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https://www.readbyqxmd.com/read/29779551/emerging-roles-for-peer-providers-in-mental-health-and-substance-use-disorders
#1
Susan A Chapman, Lisel K Blash, Kimberly Mayer, Joanne Spetz
INTRODUCTION: The purpose of this study was to identify and assess states with best practices in peer provider workforce development and employment. A growing body of research demonstrates that peer providers with lived experience contribute positively to the treatment and recovery of individuals with behavioral health needs. Increased employment opportunities have led to policy concerns about training, certification, roles, and reimbursement for peer provider services. METHODS: A case study approach included a national panel of subject matter experts who suggested best practice states...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779546/state-legislative-approach-to-enumerating-behavioral-health-workforce-shortages-lessons-learned-in-new-mexico
#2
Deborah B Altschul, Caroline A Bonham, Martha J Faulkner, Amy W Farnbach Pearson, Jessica Reno, Wayne Lindstrom, Shelley M Alonso-Marsden, Annette Crisanti, Julie G Salvador, Richard Larson
Nationally, the behavioral health workforce is in crisis because of a lack of resources, culturally responsive services, quality clinical supervision, sufficient training in evidence-based practices, and targeted recruitment and retention. Disparities in access to behavioral health care are particularly significant in New Mexico, where 25% of the population live in rural areas, and behavioral health shortages are among the highest in the nation. Additionally, as a Medicaid expansion state, New Mexico providers experience increased demand for services at a time when the state is challenged with limited workforce capacity...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29776778/three-years-post-affordable-care-act-sexually-transmitted-disease-clinics-remain-critical-among-vulnerable-populations
#3
Nicky J Mehtani, Christina M Schumacher, Luke E Johnsen, Adena Greenbaum, C Patrick Chaulk, Khalil G Ghanem, Jacky M Jennings, Kathleen R Page
INTRODUCTION: The purpose of the study is to examine whether demand for publicly funded sexually transmitted disease clinics changed after Affordable Care Act implementation. METHODS: The percentages of total incident sexually transmitted infections in Baltimore City that occurred at publicly funded sexually transmitted disease clinics were compared between the 3 years prior to and following the 2014 Medicaid and private insurance expansions. Risk factors associated with diagnosis at sexually transmitted disease clinics were identified using log binomial regression...
May 15, 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29771619/affordable-care-act-impact-in-kentucky-increasing-access-reducing-disparities
#4
Lynn A Blewett, Colin Planalp, Giovann Alarcon
OBJECTIVES: To examine health insurance disparities since Kentucky's implementation of the Affordable Care Act (ACA). METHODS: Using the American Community Survey, we estimated coverage rates by race/ethnicity before and after implementation of the ACA (2013 and 2015), and we estimated whether groups were over- or underrepresented among the uninsured, compared with their share of the state population. RESULTS: Kentucky's uninsurance rate declined from 14...
May 17, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29762274/decomposing-medicaid-spending-during-health-system-reform-and-aca-expansion-evidence-from-oregon
#5
Stephanie Renfro, Stephan Lindner, K John McConnell
BACKGROUND: Expansion of the Medicaid program is likely to create new budgetary pressures at the state and federal levels, creating a need for greater understanding of how program dollars are allocated and what drives spending growth. OBJECTIVE: To characterize Oregon Medicaid expenditures across diseases and medical conditions, during periods of payment reform and coverage expansion. RESEARCH DESIGN: Decomposition of changes in Medicaid expenditures using a person-based allocation of spending across 50 diseases/medical conditions...
May 12, 2018: Medical Care
https://www.readbyqxmd.com/read/29757880/leveraging-health-care-reform-to-accelerate-nurse-practitioner-full-practice-authority
#6
Heather M Brom, Pamela J Salsberry, Margaret Clark Graham
BACKGROUND AND PURPOSE: Since development of the nurse practitioner (NP) role, NPs have been advocating for policy allowing them to practice to the full extent of their training. The aim of this research was to determine whether passage of the Affordable Care Act (ACA) had an impact on expansion of NPs' scope of practice. METHODS: This was a retrospective descriptive study of NPs' scope of practice legislation from 1994 to 2016 using regulatory theory. Data sources included annual reports on NP legislation and state-level legislative and media coverage...
