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Affordable care act

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https://www.readbyqxmd.com/read/29149139/reversal-of-growth-of-utilization-of-interventional-techniques-in-managing-chronic-pain-in-medicare-population-post-affordable-care-act
#1
Laxmaiah Manchikanti, Amol Soin, Dharam P Mann, Sanjay Bakshi, Vidyasagar Pampati, Joshua A Hirsch
BACKGROUND: Over the past 2 decades, the increase in the utilization of interventional techniques has been a cause for concern. Despite multiple regulations to reduce utilization of interventional techniques, growth patterns continued through 2009. A declining trend was observed in a previous evaluation; however, a comparative analysis of utilization patterns of interventional techniques has not been performed showing utilization before and after the enactment of the Affordable Care Act (ACA)...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148343/lessons-learned-from-the-affordable-care-act-the-premium-subsidy-design-may-promote-adverse-selection
#2
Ilana Graetz, Caitlin N McKillop, Cameron M Kaplan, Teresa M Waters
Since 2014, average premiums for health plans available in the Affordable Care Act marketplaces have increased. We examine how premium price changes affected the amount consumers pay after subsidies for the lowest-cost bronze and silver plans available by age in the federally facilitated exchanges. Between 2015 and 2016, benchmark plan premiums increased in 83.3% of counties. Overall, rising benchmark premiums were associated with lower average after-subsidy premiums for the lowest-cost bronze and silver plans for older subsidy-eligible adults, but with higher after-subsidy premiums for younger adults purchasing the same plans, regardless of income...
May 1, 2017: Medical Care Research and Review: MCRR
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
#3
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
#4
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/29148331/financial-performance-of-health-insurers-state-run-versus-federal-run-exchanges
#5
Mark A Hall, Michael J McCue, Jennifer R Palazzolo
Many insurers incurred financial losses in individual markets for health insurance during 2014, the first year of Affordable Care Act mandated changes. This analysis looks at key financial ratios of insurers to compare profitability in 2014 and 2013, identify factors driving financial performance, and contrast the financial performance of health insurers operating in state-run exchanges versus the federal exchange. Overall, the median loss of sampled insurers was -3.9%, no greater than their loss in 2013. Reduced administrative costs offset increases in medical losses...
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
#6
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/29148321/impact-of-the-affordable-care-act-s-dependent-coverage-expansion-on-the-health-care-and-health-status-of-young-adults-what-do-we-know-so-far
#7
Joshua Breslau, Bradley D Stein, Bing Han, Shoshanna Shelton, Hao Yu
The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders' children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent...
December 1, 2016: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29146230/race-insurance-status-and-traumatic-brain-injury-outcomes-before-and-after-enactment-of-the-affordable-care-act
#8
Eric W Moffet, Tiffany J Zens, Krista L Haines, Megan V Beems, Kaitlyn M McQuistion, Glen E Leverson, Suresh K Agarwal
BACKGROUND: The Affordable Care Act aims to improve patient outcomes. Race/ethnicity and insurance status impact outcomes after traumatic brain injury. We sought to gauge the Affordable Care Act's effect on outcomes after traumatic brain injury, as graded by race/ethnicity and insurance status. METHODS: The National Trauma Data Bank was utilized to identify traumatic brain injury patients before and after the Affordable Care Act. Patient outcomes comprised of hospital duration of stay, in-hospital mortality, discharge to rehabilitation, and surgical procedures...
November 13, 2017: Surgery
https://www.readbyqxmd.com/read/29142907/social-effects-of-health-care-reform-medicaid-expansion-under-the-affordable-care-act-and-changes-in-volunteering
#9
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/29141639/tobacco-use-and-health-insurance-literacy-among-vulnerable-populations-implications-for-health-reform
#10
Robert T Braun, Yaniv Hanoch, Andrew J Barnes
BACKGROUND: Under the Affordable Care Act (ACA), millions of Americans have been enrolling in the health insurance marketplaces. Nearly 20% of them are tobacco users. As part of the ACA, tobacco users may face up to 50% higher premiums that are not eligible for tax credits. Tobacco users, along with the uninsured and racial/ethnic minorities targeted by ACA coverage expansions, are among those most likely to suffer from low health literacy - a key ingredient in the ability to understand, compare, choose, and use coverage, referred to as health insurance literacy...
