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Affordable care act

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https://www.readbyqxmd.com/read/28097328/diabetes-outpatient-care-and-acute-complications-before-and-after-high-deductible-insurance-enrollment-a-natural-experiment-for-translation-in-diabetes-next-d-study
#1
J Frank Wharam, Fang Zhang, Emma M Eggleston, Christine Y Lu, Stephen Soumerai, Dennis Ross-Degnan
Importance: High-deductible health plans (HDHPs) have expanded under the Affordable Care Act and are expected to play a major role in the future of US health policy. The effects of modern HDHPs on chronically ill patients and adverse outcomes are unknown. Objective: To determine the association of HDHP with high-priority diabetes outpatient care and preventable acute complications. Design, Setting, and Participants: Controlled interrupted-time-series study using a large national health insurer database from January 1, 2003, to December 31, 2012...
January 9, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28094586/perceptions-of-occupational-therapists-on-the-patient-protection-and-affordable-care-act-five-years-after-its-enactment
#2
Hon K Yuen, Hillary S Spicher, Madelyn R Semon, Leah M Winwood, Brian J Dudgeon
This study explored the perceptions of occupational therapists regarding the impact and implications of the Patient Protection and Affordable Care Act (PPACA or ACA) on occupational therapy practice. Fifteen occupational therapists participated in an interview to answer open-ended questions related to their thoughts and perceptions regarding the impact and implications of the ACA on their practice. The participants were practicing in eight different states and worked in five different settings with clinical experience ranging from 3 to 38 years; their positions ranged from staff therapist to owner of a free-standing outpatient clinic...
January 17, 2017: Occupational Therapy in Health Care
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/28087524/us-senate-takes-first-step-to-repeal-affordable-care-act
#5
Michael McCarthy
No abstract text is available yet for this article.
January 13, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28080012/medicaid-s-future-what-might-aca-repeal-mean
#6
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/28079673/differences-in-use-of-high-quality-and-low-quality-hospitals-among-working-age-individuals-by-insurance-type
#7
Ioana Popescu, Kevin C Heslin, Rosanna M Coffey, Raynard E Washington, Marguerite L Barrett, Lucy H Karnell, José J Escarce
BACKGROUND: Research suggests that individuals with Medicaid or no insurance receive fewer evidence-based treatments and have worse outcomes than those with private insurance for a broad range of conditions. These differences may be due to patients' receiving care in hospitals of different quality. RESEARCH DESIGN: We used the Healthcare Cost and Utilization Project State Inpatient Databases 2009-2010 data to identify patients aged 18-64 years with private insurance, Medicaid, or no insurance who were hospitalized with acute myocardial infarction, heart failure, pneumonia, stroke, or gastrointestinal hemorrhage...
February 2017: Medical Care
https://www.readbyqxmd.com/read/28074575/the-aca-from-behind-the-veil-of-ignorance
#8
Susan Dentzer
John Rawls posited that we could determine the nature of justice if we imagined ourselves observing conditions in society from behind a hypothetical "veil of ignorance." Not knowing how or where we would end up-rich, poor, empowered, disabled-we would choose governing principles that did not leave one disadvantaged because of his or her circumstances. Rawls's concepts are implicitly embedded in the Affordable Care Act, which guarantees that vastly more Americans can obtain health insurance. The law effectively closed down the de facto lottery that awarded coverage to most but left out millions of others...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28073856/reinventing-american-health-care-how-the-affordable-care-act-will-improve-our-terribly-complex-blatantly-unjust-outrageously-expensive-grossly-inefficient-error-prone-system
#9
William P Brandon
No abstract text is available yet for this article.
