As of June 2020, the coronavirus pandemic has led to more than 2.3 million confirmed infections and 121 thousand fatalities in USA, with starkly different incidence by race ethnicity. Our study examines racial ethnic disparities COVID-19 cases across six diverse cities-Atlanta, Baltimore, Chicago, New York City, San Diego, St. Louis-at ZIP code level (covering 436 "neighborhoods" a population 17.7 million). analysis links these outcomes separate data sources control for demographics;...

Kentucky is one of only two southern states, at the time this writing, to have expanded Medicaid under Affordable Care Act. The expansion raised eligibility levels as a means make coverage more accessible and health care affordable for population likely face financial barriers in using medical care. This article examines first-year impact Kentucky's on insurance access Focusing low-income population, we observed large reductions uninsurance rate from 35 percent end 2013 just below 11 by...

Abstract Background Physical Medicaid offices may play an important role in supporting beneficiaries and alleviating administrative burdens during critical enrollment or redetermination periods. Limited research has explored whether racial, ethnic, rural disparities access to exist. Methods Leveraging a county-level dataset of geocoded merged with American Community Survey data, we examined variation office density. We used choropleth map demonstrate variability within across states, linear...

Medicaid expansions, prompted by the Affordable Care Act, generated generally positive effects on coverage and alleviated much of financial burden associated with seeking health care. We do not know if these shifts also extend to nation's rural populations.Using 2011-2015 Behavioral Risk Factor Surveillance System data, this study compares trend changes for coverage, access care, care utilization in response expansion among urban residents using a difference-in-differences regression...

The rate of opioid-related emergency department (ED) visits and inpatient hospitalizations has increased rapidly in recent years. Medicaid expansions have the potential to reduce overall hospital events by improving access outpatient treatment for opioid use disorder.To examine association between rates ED hospitalizations.A difference-in-differences observational design was used compare changes US nonfederal, nonrehabilitation hospitals states that implemented first quarter 2005 last 2017...

<h3>Importance</h3> The COVID-19 pandemic has been associated with increased unemployment rates and long periods when individuals were without health insurance. Little is known about how Medicaid expansion facilitates enrollment as a buffer to coverage loss owing unemployment. <h3>Objective</h3> To compare changes in insurance status pandemic-related among previously employed adults states that have vs not expanded eligibility. <h3>Design, Setting, Participants</h3> This cohort study...

As the US population increases and ages, more patients require care. A reengineered health care system relies on physician assistants nurse practitioners; however, extent to which they for medical conditions is marginally known. We analyzed ambulatory visits by provider type diagnosis focusing chronic diseases identify differences in seen each of provider. Both practitioners attended 14% 777 million weighted visits. Overall, diabetes hypertension accounted 2% 4% The distribution disease...

Objective To evaluate the impact of Kentucky's full rollout Affordable Care Act on disparities in access to care due poverty. Data Source Restricted version Behavioral Risk Factor Surveillance System ( BRFSS ) for Kentucky and years 2011–2015. Study Design We use a difference‐in‐differences framework compare trends before after implementation ACA health insurance coverage, several measures, utilization residents higher versus lower poverty ZIP codes. Principal Findings Much reduction...

Medicaid enrollment increases during economic downturns which imply households using the public health insurance program coverage gaps due to job loss. However, we provide new evidence demonstrating that program's countercyclical protections against are largely concentrated in states with more generous eligibility criteria for adults. We exploit timing of 2007-2009 Great Recession compare trends recession-linked between guidelines and restrictive guidelines. For similar effects recession,...

Greater use of physician assistants (PAs) and nurse practitioners (NPs) to meet growing demand for healthcare in the United States is an increasingly common strategy improve access care control costs. Evidence suggests that payment services differs depending on type provider. This study sought determine if source a medical visit varies based whether provided by physician, PA, or NP. Data from National Hospital Ambulatory Medical Care Survey (2006 through 2010) were analyzed. Physicians...

To explore whether expanded Medicaid helps mitigate the relationship between unemployment due to COVID and being uninsured. Unanticipated spells are generally associated with disruptions in health insurance coverage, which could also be case for job losses during COVID-19 pandemic. Expanded access may insulate some households from long uninsurance gaps loss.Phase 1 of Census Bureau's Experimental Household Pulse Survey covering April 23, 2020-July 21, 2020.We compare differences coverage...