March 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29749302/integrated-accountable-care-for-medicaid-expansion-enrollees-a-comparative-evaluation-of-hennepin-health
#7
Katherine D Vickery, Nathan D Shippee, Jeremiah Menk, Ross Owen, David M Vock, Peter Bodurtha, Dana Soderlund, Rodney A Hayward, Matthew M Davis, John Connett, Mark Linzer
Hennepin Health, a Medicaid accountable care organization, began serving early expansion enrollees (very low-income childless adults) in 2012. It uses an integrated care model to address social and behavioral needs. We compared health care utilization in Hennepin Health with other Medicaid managed care in the same area from 2012 to 2014, controlling for demographics, chronic conditions, and enrollment patterns. Homelessness and substance use were higher in Hennepin Health. Overall adjusted results showed Hennepin Health had 52% more emergency department visits and 11% more primary care visits than comparators...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29749288/changes-in-quality-of-life-among-enrollees-in-hennepin-health-a-medicaid-expansion-aco
#8
Katherine D Vickery, Nathan D Shippee, Laura M Guzman-Corrales, Cindy Cain, Sarah Turcotte Manser, Tom Walton, Jessica Richards, Mark Linzer
Despite limited program evaluations of Medicaid accountable care organizations (ACOs), no studies have examined if cost-saving goals negatively affect quality of life and health care experiences of low-income enrollees. The Hennepin Health ACO uses an integrated care model to address the physical, behavioral, and social needs of Medicaid expansion enrollees. As part of a larger evaluation, we conducted semistructured interviews with 35 primary care using Hennepin Health members enrolled for 2 or more years...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29747862/the-effect-of-insurance-type-on-access-to-inguinal-hernia-repair-under-the-affordable-care-act
#9
Walter Hsiang, Catherine McGeoch, Sarah Lee, William Cheung, Robert Becher, Kimberly A Davis, Kevin M Schuster
BACKGROUND: The expansion of Medicaid under the Affordable Care Act extended coverage to any individual with an income up to 138% of the federal poverty level. Our study of surgeon practice management investigated the impact of the type of insurance on access to elective inguinal hernia repair and the disparities in access between Medicaid expansion and nonexpansion states. METHODS: Practices of 240 hernia repair surgeons across 8 states were randomly selected from the American College of Surgeons Find a Surgeon Database...
May 7, 2018: Surgery
https://www.readbyqxmd.com/read/29745303/the-effect-of-aca-state-medicaid-expansions-on-medical-out-of-pocket-expenditures
#10
Joelle Abramowitz
This article considers the extent to which Affordable Care Act state Medicaid expansions alleviated the burden of out-of-pocket costs associated with obtaining health insurance and medical care using data from the 2011 to 2016 Current Population Survey Annual Social and Economic Supplement. Using a difference-in-differences framework, the analysis examines effects of the Medicaid expansions on out-of-pocket expenditures for health insurance premiums and medical care, comparing expenditures across expansion and nonexpansion states before and after the expansions were implemented, performing separate analyses for individuals with family income at various eligibility cutoff levels in the first and second years of expansion implementation...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29734277/shifts-in-medicaid-and-uninsured-payer-mix-at-safety-net-and-non-safety-net-hospitals-during-the-great-recession
#11
Kathryn R Fingar, Rosanna M Coffey, Andrew W Mulcahy, Roxanne M Andrews, Carol Stocks
There has been ongoing concern regarding the viability of safety-net hospitals (SNHs), which care for vulnerable populations. The authors examined payer mix at SNHs and non-SNHs during a period covering the Great Recession using data from the 2006 to 2012 Healthcare Cost and Utilization Project State Inpatient Databases from 38 states. The number of privately insured stays decreased at both SNHs and non-SNHs. Non-SNHs increasingly served Medicaid-enrolled and uninsured patients; in SNHs, the number of Medicaid stays decreased and uninsured stays remained stable...
May 2018: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29719220/access-to-us-primary-care-physicians-for-new-patients-concerned-about-smoking-or-weight
#12
Sarah E Tinkler, Rajiv L Sharma, Raven R H Susu-Mago, Sudeshna Pal, Miron Stano
Tobacco smoking and obesity are leading causes of preventable morbidity and mortality in the US, and primary care physicians are the main source of preventive care. However, it is not known whether access for new patients is affected by an expression of interest in preventive care. In a 2015 audit, we called US primary care physicians' offices to request appointment information regarding new patient physicals for simulated patients. Simulated patients were differentiated by smoking concerns (N = 907), weight concerns (N = 867), or no health concerns ("healthy" patients; N = 3561)...
April 29, 2018: Preventive Medicine
https://www.readbyqxmd.com/read/29698286/medicaid-expansion-leads-to-improved-breast-cancer-care
#13
Karen Rosenberg
No abstract text is available yet for this article.
