AHRQ, Author Interviews / 07.02.2015

Steven C. Hill, PhD Center for Financing, Access and Cost Trends Agency for Healthcare Research and Quality Rockville, MD 2085MedicalResearch.com Interview with: Steven C. Hill, PhD Center for Financing, Access and Cost Trends Agency for Healthcare Research and Quality Rockville, MD 20850 MedicalResearch: What is the background for this study? Dr. Hill: The Affordable Care Act offers two major ways to extend health coverage to more Americans: through expanding state Medicaid programs and through the Marketplace. States can expand Medicaid coverage to adults with family incomes at or below 138 percent of the federal poverty guidelines (approximately $16,242 for an individual and $33,465 for a family of four in 2015). At the time of the study, 23 states had not yet expanded their Medicaid programs. In those states, poor adults typically continue to have very limited access to Medicaid. However, adults with incomes at or above the poverty guidelines who lack access to affordable insurance elsewhere are eligible for premium tax credits in the Marketplace. If these low-income adults purchase silver plans, then they are also generally eligible for cost sharing reductions. MedicalResearch: What was the methodology for study? Dr. Hill: The study used data from then Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey (MEPS) to determine family out-of-pocket health care spending in 2005 – 2010 for uninsured, low-income adults who lived in the states that had not yet expanded Medicaid under the Affordable Care Act at the time of the study. The study focused on those who would have been eligible for Medicaid if their states expanded eligibility (income at or below 138 percent of poverty guideline), and whose incomes were high enough to be eligible for premium tax credits and cost sharing reductions through the Health Insurance Marketplace (at or above poverty guidelines). The study then compared those data with the following simulated scenarios for these adults: coverage in a Marketplace silver plan with financial assistance; and enrolling in expanded Medicaid.
Author Interviews, Cancer Research, Cost of Health Care, Journal Clinical Oncology / 09.06.2014

Ayal A. Aizer, MD, MHS Harvard Radiation Oncology Program Boston, MAMedicalResearch Interview with: Ayal A. Aizer, MD, MHS Harvard Radiation Oncology Program Boston, MA MedicalResearch: What are the main findings of the study? Dr. Aizer: We studied Americans between the ages of 20-40 using the SEER Database (a national cancer registry) and found that patients who had insurance were more likely to present with localized (curable) versus metastatic (generally incurable) cancer. Patients with localized tumors were more likely to receive the appropriate treatment and, most importantly, survived longer than patients without insurance. Our analysis accounted for demographic and socioeconomic differences between patients who were insured versus uninsured. Our results indicate that insurance status is a powerful predictor of outcome among young adults with cancer. The Affordable Care Act, which will likely improve insurance coverage nationally, may yield improved cancer outcomes among Americans.
Asthma, Author Interviews, Cost of Health Care / 21.05.2014

dr_vicki_fung MedicalResearch.com Interview with: Vicki Fung, Ph.D. Assistant Professor Department of Medicine, Harvard Medical School Mongan Institute for Health Policy, Massachusetts General Hospital   MedicalResearch: What are the main findings of the study? Dr. Fung: We found that lower income parents of children with asthma were more likely to delay or avoid taking their children to a doctor's office visit or to the emergency room if they had to pay higher out-of-pocket costs for care; they were also more likely to report borrowing money to pay for asthma care.
Author Interviews, Cost of Health Care, Emergency Care / 06.11.2013

MedicalResearch.com Interview with: Jessica E. Galarraga, MD, MPH Resident Physician Department of Emergency Medicine George Washington University Hospital 2120 L. St. N.W. Suite 475 Washington D.C. Jessica E. Galarraga, MD, MPH Resident Physician Department of Emergency Medicine George Washington University Hospital 2120 L. St. N.W. Suite 475 Washington D.C.   MedicalResearch.com: What are the main findings of the study? Dr. Galarraga: This study examined how emergency department (ED) reimbursements for outpatient visits may be impacted by the insurance coverage expansion of the Patient Protection and Affordable Care Act as newly eligible patients gain coverage either through the Medicaid expansion or through health insurance exchanges. We conducted our analyses using the Medical Expenditure Panel Survey, a nationally representative survey managed by the Agency for Healthcare Research and Quality. We found that ED reimbursements for outpatient encounters by the previously uninsured who gain Medicaid insurance may increase by  17 percent and moving Medicaid-expansion ineligible patients to the private insurance market through insurance exchanges may increase reimbursements as high as 39 percent after the act is implemented.
Cost of Health Care, JAMA / 28.06.2013

Genevieve Kenney Ph.D Senior Fellow and Co-Director, Health Policy Center The Urban Institute 2100 M Street NW Washington DC 20037MedicalResearch.com  Interview with Genevieve Kenney Ph.D Senior Fellow and Co-Director, Health Policy Center The Urban Institute 2100 M Street NW Washington DC 20037 MedicalResearch.com: What are the main findings of the study? Dr. Kenney: Our study is the first published analysis that draws on physical examinations, laboratory tests, and patient reports to assess the health needs and health risks of uninsured adults who could be eligible for Medicaid coverage under the Affordable Care Act relative to the adults who are already enrolled in Medicaid. Our main findings are that the uninsured adults who could enroll under the ACA are less likely than the adults with Medicaid coverage to be obese and to have functional limitations and chronic health problems, such as hypertension, hypercholesterolemia, or diabetes, but that the uninsured adults with these chronic conditions are less likely to be aware that they have them and less likely to have the condition under control. In comparison to the Medicaid population, the uninsured adults in our study were also less likely to have seen a health professional in the prior year and to have a routine place for care.  The rates of undiagnosed and uncontrolled chronic health care problems found in our study indicate that millions of low-income uninsured adults are currently at risk of premature mortality and other significant health issues.  These findings provide new evidence of the potential health benefits associated with the Medicaid expansion under the Affordable Care Act.