) may affect their ability to provide cancer therapies for people with cancer enrolled in ACA health plans and why proposals to change Medicaid funding may make it even more difficult for Medicaid beneficiaries to access cancer treatments. METHODS: We examined the regulations and provisions of the ACA related to how health insurance impacts access to diagnostic testing and treatments for people with cancer, including access to clinical trials...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537961/the-affordable-care-act-and-cancer-care-delivery
#3
Gabriel A Brooks, J Russell Hoverman, Carrie H Colla
The Affordable Care Act (ACA) has reformed US health care delivery through insurance coverage expansion, experiments in payment design, and funding for patient-centered clinical and health care delivery research. The impact on cancer care specifically has been far reaching, with new ACA-related programs that encourage coordinated, patient-centered, cost-effective care. Insurance expansions through private exchanges and Medicaid, along with preexisting condition clauses, have helped more than 20 million Americans gain health care coverage...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28529137/medicaid-participation-among-liver-transplant-candidates-after-the-affordable-care-act-medicaid-expansion
#4
Dmitry Tumin, Eliza W Beal, Khalid Mumtaz, Don Hayes, Joseph D Tobias, Timothy M Pawlik, W Kenneth Washburn, Sylvester M Black
BACKGROUND: The 2014 Medicaid expansion in participating states increased insurance coverage among people with chronic health conditions, but its implications for access to surgical care remain unclear. We investigated how Medicaid expansion influenced the insurance status of candidates for liver transplantation (LT) and transplant center payor mix. STUDY DESIGN: Data on LT candidates age 18-64 years in 2012-2013 (pre-expansion) and 2014-2015 (post-expansion) were obtained from the United Network for Organ Sharing registry...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28520483/effect-of-the-affordable-care-act-on-disparities-in-breastfeeding-the-case-of-maine
#5
Summer Sherburne Hawkins, Alice Noble, Christopher F Baum
OBJECTIVES: To evaluate the Affordable Care Act (ACA) breastfeeding provision and test whether changes in coverage affected women differently according to health insurance status. METHODS: We used the All-Payer Claims Database from Maine (2012-2014) to compare health insurance claims for lactation classes and breast pumps between women with private insurance and women with Medicaid (1) before the ACA breastfeeding provision, (2) after the provision came into effect, and (3) after health insurance expansion through the Marketplace...
May 18, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28517042/the-impact-of-the-aca-medicaid-expansions-on-health-insurance-coverage-through-2015-and-coverage-disparities-by-age-race-ethnicity-and-gender
#6
George L Wehby, Wei Lyu
OBJECTIVE: Examine the ACA Medicaid expansion effects on Medicaid take-up and private coverage through 2015 and coverage disparities by age, race/ethnicity, and gender. DATA SOURCES: 2011-2015 American Community Survey for 3,137,989 low-educated adults aged 19-64 years. STUDY DESIGN: Difference-in-differences regressions accounting for national coverage trends and state fixed effects. PRINCIPAL FINDINGS: Expansion effects doubled in 2015 among low-educated adults, with a nearly 8 percentage-point increase in Medicaid take-up and 6 percentage-point decline in uninsured rate...
May 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28515140/three-year-impacts-of-the-affordable-care-act-improved-medical-care-and-health-among-low-income-adults
#7
Benjamin D Sommers, Bethany Maylone, Robert J Blendon, E John Orav, Arnold M Epstein
Major policy uncertainty continues to surround the Affordable Care Act (ACA) at both the state and federal levels. We assessed changes in health care use and self-reported health after three years of the ACA's coverage expansion, using survey data collected from low-income adults through the end of 2016 in three states: Kentucky, which expanded Medicaid; Arkansas, which expanded private insurance to low-income adults using the federal Marketplace; and Texas, which did not expand coverage. We used a difference-in-differences model with a control group and an instrumental variables model to provide individual-level estimates of the effects of gaining insurance...
