scholarly journals Geographic Variation in Medicare Fee-for-Service Health Care Expenditures Before and After the Passage of the Affordable Care Act

2021 ◽  
Vol 2 (12) ◽  
pp. e214122
Author(s):  
Neeraj Sood ◽  
Zhiyou Yang ◽  
Peter Huckfeldt ◽  
José Escarce ◽  
Ioana Popescu ◽  
...  
Keyword(s):  
Health Care ◽  
Geographic Variation ◽  
Affordable Care Act ◽  
Health Care Expenditures ◽  
Fee For Service ◽  
Before And After ◽  
The Affordable Care Act

scholarly journals Health Care Access and Utilization Among U.S. Immigrants Before and After the Affordable Care Act

2018 ◽  
Vol 21 (2) ◽  
pp. 211-218 ◽  
Author(s):  
Arturo Vargas Bustamante ◽  
Jie Chen ◽  
Ryan M. McKenna ◽  
Alexander N. Ortega
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
Health Care Access ◽  
Care Access ◽  
Before And After ◽  
The Affordable Care Act

Geographic Variation in Medicaid Acceptance Across Michigan Primary Care Practices in the Era of the Affordable Care Act

2017 ◽  
Vol 75 (5) ◽  
pp. 633-650 ◽  
Author(s):  
Renuka Tipirneni ◽  
Karin V. Rhodes ◽  
Rodney A. Hayward ◽  
Richard L. Lichtenstein ◽  
HwaJung Choi ◽  
...  
Keyword(s):  
Primary Care ◽  
Geographic Variation ◽  
Affordable Care Act ◽  
Policy Makers ◽  
Lower Baseline ◽  
Before And After ◽  
Care Practices ◽  
The Affordable Care Act ◽  
Using Data ◽  
Primary Care Practices

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. Geographic regions with lower baseline (<50%) Medicaid acceptance had significant increases in Medicaid acceptance at 4 and 8 months post-expansion, while regions with higher baseline (≥50%) Medicaid acceptance did not experience significant changes in Medicaid acceptance. As state Medicaid expansions continue to be implemented across the country, policy makers should consider the local dynamics of incentives for provider participation in Medicaid.

scholarly journals Utilization of Screening Mammograms in the Medicare Population Before and After the Affordable Care Act Implementation

2018 ◽  
Vol 32 (1-2) ◽  
pp. 25-32
Author(s):  
Laura M. Bozzi ◽  
Bruce Stuart ◽  
Eberechukwu Onukwugha ◽  
Sarah E. Tom
Keyword(s):  
Affordable Care Act ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Future Research ◽  
Fee For Service ◽  
Cross Sectional ◽  
Before And After ◽  
The Affordable Care Act ◽  
Screening Mammograms ◽  
Adjusted Logistic Regression

Objective: This study examined screening mammograms in women aged 65 to 74 years and 75+ years before and after the Affordable Care Act (ACA) implementation. Method: This repeated cross-sectional study of community-dwelling women age 65+ years without a history of breast cancer or mastectomy utilized the Medicare Current Beneficiary Survey and Medicare fee-for-service claims data from 2001 to 2013. We used covariate-adjusted logistic regression with generalized estimating equations, stratified by age group. Results: The adjusted odds of screening mammograms in women aged 65-74 ( n = 742) and 75+ years ( n = 681) were lower in 2013 (odds ratio [OR]: 0.75, 95% confidence interval [CI]: [0.67, 0.83]; OR: 0.67, 95% CI: [0.60, 0.75], respectively) than the odds of screening mammograms in 2001. Discussion: Annual screening mammograms decreased in women aged 65 to 74 years and 75+ years, despite increased access from the ACA implementation. Future research as to why women are no longer receiving screening mammograms, such as changes in physician specialty guidelines, is warranted.

scholarly journals Disparities in Insurance Coverage, Health Services Use, and Access Following Implementation of the Affordable Care Act: A Comparison of Disabled and Nondisabled Working-Age Adults

2017 ◽  
Vol 54 ◽  
pp. 004695801773403 ◽  
Author(s):  
Jae Kennedy ◽  
Elizabeth Geneva Wood ◽  
Lex Frieden
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
Health Care Access ◽  
Insurance Coverage ◽  
Adults With Disabilities ◽  
Full Implementation ◽  
Care Access ◽  
Before And After ◽  
Working Age ◽  
The Affordable Care Act

The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as their previously limited insurance options. However, most published research on this population does not systematically look at effects before and after full implementation of the ACA. As the US Congress considers new health policy reforms, current and accurate data on this vulnerable population are essential. Weighted estimates, trend analyses and analytic models were conducted using the 1998-2016 National Health Interview Surveys (NHIS) and the 2014 Medical Expenditure Panel Survey. Compared with working-age adults without disabilities, those with disabilities are less likely to work, more likely to earn below the federal poverty level, and more likely to use public insurance. Average health costs for this population are 3 to 7 times higher, and access problems are far more common. Repeal of key features of the ACA, like Medicaid expansion and marketplace subsidies, would likely diminish health care access for working-age adults with disabilities.

