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Medicaid expansion

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https://www.readbyqxmd.com/read/28323472/the-affordable-care-act-insurance-coverage-and-health-care-utilization-of-previously-incarcerated-young-men-2008-2015
#1
Tyler N A Winkelman, HwaJung Choi, Matthew M Davis
OBJECTIVES: To estimate health insurance and health care utilization patterns among previously incarcerated men following implementation of the Affordable Care Act's (ACA's) Medicaid expansion and Marketplace plans in 2014. METHODS: We performed serial cross-sectional analyses using data from the National Survey of Family Growth between 2008 and 2015. Our sample included men aged 18 to 44 years with (n = 3476) and without (n = 8702) a history of incarceration...
March 21, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28319791/premium-subsidies-the-mandate-and-medicaid-expansion-coverage-effects-of-the-affordable-care-act
#2
Molly Frean, Jonathan Gruber, Benjamin D Sommers
Using premium subsidies for private coverage, an individual mandate, and Medicaid expansion, the Affordable Care Act (ACA) has increased insurance coverage. We provide the first comprehensive assessment of these provisions' effects, using the 2012-2015 American Community Survey and a triple-difference estimation strategy that exploits variation by income, geography, and time. Overall, our model explains 60% of the coverage gains in 2014-2015. We find that coverage was moderately responsive to price subsidies, with larger gains in state-based insurance exchanges than the federal exchange...
March 6, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28296674/impact-of-medicaid-expansion-on-medicaid-covered-utilization-of-buprenorphine-for-opioid-use-disorder-treatment
#3
Hefei Wen, Jason M Hockenberry, Tyrone F Borders, Benjamin G Druss
BACKGROUND: Buprenorphine has been proven effective in treating opioid use disorder. However, the high cost of buprenorphine and the limited prescribing capacity may restrict access to this effective medication-assisted treatment for opioid use disorder. OBJECTIVE: To examine whether Medicaid expansion and physician prescribing capacity may have impacted buprenorphine utilization covered by Medicaid. RESEARCH DESIGN: We used a quasi experimental difference-in-differences design to compare the pre-post changes in Medicaid-covered buprenorphine prescriptions and buprenorphine spending between the 26 states that implemented Medicaid expansions under the Affordable Care Act in 2014 and those that did not...
April 2017: Medical Care
https://www.readbyqxmd.com/read/28296579/perceived-impacts-of-the-affordable-care-act-perspectives-of-buprenorphine-prescribers
#4
Hannah K Knudsen, Jamie L Studts
The Affordable Care Act (ACA) has been heralded as a major policy change that is expected to transform the delivery of substance use disorder (SUD) treatment. Few studies have reported on the perceived impacts of ACA from the perspectives of SUD treatment providers, such as physicians who prescribe buprenorphine to patients with opioid use disorder. The present study describes buprenorphine prescribers' perceptions regarding impacts of the ACA on the delivery of buprenorphine and examines whether state-level approaches to implementing ACA are associated with its perceived impacts...
March 15, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28289108/access-to-primary-care-appointments-following-2014-insurance-expansions
#5
Karin V Rhodes, Simon Basseyn, Ari B Friedman, Genevieve M Kenney, Douglas Wissoker, Daniel Polsky
PURPOSE: The Patient Protection and Affordable Care Act (ACA) expanded coverage to roughly 12 million individuals by mid-2014 and 20 million by 2016, raising concern about the capacity of the primary care system to absorb these individuals. We set out to determine how justified the concern was. METHODS: We used an audit design in which simulated patients called primary care practices seeking new-patient appointments in 10 diverse states (Arkansas, Georgia, Iowa, Illinois, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania, and Texas) from November 2012 through March 2013 and from May 2014 through July 2014, before and after the major ACA insurance expansions...
March 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28275997/caring-by-numbers-evaluation-of-inconsistencies-and-incompleteness-in-the-reporting-of-racial-and-ethnic-data
#6
Beth Marie Hartzler, Angela Snyder
Significant health disparities throughout the lifespan have long been evident within the American, non-White population. These differences include increased incidence of infant mortality, childhood hospitalization, diabetes, mental and behavioral health problems, cardiovascular disease, and late-stage cancer diagnoses. These types of disparities could be addressed by identifying those individuals at greatest risk for chronic disease or higher mortality rates and improving their health literacy and access to care...