May 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29697846/recent-changes-in-health-insurance-coverage-for-urban-and-rural-veterans-evidence-from-the-first-year-of-the-affordable-care-act
#14
Michel Boudreaux, Deanna Barath, Lynn A Blewett
Introduction: Prior to the Affordable Care Act, as many as 1.3 million veterans lacked health insurance. With the passage of the Affordable Care Act, veterans now have new pathways to coverage through Medicaid expansion in those states that chose to expand Medicaid and through private coverage options offered through the Health Insurance Marketplace. We examined the impact of the ACA on health insurance coverage for veterans in expansion and non-expansion states and for urban and rural veterans...
April 25, 2018: Military Medicine
https://www.readbyqxmd.com/read/29672187/early-life-medicaid-coverage-and-intergenerational-economic-mobility
#15
Rourke L O'Brien, Cassandra L Robertson
New data reveal significant variation in economic mobility outcomes across U.S. localities. This suggests that social structures, institutions, and public policies-particularly those that influence critical early-life environments-play an important role in shaping mobility processes. Using new county-level estimates of intergenerational economic mobility for children born between 1980 and 1986, we exploit the uneven expansions of Medicaid eligibility across states to isolate the causal effect of this specific policy change on mobility outcomes...
April 1, 2018: Journal of Health and Social Behavior
https://www.readbyqxmd.com/read/29663343/patient-protection-and-affordable-care-act-medicaid-expansion-and-gains-in-health-insurance-coverage-and-access-among-cancer-survivors
#16
Sayeh S Nikpay, Margaret G Tebbs, Emily H Castellanos
BACKGROUND: The Patient Protection and Affordable Care Act extends Medicaid coverage to millions of low-income adults, including many survivors of cancer who were unable to purchase affordable health insurance coverage in the individual health insurance market. METHODS: Using data from the 2011 to 2015 Behavioral Risk Factor Surveillance System, the authors compared changes in coverage and health care access measures for low-income cancer survivors in states that did and did not expand Medicaid...
April 17, 2018: Cancer
https://www.readbyqxmd.com/read/29620480/improved-health-and-insurance-status-among-cigarette-smokers-after-medicaid-expansion-2011-2016
#17
Clare C Brown, J Mick Tilford, T Mac Bird
OBJECTIVES: The high concentration of smokers among subgroups targeted by the Affordable Care Act and the historically worse health and lower access to health care among smokers warrants an evaluation of how Medicaid expansion affects smokers. We evaluated the impact of Medicaid expansion on smoking behavior, access to health care, and health of low-income adults, and we compared outcomes of all low-income people with outcomes of low-income current smokers by states' Medicaid expansion status...
January 1, 2018: Public Health Reports
https://www.readbyqxmd.com/read/29615354/improved-access-to-health-care-in-massachusetts-after-2006-massachusetts-healthcare-reform-law-is-associated-with-a-significant-decrease-in-mortality-among-vascular-surgery-patients
#18
Mohammad H Eslami, Katherine Moll Reitz, Denis V Rybin, Gheorghe Doros, Alik Farber
BACKGROUND: Access to medical care, by adequate insurance coverage, has a direct impact on outcomes for patients undergoing vascular procedures. We evaluated in-hospital mortality for patients undergoing index vascular procedures before and after the Massachusetts Healthcare Reform Law (MHRL) in 2006, which mandated insurance for all Massachusetts residents, both in Massachusetts and throughout the United States. METHODS: The National Inpatient Sample was queried to identify patients undergoing interventions for peripheral arterial disease, carotid artery stenosis, and abdominal aortic aneurysms based on International Classification of Diseases, Ninth Revision, Clinical Modification procedural and diagnostic codes...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29611719/early-hospital-readmissions-following-an-acute-exacerbation-of-copd-in-the-nationwide-readmissions-database
#19
David M Jacobs, Katia Noyes, Jiwei Zhao, Walter Gibson, Timothy F Murphy, Sanjay Sethi, Heather M Ochs-Balcom
RATIONALE: Understanding the causes and factors related to readmission for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) within a nationwide database including all payers and ages can provide valuable input for the development of generalizable readmission reduction strategies. OBJECTIVES: To determine the rates, causes, and predictors for early (3-, 7-, and 30-day) readmission in patients hospitalized with AECOPD in the United States utilizing the Nationwide Readmission Database (NRD) following the initiation of the Hospital Readmissions Reduction Program (HRRP) but prior to its expansion to COPD...
April 3, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29608347/employer-sponsored-insurance-stable-for-low-income-workers-in-medicaid-expansion-states
#20
Adele Shartzer, Fredric Blavin, John Holahan
We assessed rates of employer health insurance offer, take-up, and coverage in June 2013 and March 2017 among workers. Overall, offer rates remained stable, and take-up and coverage rates increased. In Medicaid expansion states, the share of workers with family incomes at or below 138 percent of the federal poverty level who had employer-based coverage held steady, while uninsurance rates declined.
April 2018: Health Affairs
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