Trends in cancer care with the Affordable Care Act.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 46-46
Author(s):  
Tasneem Kaleem ◽  
Robert Clell Miller
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
Large Scale ◽  
Primary Care Providers ◽  
The United States ◽  
Outcome Data ◽  
Fee For Service ◽  
Care Providers ◽  
The Affordable Care Act ◽  
Set Up

46 Background: Accountable Care Organizations (ACO), as proposed by the Affordable Care Act, will change the delivery of health care in the United States. ACO serve as a network of providers with primary care providers (PCP) set up as gate-keepers for referrals to specialists. Within the next several years, many trends will emerge and drive progress of change, requiring oncologist to take a lead role to adapt to the evolving landscape of health care. Methods: Literature search of internet-based and academic sources for oncology and the Affordable Care, with a focus on ACO formation. Results: Four main expected trends and strategies to adapt to changes were formulated. Trend 1: Changes in referral patterns towards oncologists. Referral will be based on outcome data and ACO membership. Strategy: Increase communication and education to PCP and other providers. Endorse multidisciplinary clinics, which have shown to improve guideline compliance, coordination, and communication. Trend 2: Formation of large scale oncology provider groups collaborating with PCP/ACO. Physicians will be able to provide around the clock care to patients with the goal of reducing hospital visits. Strategy: Establish oncology homes with goal of reducing inpatient and ED visits by providing telephone symptom management, daily questionnaires and opportunities for end of life discussions. Trend 3: Reimbursement reform to oncologists based on quality measures. ACO can bill fee for service basis and eligibility for bonus payments based on outcomes. Strategy:Adherence to evidence based guidelines chosen by evaluating efficacy, toxicity and cost have been proven to increase quality of patient care. Trend 4: Development to pathway driven medicine.ACO structure lends to a centralized governance committee responsible in choosing guidelines for treatment within an ACO. Strategy: Oncologists should provide a voice for the field and patients when different guidelines are chosen. Conclusions: In the context of the Affordable Care Act, oncology specialists are encouraged to participate in the new organization model to ensure best outcomes for both physicians and patients. Awareness of future trends and ways to contribute will be the first step in adapting to implementation of the Affordable Care Act.

Insurance Coverage and Health Care Utilization Among Asian Youth Before and After the Affordable Care Act

2020 ◽  
Vol 20 (5) ◽  
pp. 670-677 ◽  
Author(s):  
Sungchul Park ◽  
Dylan H. Roby ◽  
Jessie Kemmick Pintor ◽  
Jim P. Stimpson ◽  
Jie Chen ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Care Utilization ◽  
Before And After ◽  
The Affordable Care Act ◽  
Asian Youth

scholarly journals Health Insurance Coverage before and after the Affordable Care Act in the USA

Sci ◽  
2021 ◽  
Vol 3 (2) ◽  
pp. 25
Author(s):  
Jesse Patrick ◽  
Philip Q. Yang
Keyword(s):  
Health Insurance ◽  
National Health ◽  
Affordable Care Act ◽  
The United States ◽  
Insurance Status ◽  
Health Insurance Status ◽  
Full Implementation ◽  
Before And After ◽  
The Affordable Care Act ◽  
Partial Implementation

The Affordable Care Act (ACA) is at the crossroads. It is important to evaluate the effectiveness of the ACA in order to make rational decisions about the ongoing healthcare reform, but existing research into its effect on health insurance status in the United States is insufficient and descriptive. Using data from the National Health Interview Surveys from 2009 to 2015, this study examines changes in health insurance status and its determinants before the ACA in 2009, during its partial implementation in 2010–2013, and after its full implementation in 2014 and 2015. The results of trend analysis indicate a significant increase in national health insurance rate from 82.2% in 2009 to 89.4% in 2015. Logistic regression analyses confirm the similar impact of age, gender, race, marital status, nativity, citizenship, education, and poverty on health insurance status before and after the ACA. Despite similar effects across years, controlling for other variables, youth aged 26 or below, the foreign-born, Asians, and other races had a greater probability of gaining health insurance after the ACA than before the ACA; however, the odds of obtaining health insurance for Hispanics and the impoverished rose slightly during the partial implementation of the ACA, but somewhat declined after the full implementation of the ACA starting in 2014. These findings should be taken into account by the U.S. Government in deciding the fate of the ACA.

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