March 8, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28274601/producing-a-worthy-illness-personal-crowdfunding-amidst-financial-crisis
#7
Lauren S Berliner, Nora J Kenworthy
For Americans experiencing illnesses and disabilities, crowdfunding has become a popular strategy for addressing the extraordinary costs of health care. The political, social, and health consequences of austerity--along with fallout from the 2008 financial collapse and the shortcomings of the Affordable Care Act (ACA)--are made evident in websites like GoFundMe. Here, patients and caregivers create campaigns to solicit donations for medical care, hoping that they will spread widely through social networks. As competition increases among campaigns, patients and their loved ones are obliged to produce compelling and sophisticated appeals...
February 8, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28274334/the-effect-of-insurance-type-on-trauma-patient-access-to-psychiatric-care-under-the-affordable-care-act
#8
Daniel H Wiznia, Julianna Maisano, Chang-Yeon Kim, Theodore Zaki, Hochang B Lee, Michael P Leslie
OBJECTIVE: The objective of the study was to assess the effect of insurance type (Medicaid, Medicare, private insurance or cash pay) on patients' access to psychiatrists for a new patient consultation. METHOD: 240 psychiatrists identified as interested in treating patients with PTSD were called across 8 states. The caller requested an appointment for her fictitious boyfriend who had been in a car accident to be evaluated for PTSD. Each office was called four times to assess the responses for each payment type...
March 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28273021/health-and-access-to-care-during-the-first-2-years-of-the-aca-medicaid-expansions
#9
Sarah Miller, Laura R Wherry
Background By September 2015, a total of 29 states and Washington, D.C., were participating in Medicaid expansions under the Affordable Care Act. We examined whether Medicaid expansions were associated with changes in insurance coverage, health care use, and health among low-income adults. Methods We compared changes in outcomes during the 2 years after implementation of the Medicaid expansion (2014 and 2015) relative to the 4 years before expansion (2010 through 2013) in states with and without expansions, using data from the National Health Interview Survey...
March 9, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28272310/the-cost-of-cost-sharing-the-impact-of-medicaid-benefit-design-on-influenza-vaccination-uptake
#10
Charles Stoecker, Alexandra M Stewart, Megan C Lindley
Prior research indicates that cost-sharing and lack of insurance coverage reduce preventive services use among low-income persons. State Medicaid policy may affect the uptake of recommended adult vaccinations. We examined the impact of three aspects of Medicaid benefit design (coverage for vaccines, prohibiting cost-sharing, and copayment amounts) on vaccine uptake in the fee-for-service Medicaid population 19-64 years old. We combined previously published reports to obtain state Medicaid policy information from 2003 and 2012...
March 6, 2017: Vaccines
https://www.readbyqxmd.com/read/28258807/medication-assisted-treatment-for-adolescents-in-specialty-treatment-for-opioid-use-disorder
#11
Kenneth A Feder, Noa Krawczyk, Brendan Saloner
PURPOSE: The American Academy of Pediatrics recently recommended that pediatricians consider medication-assisted treatment (MAT) for adolescents with severe opioid use disorders. Little is known about adolescents' current use of MAT. METHODS: We use data on episodes of specialty treatment for heroin or opioid use (n = 139,092) from a database of publicly funded treatment programs in the U.S. We compare the proportions of adolescents and adults who received MAT, first using unadjusted comparison of proportions, then using logistic regression to adjust for potential confounders...
February 28, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28258527/commentary-the-importance-of-medicaid-expansion-for-criminal-justice-populations-in-the-south
#12
EDITORIAL
Nickolas D Zaller, David H Cloud, Lauren Brinkley-Rubinstein, Benjamin Bouvier, Sarah Martino, Brad Brockmann
Though the full implications of a Trump presidency for ongoing health care and criminal justice reform efforts remain uncertain, whatever policy changes are made will be particularly salient for the South, which experiences the highest incarceration rates, highest uninsured rates, and worst health outcomes in the United States. The passage of the Affordable Care Act (ACA) in 2010 was a watershed event and many states have taken advantage of opportunities created by the ACA to expand healthcare coverage to their poorest residents, and to develop partnerships between health and justice systems...
December 2017: Health & Justice
https://www.readbyqxmd.com/read/28242432/medicaid-family-spending-and-the-financial-implications-of-crowd-out
#13
Marcus Dillender
A primary purpose of health insurance is to protect families from medical expenditure risk. Despite this goal and despite the fact that research has found that Medicaid can crowd out private coverage, little is known about the effect of Medicaid on families' spending patterns. This paper implements a simulated instrumental variables strategy with data from the Consumer Expenditure Survey to estimate the effect of an additional family member becoming eligible for Medicaid on family-level health insurance coverage and spending...