May 17, 2017: Health Affairs
https://www.readbyqxmd.com/read/28513249/medicaid-expansion-produces-long-term-impact-on-insurance-coverage-rates-in-community-health-centers
#8
Nathalie Huguet, Megan J Hoopes, Heather Angier, Miguel Marino, Heather Holderness, Jennifer E DeVoe
BACKGROUND: It is crucial to understand the impact of the Affordable Care Act (ACA). This study assesses changes in insurance status of patients visiting community health centers (CHCs) comparing states that expanded Medicaid to those that did not. METHODS: Electronic health record data on 875,571 patients aged 19 to 64 years with ≥ 1 visit between 2012 and 2015 in 412 primary care CHCs in 9 expansion and 4 nonexpansion states. We assessed changes in rates of total, uninsured, Medicaid-insured, and privately insured primary care and preventive care visits; immunizations administered, and medications ordered...
May 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28483811/expanding-medicaid-expanding-the-electorate-the-affordable-care-act-s-short-term-impact-on-political-participation
#9
Jake Haselswerdt
The Affordable Care Act is a landmark piece of social legislation with the potential to reshape health care in the United States. Its potential to reshape politics is also considerable, but existing scholarship suggests conflicting expectations about the law's policy feedbacks, especially given uneven state-level implementation. In this article I focus on the policy feedbacks of the law's Medicaid expansion on political participation, using district-level elections data for 2012 and 2014 US House races and cross-sectional survey data from 2014...
May 8, 2017: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/28483807/closing-kynect-and-restructuring-medicaid-threaten-kentucky-s-health-and-economy
#10
Charles B Wright, Nathan L Vanderford
Following passage of the Patient Protection and Affordable Care Act (ACA) in the United States, the Kentucky Health Benefit Exchange, Kynect, began operating in Kentucky in October 2013. Kentucky expanded Medicaid eligibility in January 2014. Together, Kynect and Medicaid expansion provided access to affordable health care coverage to hundreds of thousands of individuals in Kentucky. However, following the Kentucky gubernatorial election in 2015, the newly inaugurated governor moved to dismantle Kynect and restructure the Medicaid expansion, jeopardizing public health gains and the state economy...
May 8, 2017: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/28480593/the-aca-medicaid-expansion-disproportionate-share-hospitals-and-uncompensated-care
#11
Susan Camilleri
OBJECTIVE: To estimate the effect of the first full year of the ACA Medicaid expansion on hospital provision of uncompensated care, with special attention paid to hospitals that treat a disproportionate share of low-income patients. DATA SOURCES: Data from a balanced panel of short-term, general, nonfederal, Medicare-certified hospitals were obtained from Medicare cost reports from 2011 to 2014. STUDY DESIGN/STUDY SETTING: A series of difference-in-differences analyses were performed using hospitals in nonexpansion states as the control group...
May 8, 2017: Health Services Research
https://www.readbyqxmd.com/read/28462901/-canaries-in-the-mine-the-impact-of-affordable-care-act-implementation-on-people-with-disabilities-evidence-from-interviews-with-disability-advocates
#12
Stephan Lindner, Ruth Rowland, Margaret Spurlock, Stan Dorn, Melinda Davis
BACKGROUND: The Affordable Care Act (ACA) has many provisions that could improve health care for people with disabilities, including Medicaid expansion and the ability to purchase qualified health plans (QHPs). OBJECTIVE: To explore how ACA provisions affected people with disabilities' health care experiences during the first enrollment period and to suggest hypotheses for future research. METHOD: We conducted semi-structured interviews with disability community leaders (N = 16) from a maximum variation sample of 10 U...