February 2017: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/28072508/repealing-federal-health-reform-economic-and-employment-consequences-for-states
#10
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/28069852/affordable-care-act-changes-to-medicare-led-to-increased-diagnoses-of-early-stage-colorectal-cancer-among-seniors
#11
Brett Lissenden, Nengliang Aaron Yao
The Affordable Care Act (ACA) helped make preventive care, including recommended cancer screening, more affordable and accessible for millions of Americans. Using population-based data from the Surveillance, Epidemiology, and End Results (SEER) Program, we estimated the impact of ACA policy changes to facilitate the diagnosis of cancer at an earlier and more treatable stage. We estimated that the ACA resulted in an increase of 8,400 (8 percent) diagnoses of early-stage colorectal cancer among US seniors in the period 2011-13...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069846/medicaid-expansion-and-grant-funding-increases-helped-improve-community-health-center-capacity
#12
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
#13
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
#14
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/28069843/nearly-one-third-of-enrollees-in-california-s-individual-market-missed-opportunities-to-receive-financial-assistance
#15
Vicki Fung, Catherine Y Liang, Karen Donelan, Cassandra G K Peitzman, William H Dow, Alan M Zaslavsky, Bruce Fireman, Stephen F Derose, Michael E Chernew, Joseph P Newhouse, John Hsu
The Affordable Care Act includes financial assistance that reduces both premiums and cost-sharing amounts for lower-income Americans, to increase the affordability of health insurance coverage and care. To receive both types of assistance, enrollees must purchase a qualified health plan through a public insurance exchange, and those eligible for the cost-sharing reduction must purchase a silver-tier plan. We estimate that 31 percent of individual-market enrollees in California who were likely eligible for financial assistance purchased plans that were not silver tier or that were not sold on the state's exchange and thus missed opportunities to receive premium or cost-sharing assistance or both...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069842/most-newly-insured-people-in-2014-were-long-term-uninsured
#16
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/28069841/consumers-buy-lower-cost-plans-on-covered-california-suggesting-exposure-to-premium-increases-is-less-than-commonly-reported
#17
Jon R Gabel, Daniel R Arnold, Brent D Fulton, Sam T Stromberg, Matthew Green, Heidi Whitmore, Richard M Scheffler
With the notable exception of California, states have not made enrollment data for their Affordable Care Act (ACA) Marketplace plans publicly available. Researchers thus have tracked premium trends by calculating changes in the average price for plans offered (a straight average across plans) rather than for plans purchased (a weighted average). Using publicly available enrollment data for Covered California, we found that the average purchased price for all plans was 11.6 percent less than the average offered price in 2014, 13...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069581/obama-calls-plan-to-repeal-affordable-care-act-reckless-and-irresponsible
#18
Michael McCarthy
No abstract text is available yet for this article.
January 9, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28068854/breast-cancer-care-in-california-and-ontario
#19
Kevin M Gorey, Caroline Hamm, Isaac N Luginaah, Guangyong Zou, Eric J Holowaty
BACKGROUND: Better health care among Canada's socioeconomically vulnerable versus America's has not been fully explained. We examined the effects of poverty, health insurance and the supply of primary care physicians on breast cancer care. METHODS: We analyzed breast cancer data in Ontario (n = 950) and California (n = 6300) between 1996 and 2000 and followed until 2014. We obtained socioeconomic data from censuses, oversampling the poor. We obtained data on the supply of physicians, primary care and specialists...
January 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28068172/access-to-accredited-cancer-hospitals-within-federal-exchange-plans-under-the-affordable-care-act
#20
Kenneth L Kehl, Kai-Ping Liao, Trudy M Krause, Sharon H Giordano
Purpose The Affordable Care Act expanded access to health insurance in the United States, but concerns have arisen about access to specialized cancer care within narrow provider networks. To characterize the scope and potential impact of this problem, we assessed rates of inclusion of Commission on Cancer (CoC) -accredited hospitals and National Cancer Institute (NCI) -designated cancer centers within federal exchange networks. Methods We downloaded publicly available machine-readable network data and public use files for individual federal exchange plans from the Centers for Medicare and Medicaid Services for the 2016 enrollment year...
January 9, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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