Author Interviews, Blood Pressure - Hypertension, Diabetes, JAMA, Race/Ethnic Diversity / 13.09.2021

MedicalResearch.com Interview with: Megan B. Cole, PhD, MPH Assistant Professor | Dept. of Health Law, Policy, & Management Co-Director | BU Medicaid Policy Lab Boston University School of Public Health Boston, MA 02118 MedicalResearch.com: What is the background for this study? Response: Under the Affordable Care Act, states were given the option to expand Medicaid eligibility to nonelderly adults with incomes up to 138% of the federal poverty level, where in January 2014, 25 states plus Washington, DC expanded eligibility, with 13 additional states expanding thereafter. State Medicaid expansion decisions were particularly consequential for federally qualified health centers (FQHCs), which serve nearly 30 million low-income, disproportionately uninsured patients across the US. We know from earlier work that in the shorter-term, Medicaid expansion was associated with improvements in quality of care process measures and FQHC service capacity. However, we conducted the first known nationally representative study to examine how Medicaid expansion impacted key chronic disease outcome measures at FQHCs over the longer-term by looking at changes five years after implementation, including changes by race/ethnicity.  (more…)
Author Interviews, Cost of Health Care, JAMA, Race/Ethnic Diversity / 24.06.2020

MedicalResearch.com Interview with: Megan B. Cole Brahim, PhD, MPH Assistant Professor | Dept. of Health Law, Policy, & Management Boston University School of Public Health Boston, MA MedicalResearch.com: What is the background for this study? Response: Enrollment in high deductible health plans (HDHPs)—which require patients to pay on the upwards of thousands of dollars in out-of-pocket costs before they can use their health insurance coverage for most services—has skyrocketed over the last decade. For cancer survivors in particular, this is really concerning, as patients may avoid or delay necessary health care services or important medications because they can’t afford their deductible. We know from previous work that HDHPs are associated with less use of health care, including less cancer screening and treatment. However, there has been very little work to assess how HDHPs may contribute to racial/ethnic disparities in care, and our study is the first known study to assess how HDHPs may contribute to racial/ethnic disparities in cancer survivors. To fill this gap, we used nationally representative survey data from 2013-2018 to assess how enrollment in high deductible health plans was associated with cost-related barriers to care among cancer survivors with private insurance, and how this relationship varied across racial/ethnic groups. (more…)