April 12, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/28461347/medicaid-expansion-coverage-effects-grew-in-2015-with-continued-improvements-in-coverage-quality
#13
Sandra L Decker, Brandy J Lipton, Benjamin D Sommers
Previous research has demonstrated large gains in insurance coverage associated with the Affordable Care Act's (ACA's) Medicaid expansion in 2014. We used detailed federal survey data through 2015 to analyze more recent changes in coverage for low-income adults after the expansion. We found that the uninsurance rate fell in both expansion and nonexpansion states but that it fell significantly more in expansion states. By 2015 the post-ACA uninsurance rate for low-income adults had fallen by 7.5 percentage points more in expansion than in nonexpansion states, a difference that was similar (about 6...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28461346/medicaid-expansion-increased-coverage-improved-affordability-and-reduced-psychological-distress-for-low-income-parents
#14
Stacey McMorrow, Jason A Gates, Sharon K Long, Genevieve M Kenney
Despite receiving less attention than their childless counterparts, low-income parents also experienced significant expansions of Medicaid eligibility under the Affordable Care Act (ACA). We used data for the period 2010-15 from the National Health Interview Survey to examine the impacts of the ACA's Medicaid expansion on coverage, access and use, affordability, and health status for low-income parents. We found that eligibility expansions increased coverage, reduced problems paying medical bills, and reduced severe psychological distress...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28461345/iowa-s-medicaid-expansion-promoted-healthy-behaviors-but-was-challenging-to-implement-and-attracted-few-participants
#15
Natoshia M Askelson, Brad Wright, Suzanne Bentler, Elizabeth T Momany, Peter Damiano
As part of Iowa's Medicaid expansion, the Healthy Behaviors Program was designed to provide members with incentives to complete specified healthy activities in return for waiving monthly premiums. We used claims data and interviews to document the first year (2014) of the program's implementation. Healthy activities completion rates did not exceed 17 percent. Interviews with members and clinic managers revealed low levels of awareness of the program's existence, deficits in knowledge about how the program works, and a variety of barriers to activity completion...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28461344/growing-insurance-coverage-did-not-reduce-access-to-care-for-the-continuously-insured
#16
Salam Abdus, Steven C Hill
Recent expansions in health insurance coverage have raised concerns about health care providers' capacity to supply additional services and how that may have affected access to care for people who were already insured. When we examined data for the period 2008-14 from the Medical Expenditure Panel Survey, we found no consistent evidence that increases in the proportions of adults with insurance at the local-area level affected access to care for adults residing in the same areas who already had, and continued to have, insurance...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28453244/a-cap-on-medicaid-how-block-grants-per-capita-caps-and-capped-allotments-might-fundamentally-change-the-safety-net
#17
Haleigh Mager-Mardeusz, Cosima Lenz, Gerald F Kominski
Changing the Medicaid program is a top priority for the Republican party. Common themes from GOP proposals include converting Medicaid from a jointly financed entitlement benefit to a form of capped federal financing. While proponents of this reform argue that it would provide greater flexibility and a more predictable budget for state governments, serious consequences would likely result for Medicaid enrollees and state governments. Under all three scenarios promoted by Republicans--block grants, capped allotments, and per capita caps—most states would face increased costs...
April 2017: Policy Brief
https://www.readbyqxmd.com/read/28449128/comprehensive-ryan-white-assistance-and-hiv-clinical-outcomes-retention-in-care-and-viral-suppression-in-a-medicaid-non-expansion-state
#18
Karen L Diepstra, Anne G Rhodes, Rose S Bono, Sonam Patel, Lauren E Yerkes, April D Kimmel
Background: Knowledge gaps remain about how the Ryan White HIV/AIDS Program (RW) contributes to health outcomes. We examined the association between different RW service classes and retention in care (RiC) or viral suppression (VS). Methods: We identified Virginians engaged in any HIV care, January 1-December 31, 2014. RW beneficiaries were classified by receipt of ≥1 service from three classes: Core medical, Support and insurance and/or direct medication assistance through the AIDS Drug Assistance Program (ADAP)...
April 25, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28448109/how-medicaid-enrollees-fare-compared-with-privately-insured-and-uninsured-adults-findings-from-the-commonwealth-fund-biennial-health-insurance-survey-2016
#19
Munira Z Gunja, Sara R Collins, David Blumenthal, Michelle M Doty, Sophie Beutel
ISSUE: The number of Americans insured by Medicaid has climbed to more than 70 million, with an estimated 12 million gaining coverage under the Affordable Care Act’s Medicaid expansion. Still, some policymakers have questioned whether Medicaid coverage actually improves access to care, quality of care, or financial protection. GOALS: To compare the experiences of working-age adults who were either: covered all year by private employer or individual insurance; covered by Medicaid for the full year; or uninsured for some time during the year...
April 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28431415/potential-impact-of-affordable-care-act-related-insurance-expansion-on-trauma-care-reimbursement
#20
John W Scott, Pooja U Neiman, Peter A Najjar, Thomas C Tsai, Kirstin W Scott, Mark G Shrime, David M Cutler, Ali Salim, Adil H Haider
BACKGROUND: Nearly one quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. METHODS: We abstracted nonelderly adults (ages 18-64 years) admitted for trauma from the Nationwide Inpatient Sample during 2010-the last year before most major ACA coverage expansion policies...
May 2017: Journal of Trauma and Acute Care Surgery
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