scholarly journals Association of Medicaid Expansion in Arkansas With Postpartum Coverage, Outpatient Care, and Racial Disparities

2021 ◽  
Vol 2 (12) ◽  
pp. e214167
Author(s):  
Maria W. Steenland ◽  
Ira B. Wilson ◽  
Kristen A. Matteson ◽  
Amal N. Trivedi
Keyword(s):  
Racial Disparities ◽  
Outpatient Care ◽  
Medicaid Expansion

Racial disparities in use of non-emergency outpatient care by Medicaid-eligible adults after release from prison: Wisconsin, 2015–2017

2021 ◽  
pp. 108484
Author(s):  
Karli R. Hochstatter ◽  
Wajiha Z. Akhtar ◽  
Nabila El-Bassel ◽  
Ryan Westergaard ◽  
Marguerite E. Burns
Keyword(s):  
Racial Disparities ◽  
Outpatient Care ◽  
Release From Prison

scholarly journals The association of Medicaid expansion and racial/ethnic inequities in access, treatment, and outcomes for patients with acute myocardial infarction

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241785
Author(s):  
Erica M. Valdovinos ◽  
Matthew J. Niedzwiecki ◽  
Joanna Guo ◽  
Renee Y. Hsia
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Racial Disparities ◽  
Hospital Admissions ◽  
Hospital Readmissions ◽  
Medicaid Expansion ◽  
Difference In Differences ◽  
Percentage Points ◽  
White Patients

Introduction After having an acute myocardial infarction (AMI), racial and ethnic minorities have less access to care, decreased rates of invasive treatments such as percutaneous coronary intervention (PCI), and worse outcomes compared with white patients. The objective of this study was to determine whether the Affordable Care Act’s expansion of Medicaid eligibility was associated with changes in racial disparities in access, treatments, and outcomes after AMI. Methods Quasi-experimental, difference-in-differences-in-differences analysis of non-Hispanic white and minority patients with acute myocardial infarction in California and Florida from 2010–2015, using linear regression models to estimate the difference-in-differences. This population-based sample included all Medicaid and uninsured patients ages 18–64 hospitalized with acute myocardial infarction in California, which expanded Medicaid through the Affordable Care Act beginning as early as July 2011 in certain counties, and Florida, which did not expand Medicaid. The main outcomes included rates of admission to hospitals capable of performing PCI, rates of transfer for patients who first presented to hospitals that did not perform PCI, rates of PCI during hospitalization and rates of early (within 48 hours of admission) PCI, rates of readmission to the hospital within 30 days, and rates of in-hospital mortality. Results A total of 55,991 hospital admissions met inclusion criteria, 32,540 of which were in California and 23,451 were in Florida. Among patients with AMI who initially presented to a non-PCI hospital, the likelihood of being transferred increased by 12 percentage points (95% CI 2 to 21) for minority patients relative to white patients after the Medicaid expansion. The likelihood of undergoing PCI increased by 3 percentage points (95% CI 0 to 5) for minority patients relative to white patients after the Medicaid expansion. We did not find an association between the Medicaid expansion and racial disparities in overall likelihood of admission to a PCI hospital, hospital readmissions, or in-hospital mortality. Conclusions The Medicaid expansion was associated with a decrease in racial disparities in transfers and rates of PCI after AMI. We did not find an association between the Medicaid expansion and admission to a PCI hospital, readmissions, and in-hospital mortality. Additional factors outside of insurance coverage likely continue to contribute to disparities in outcomes after AMI. These findings are crucial for policy makers seeking to reduce racial disparities in access, treatment and outcomes in AMI.

Abstract SS1-10: Impact of Medicaid expansion on racial disparities in time to adjuvant chemotherapy administration among breast cancer (BC) patients

2021 ◽  
Author(s):  
Mariana Chavez-MacGregor ◽  
Xiudong Lei ◽  
Hui Zhao ◽  
Tina Shih ◽  
Sharon H Giordano
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Racial Disparities ◽  
Medicaid Expansion ◽  
Chemotherapy Administration

Medicaid Expansion Reduced Emergency Department Visits by Low-income Adults Due to Barriers to Outpatient Care

Medical Care ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Shih-Chuan Chou ◽  
Suhas Gondi ◽  
Scott G. Weiner ◽  
Jeremiah D. Schuur ◽  
Benjamin D. Sommers
Keyword(s):  
Emergency Department ◽  
Low Income ◽  
Outpatient Care ◽  
Emergency Department Visits ◽  
Medicaid Expansion

Affordable Care Act (ACA) Medicaid expansion impact on racial disparities in time to cancer treatment.

2019 ◽  
Vol 37 (18_suppl) ◽  
pp. LBA1-LBA1 ◽  
Author(s):  
Blythe J.S. Adamson ◽  
Aaron B. Cohen ◽  
Melissa Estevez ◽  
Kelly Magee ◽  
Erin Williams ◽  
...  
Keyword(s):  
African American ◽  
Racial Disparities ◽  
Fixed Effects ◽  
Metastatic Cancer ◽  
Private Insurance ◽  
Cancer Type ◽  
Medicaid Expansion ◽  
The Impact ◽  
Medicaid Expansions ◽  
Timely Treatment

LBA1 Background: Racial disparities in cancer outcomes remain a societal challenge. The ACA sought to improve equity in healthcare access and outcomes by permitting states to expand Medicaid and providing subsidies for purchase of private insurance. We assessed the impact of Medicaid expansions on racial disparities in time to treatment among patients (pts) with advanced cancer. Methods: We selected pts ages 18-64 years with advanced or metastatic cancer (NSCLC, breast, urothelial, gastric, colorectal, renal cell, prostate, and melanoma), diagnosed between Jan 1, 2011 and Dec 31, 2018, from the nationwide Flatiron Health electronic health record-derived database. We assigned expansion status based on whether the pts’ state of residence had expanded Medicaid as of the diagnosis date. We estimated Medicaid expansion-related changes in the rate of “timely treatment,” an outcome defined as first-line treatment start within 30 days of advanced or metastatic diagnosis. Regression model covariates included race (White, African American, Asian, and Other race), age, sex, practice type, cancer type, stage, and unemployment rate, using time and state fixed-effects. Regression results present predictive margins. Results: The study included 34,067 pts (median age 57 years; 12% African American). Racial disparities were observed pre-expansion: African American pts were 4.9 percentage points (%pt) less likely to receive timely treatment (Table). Regardless of race, Medicaid expansion trended toward an increase in timely treatment overall (p = 0.05). Expansion was associated with a differential benefit for African American vs white pts (6.9 %pt and 1.8 %pt). Prior racial disparities were no longer observed after Medicaid expansion. Conclusions: Implementation of Medicaid expansions as part of the ACA differentially improved African American cancer pts’ receipt of timely treatment, reducing racial disparities in access to care.[Table: see text]

scholarly journals Where Do Oregon Medicaid Enrollees Seek Outpatient Care Post-affordable Care Act Medicaid Expansion?

Medical Care ◽  
2019 ◽  
Vol 57 (10) ◽  
pp. 788-794
Author(s):  
Heather Holderness ◽  
Heather Angier ◽  
Nathalie Huguet ◽  
Jean O’Malley ◽  
Miguel Marino ◽  
...  
Keyword(s):  
Affordable Care Act ◽  
Outpatient Care ◽  
Medicaid Expansion

Medicaid Expansion Reduced Racial Disparities in Access to Treatment

2019 ◽  
Vol 41 (15) ◽  
pp. 28
Author(s):  
Mark L. Fuerst
Keyword(s):  
Racial Disparities ◽  
Medicaid Expansion ◽  
Access To Treatment
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