To examine the impact of state Medicaid expansion on delivery population health activities in cross-sector and social services networks. Community networks are multisector, interorganizational that provide ranging from direct provision individual to implementation population-level initiatives addressing community outcomes.We used data measuring composition 2006-2018 National Longitudinal Survey Public Health Systems (NALSYS) linked with Area Resource File.A difference-in-differences approach...

To examine trends in uninsured rates between 2012 and 2016 among low-income adults aged <65 years to determine whether the Patient Protection Affordable Care Act (ACA), which expanded Medicaid, impacted insurance coverage Diabetes Belt, a region across 15 southern eastern U.S. states residents have high of diabetes.Data for 3,129 counties, obtained from Small Area Health Insurance Estimates Resources Files, were used analyze populations with household income ≤138% federal poverty level....

The objective of this study was to determine whether the Affordable Care Act's (ACA) major coverage expansions mitigated impact unemployment on health insurance status.A 2011-2019 versions American Community Survey developed by University Minnesota Integrated Public Use Microdata Series program.We use difference-in-difference-in-differences (ie, triple difference) regressions compare changes in short-run impacts local rates before and after ACA.Before ACA, rises were associated with...

Three major hospital pay for performance (P4P) programs were introduced by the Affordable Care Act and intended to improve quality, safety efficiency of care provided Medicare beneficiaries. The financial risk hospitals associated with Medicare's P4P is substantial. Evidence on positive impact these programs, however, has been mixed, no study assessed their combined impact. In this study, we examined clinical areas populations targeted as well those outside focus.We used 2007-2016 Healthcare...

Abstract Objective We examine whether broadened access to Medicaid helped insulate households from declines in health coverage and care linked the 2007‐2009 Great Recession. Data Source 2004‐2010 Behavioral Risk Factor Surveillance System (BRFSS). Study Design Flexible difference‐in‐difference regressions were used compare impact of county‐level unemployment on states with generous eligibility guidelines versus restrictive guidelines. Collection/Extraction Methods Nonelderly adults (aged...

Preventable hospitalizations are common and costly events that burden patients our health care system. While research suggests these strongly linked to ambulatory access, emerging evidence they may also be sensitive a patient's social, environmental, economic conditions. This study examines the association between variations in social vulnerability preventable hospitalization rates. We conducted cross-sectional analysis of county-level rates for 33 states with data from 2020 Social...

Unemployment associated with the coronavirus disease 2019 (COVID-19) pandemic was linked to financial insecurity and disruptions in access health care.To explore whether expanded Medicaid mitigated likelihood of non-health hardship pandemic-linked job loss.We estimate linear regression models comparing differences levels outcomes attributable joblessness expansion nonexpansion states.A total 20,281 adults aged 19-64 were 2021 National Financial Capability Study.Our key exposure loss,...

Following the Affordable Care Act's Medicaid expansions, access to care improved through elevated coverage rates among low-income population. In Michigan, a major factor contributing patients was increased acceptance in primary settings.Prior evidence shows substantial geographic variation preacceptance and postacceptance of Medicaid. this study, we determine whether physician's willingness accept new is moderated by availability other providers close proximity.The study uses Michigan...

As of June 2020, the coronavirus pandemic has led to more than 2.3 million confirmed infections and 121 thousand fatalities in United States, with starkly different incidence by race ethnicity. Our study examines racial ethnic disparities COVID-19 cases across six diverse cities – Atlanta, Baltimore, Chicago, New York City, San Diego, St. Louis at ZIP code level (covering 436 "neighborhoods" a population 17.7 million). analysis links these outcomes separate data sources control for...

In 2016, total Medicaid spending, $574.2 billion, represented one-third of state budgets. Descriptive studies indicate that policymakers adjust social welfare programs during times financial distress, particularly Medicaid. The challenge formally estimating this effect is macroeconomic shocks increase enrollment and state-level stress. We use an exogenous measure generosity to estimate the elasticity with respect conditions. find not adjusted periods fiscal whether anticipated or not....