February 16, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28231239/surveillance-for-health-care-access-and-health-services-use-adults-aged-18-64-years-behavioral-risk-factor-surveillance-system-united-states-2014
#14
Catherine A Okoro, Guixiang Zhao, Jared B Fox, Paul I Eke, Kurt J Greenlund, Machell Town
PROBLEM/CONDITION: As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage. However, millions of adults remain uninsured or underinsured. Compared with adults without barriers to health care, adults who lack health insurance coverage, have coverage gaps, or skip or delay care because of limited personal finances might face increased risk for poor physical and mental health and premature mortality. PERIOD COVERED: 2014...
February 24, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28230452/prescription-drug-utilization-and-reimbursement-increased-following-state-medicaid-expansion-in-2014
#15
Nirosha Mahendraratnam, Stacie B Dusetzina, Joel F Farley
BACKGROUND: The Affordable Care Act (ACA) expanded health care and medication insurance coverage through Medicaid expansion in select states. Expansion has the potential to increase the availability of health services to patients, including prescription medications. However, limited studies have examined how expansion affected prescription drug utilization and reimbursement. OBJECTIVE: To compare prescription drug utilization (number of prescriptions filled) and reimbursement trends between states that did and did not expand Medicaid coverage in 2014, while accounting for known effects of expansion on Medicaid enrollment...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28224441/does-medicaid-insurance-confer-adequate-access-to-adult-orthopaedic-care-in-the-era-of-the-patient-protection-and-affordable-care-act
#16
Joseph T Labrum, Taylor Paziuk, Theresa C Rihn, Alan S Hilibrand, Alexander R Vaccaro, Mitchell G Maltenfort, Jeffrey A Rihn
BACKGROUND: A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA). QUESTIONS/PURPOSES: (1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private insurance in a blinded survey? (2) What are the surveyed state-by-state Medicaid acceptance rates for adult orthopaedic practices in the current era of Medicaid expansion set forth by the PPACA? (3) Do surveyed rates of access to orthopaedic care in the adult patient population vary across practice setting (private vs academic) or vary with different Medicaid physician reimbursement rates? (4) Are there differences in the surveyed Medicaid acceptance rates for adult orthopaedic practices in states that have expanded Medicaid coverage versus states that have foregone expansion? METHODS: Simulated Patient Survey: We performed a telephone survey study of orthopaedic offices in four states with Medicaid expansion...
February 21, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28221275/changes-in-emergency-department-utilization-after-early-medicaid-expansion-in-california
#17
Lindsay M Sabik, Peter J Cunningham, Ali Bonakdar Tehrani
BACKGROUND: Medicaid expansions aim to improve access to primary care, which could reduce nonemergent (NE) use of the emergency department (ED). In contrast, Medicaid enrollees use the ED more than other groups, including the uninsured. Thus, the expected impact of Medicaid expansion on ED use is unclear. OBJECTIVES: To estimate changes in total and NE ED visits as a result of California's early Medicaid expansion under the Affordable Care Act. In addition to overall changes in the number of visits, changes by payer and safety net hospital status are examined...
February 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28213393/the-racial-divide-in-state-medicaid-expansions
#18
Colleen M Grogan, Sunggeun Ethan Park
This study considers five important questions related to the role of race in state-level public support for the Medicaid expansion: (1) whether public support for the Medicaid expansion varies across the American states; (2) whether public support is positively related to state adoption; (3) whether this support is racialized; (4) whether, if racialized, there is evidence of more state responsiveness to white support than to nonwhite (black and/or Latino) support; and (5) does the size of the nonwhite population matter more when white support is relatively low? Our findings suggest that while public support for the Medicaid expansion is high at the state level, especially in comparison to public support for the ACA, there are important variations across the states...
February 17, 2017: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/28207344/the-future-of-the-affordable-care-act-and-insurance-coverage
#19
Sherry Glied, Adlan Jackson
We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisions of the ACA, including the Medicaid expansion and the structure of premium subsidies, have been associated with large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage...
April 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28207336/local-television-news-coverage-of-the-affordable-care-act-emphasizing-politics-over-consumer-information
#20
Sarah E Gollust, Laura M Baum, Jeff Niederdeppe, Colleen L Barry, Erika Franklin Fowler
OBJECTIVES: To examine the public health and policy-relevant messages conveyed through local television news during the first stage of Affordable Care Act (ACA) implementation, when about 10 million Americans gained insurance. METHODS: We conducted a content analysis of 1569 ACA-related local evening television news stories, obtained from sampling local news aired between October 1, 2013, and April 19, 2014. Coders systematically collected data using a coding instrument tracking major messages and information sources cited in the news...
February 16, 2017: American Journal of Public Health
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