November 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29137555/impact-of-aca-health-reforms-for-people-with-mental-health-conditions
#11
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/29135676/physician-owned-hospitals-down-but-not-out-the-evidence-versus-the-hype-commentary-on-an-article-by-p-maxwell-courtney-md-et-al-reconsidering-the-affordable-care-act-s-restrictions-on-physician-owned-hospitals-analysis-of-cms-data-for-total-hip-and-knee-arthroplasty
#12
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
#13
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/29133601/burden-of-catastrophic-health-expenditures-for-acute-myocardial-infarction-and-stroke-among-uninsured-in-the-united-states
#14
Rohan Khera, Jonathan C Hong, Anshul Saxena, Alejandro Arrieta, Salim S Virani, Ron Blankstein, James A de Lemos, Harlan M Krumholz, Khurram Nasir
Acute myocardial infarction (AMI) and stroke are unanticipated major healthcare events that require emergent and expensive care. Given the potential financial implications of AMI and stroke among uninsured patients, we sought to evaluate rates of catastrophic healthcare expenditures (CHEs), defined as expenses beyond financial means, in a period before the implementation of insurance expansion and protections in the Affordable Care Act.(1).
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29133576/spillover-effects-of-adult-medicaid-expansions-on-children-s-use-of-preventive-services
#15
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/29132952/use-of-welcome-to-medicare-visits-among-older-adults-following-the-affordable-care-act
#16
Arpit Misra, Jennifer T Lloyd, Larisa M Strawbridge, Suzanne G Wensky
INTRODUCTION: To encourage greater utilization of preventive services among Medicare beneficiaries, the 2010 Affordable Care Act waived coinsurance for the Welcome to Medicare visit, making this benefit free starting in 2011. The objective of this study was to determine the impact of the Affordable Care Act on Welcome to Medicare visit utilization. METHODS: A 5% sample of newly enrolled fee-for-service Medicare beneficiaries for 2005-2016 was used to estimate changes in Welcome to Medicare visit use over time...
November 10, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29130479/implementing-models-of-geriatric-care-behind-the-scenes
#17
Joshua Chodosh, Michael Weiner
Innovative geriatric clinical programs have proliferated in the 21st century, and many have been highlighted in the Journal of the American Geriatrics Society (JAGS). The Affordable Care Act has supported the accelerated innovation of publicized and unpublicized program development, adaptation, and implementation. Many JAGS articles report work conducted in programs with significant improvements in quality; high satisfaction for patients and providers; and for some, reductions in costs. Despite considerable detail, enabling implementers to attempt to adopt reported programs or adapt them to local environments, much less is typically conveyed about the subtleties of the implementation process that led to a successful outcome...
November 11, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29130265/the-economics-of-public-health-missing-pieces-to-the-puzzle-of-health-system-reform
#18
Glen P Mays, Adam J Atherly, Alan M Zaslavsky
The United States continues to experiment with health care delivery and financing innovations, but relatively little attention is given to the public health system and its capacity for improving health status in the U.S. population at large. The public health system operates as a multisector enterprise in which government agencies work in conjunction with private and voluntary organizations to identify health risks in the population and to mobilize community-wide actions that prevent and contain these risks...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29129209/the-medicare-annual-wellness-visit
#19
REVIEW
Jessica L Colburn, Stephanie Nothelle
The Medicare Annual Wellness Visit is an annual preventive health benefit, which was created in 2011 as part of the Patient Protection and Affordable Care Act. The visit provides an opportunity for clinicians to review preventive health recommendations and screen for geriatric syndromes. In this article, the authors review the requirements of the Annual Wellness Visit, discuss ways to use the Annual Wellness Visit to improve the care of geriatric patients, and provide suggestions for how to incorporate this benefit into a busy clinic...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129193/experiences-of-three-states-implementing-the-medicaid-health-home-model-to-address-opioid-use-disorder-case-studies-in-maryland-rhode-island-and-vermont
#20
Lisa Clemans-Cope, Jane B Wishner, Eva H Allen, Nicole Lallemand, Marni Epstein, Brenda C Spillman
PURPOSE: The United States is facing an unprecedented opioid epidemic. The Affordable Care Act (ACA) included several provisions designed to increase care coordination in state Medicaid programs and improve outcomes for those with chronic conditions, including substance use disorders. Three states-Maryland, Rhode Island, and Vermont - adopted the ACA's optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid use disorder treatment that features opioid agonist therapy provided at opioid treatment programs (OTPs) and Office-based Opioid Treatment (OBOT) with medical and behavioral health care and other services, including those addressing social determinants of health...
December 2017: Journal of Substance Abuse Treatment
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