Insurance
Substance Use Disorders Among Medicare Beneficiaries: Prevalence, Mental and Physical Comorbidities, and Treatment Barriers
This study aimed to determine the prevalence of treated and untreated substance use disorders among Medicare beneficiaries, the characteristics of Medicare beneficiaries with substance use disorders, and reasons for their unmet needs.Vaccination Coverage of Privately Insured Children: Comparing U.S. Survey and Administrative Data
National Immunization Survey-Child data are used widely to assess childhood vaccination coverage in the U.S. This study compares National Immunization Survey-Child coverage estimates with estimates using other supplementary data sources.Healthcare Utilization and Costs Associated With Perinatal Depression Among Medicaid Enrollees
Differences in healthcare utilization and medical expenditures associated with perinatal depression are estimated.Eviction, Healthcare Utilization, and Disenrollment Among New York City Medicaid Patients
Although growing evidence links residential evictions to health, little work has examined connections between eviction and healthcare utilization or access. In this study, eviction records are linked to Medicaid claims to estimate short-term associations between eviction and healthcare utilization, as well as Medicaid disenrollment.Enforcing Legal Compliance for Covering of Services Promoting Family Mental Health
The coronavirus disease 2019 (COVID-19) pandemic exacerbated a growing children's mental health crisis in the U.S. Mental health–related emergency department visits rose by 31% during COVID-19 onset compared with the same 7-month time period in 2019.1 This sudden increase built on a pre-existing trend of worsening mental health issues among children, as children experienced a 329% increase in visits for deliberate self-harm between 2007 and 2016.2 Absent intervention, these childhood mental health challenges will have long-term health and economic consequences that propagate disparities.Prenatal Syphilis Screening Among Medicaid Enrollees in 6 Southern States
The rates of syphilis among pregnant women and infants have increased in recent years, particularly in the U.S. South. Although state policies require prenatal syphilis testing, recent screening rates comparable across Southern states are not known. The purpose of this study is to measure syphilis screening among Medicaid enrollees with delivery in states in the U.S. South.Trends in the Impact of Medicaid Expansion on the Use of Clinical Preventive Services
This study aims to evaluate the trends in the impact of Medicaid expansion on the use of selected recommended clinical preventive services and examine the differences in use by income level over time.Medicaid Expansion and Cancer Mortality by Race and Sex in Louisiana
The purpose of this study is to determine the association between Medicaid expansion in Louisiana and cancer mortality by race and sex.Impact of Medicaid Expansion on Reported Incidents of Child Neglect and Physical Abuse
The U.S. Affordable Care Act Medicaid expansion, which allowed states to expand Medicaid coverage to low-income adults beginning in 2014, has reduced the risk factors for child neglect and physical abuse, including parental financial insecurity, substance use, and untreated mental illness. This study examines the associations between Medicaid expansion and the rates of overall, first-time, and repeat reports of child neglect and physical abuse incidents per 100,000 children aged 0–5, 6–12, and 13–17 years.The Past and Future of Gender Nondiscrimination Policy Under the Affordable Care Act
On September 2, 2020 in Whitman-Walker Clinic v. HHS, the U.S. District Court for the District of Columbia enjoined HHS from implementing the key provisions of its 2020 rule promulgated by the Trump Administration, which rolled back Obama-era regulations implementing Section 1557 of the Affordable Care Act (ACA).1 Section 1557, also known as the antidiscrimination mandate, prohibits discrimination based on race, color, national origin, sex, age, and disability in any health program or activity receiving federal funding.Health Insurance Disruptions and Care Access and Affordability in the U.S.
Health insurance is associated with better care in the U.S., but little is known about the associations of coverage disruptions (i.e., periods without insurance) with care access, receipt, and affordability.Impact of Neighborhood Social and Environmental Resources on Medicaid Spending
In an era of COVID-19, Black Lives Matter, and unsustainable healthcare spending, efforts to address the root causes of health are urgently needed. Research linking medical spending to variation in neighborhood resources is critical to building the case for increased funding for social conditions. However, few studies link neighborhood factors to medical spending. This study assesses the relationship between neighborhood social and environmental resources and medical spending across the spending distribution.Without Thoughtful, Hard-Earned Design, Public Option Plans Unlikely to Relieve the Rising Uninsured Rate
Although not new,1 public option insurance plans are gaining momentum and popularity as a means to decrease healthcare spending, expand coverage, and preserve consumer choice.2 Public option plans are traditionally defined by government-set payment rates and government administration of the plan (either at the state level or at the federal level).3 More recently, the administration of public option plans has been expanded to include the choice of contracting with private insurance companies, analogous to existing Medicare and Medicaid programs.Out-of-Pocket Spending for Influenza Hospitalizations in Medicare Advantage
Although many Medicare Advantage plans have waived cost sharing for COVID-19 hospitalizations, these waivers are voluntary and may be temporary. To estimate the magnitude of potential patient cost sharing if waivers are not implemented or are allowed to expire, this study assesses the level and predictors of out-of-pocket spending for influenza hospitalizations in 2018 among elderly Medicare Advantage patients.Effect of Medicaid Expansions on HIV Diagnoses and Pre-Exposure Prophylaxis Use
Increased insurance coverage and access to health care can increase identification of undiagnosed HIV infection and use of HIV prevention services such as pre-exposure prophylaxis. This study investigates whether the Medicaid expansions facilitated by the Affordable Care Act had these effects.Primary Care Use Among Commercially Insured Adolescents: Evidence From the 2018 Healthcare Effectiveness Data and Information Set
Improving the utilization of preventive care among adolescents is important for achieving individual-level and population-level health goals. The Healthcare Effectiveness Data and Information Set reports data submitted by managed care health plans, capturing a large number of individuals in the U.S.Financial Risk for COVID-19–like Respiratory Hospitalizations in Consumer-Directed Health Plans
This study aims to quantify out-of-pocket spending associated with respiratory hospitalizations for conditions similar to those caused by coronavirus disease 2019 and to compare out-of-pocket spending differences among those enrolled in consumer-directed health plans and in traditional, low-deductible plans.Impact of Medicaid Expansion on Healthcare Access Among Individuals Living With Chronic Diseases
The Affordable Care Act's Medicaid expansion has been found to increase healthcare access among low-income individuals in the general population. Fewer studies have explored the impact of Medicaid expansion on healthcare access among those living with chronic diseases. It is also unclear whether the impact of Medicaid expansion varies across levels of educational attainment or poverty among this subgroup. This study investigates the impact of Medicaid expansion on healthcare access among adults aged 18–64 years living with chronic diseases, as well as its variations across educational attainment and federal poverty levels.Accountable Care Organizations and Preventable Hospitalizations Among Patients With Depression
Accountable care organizations have been successful in improving quality of care, but little is known about who is benefiting from accountable care organizations and through what mechanism. This study examined variation of potentially preventable hospitalizations for chronic conditions with coexisting depression in adults by hospital accountable care organization affiliation and care coordination strategies by race/ethnicity.Change and Stability in the Characteristics of the Population Without Health Insurance
The uninsured population faces greater health risks than the insured population. Although prior research has examined how the uninsured rate has changed for various sociodemographic groups, less is known about how the characteristics of the uninsured population have changed in recent years.The Affordable Care Act and Ethnic Disparities in Colorectal Cancer Screening
Cost sharing can deter the use of health services and act as a potential contributor to racial/ethnic disparities in cancer. The Affordable Care Act required most health plans to cover, without cost sharing, preventive services, including colorectal cancer screening. Population-based data were used to estimate the impact of the Affordable Care Act's cost-sharing provision (together with other Affordable Care Act provisions targeting preventive care) on ethnic disparities in colorectal cancer screening, comparing Hispanics with non-Hispanics.Health Risk Assessments in Michigan's Medicaid Expansion: Early Experiences in Primary Care
Michigan is one of 3 states that have implemented health risk assessments for enrollees as a feature of its Medicaid expansion, the Healthy Michigan Plan. This study describes primary care providers’ early experiences with completing health risk assessments with enrollees and examines provider- and practice-level factors that affect health risk assessment completion.Prescription Benzodiazepine Use in Privately Insured U.S. Children and Adolescents
Benzodiazepines are commonly prescribed in the U.S. but entail safety concerns, including dependency. In pediatrics, many indications lack trial data. Authors aimed to describe youth initiating prescription benzodiazepine treatment, identify potential indications and prescribing concerns, estimate the duration of treatment by potential indication, and identify factors that predict long-term use.Impacts of Medicaid Expansion on Health Among Women of Reproductive Age
Preconception and interconception health care are critical means of identifying, managing, and treating risk factors originating before pregnancy that can harm fetal development and maternal health. However, many women in the U.S. lack health insurance, limiting their ability to access such care. State-level variation in Medicaid eligibility, particularly before and after the 2014 Medicaid expansions, offers a unique opportunity to test the hypothesis that increasing healthcare coverage for low-income women can improve preconception and interconception healthcare access and utilization, chronic disease management, overall health, and health behaviors.Breast, Cervical, and Colorectal Cancer Screening: Patterns Among Women With Medicaid and Commercial Insurance
Despite healthcare reforms mandating expanded insurance coverage and reduced out-of-pocket costs for preventive care, cancer screening rates remain relatively static. No study has measured cancer screening rates for multiple tests among non-Medicare patients.
