Objectives: Biologics account for an increasing share of US prescription drug spending. Biosimilars could lower biologic prices through competition, but barriers to increasing both supply and uptake remain. We projected US biosimilar savings from 2021 to 2025 under different scenarios.
View Article and Find Full Text PDFThis cross-sectional study examines patterns of missing information on race and ethnicity after an imputation of HealthCare.gov enrollment data between 2015 and 2021.
View Article and Find Full Text PDFMillions of Americans have been infected with SARS-CoV-2, and more than 575,000 had died as of early May 2021. Understanding who are the most vulnerable populations for COVID-19 mortality and excess deaths is critical, especially as the US prioritizes vaccine distribution. Using Medicare administrative data, we found that beneficiaries residing in nursing homes, the oldest beneficiaries, members of racial/ethnic minority groups, beneficiaries with multiple comorbid conditions, and beneficiaries who are dually eligible for Medicare and Medicaid were disproportionately likely to die after infection with SARS-CoV-2.
View Article and Find Full Text PDFImportance: The Patient Protection and Affordable Care Act (ACA) increased 2013 to 2014 Medicaid payment rates for qualifying primary care physicians (PCPs) and services to higher Medicare payment levels, with the goal of improving primary care access for Medicaid enrollees.
Objectives: To evaluate the payment increase policy and to assess whether it was associated with changes in Medicaid participation rates or Medicaid service volume among PCPs.
Design, Setting, And Participants: This study used 2012 to 2015 IMS Health aggregated medical claims and encounter data from PCPs eligible for the payment increase practicing in all states except Alaska and Hawaii and included 20 723 PCPs with observations in each month from January 1, 2012, to December 31, 2015.
Disparities by economic status are observed in the health status and health outcomes of Medicare beneficiaries. For health services and health policy researchers, one barrier to addressing these disparities is the ability to use Medicare data to ascertain information about an individual's income level or poverty, because Medicare administrative data contains limited information about individual economic status. Information gleaned from other sources-such as the Medicaid and Supplemental Security Income programs-can be used in some cases to approximate the income of Medicare beneficiaries.
View Article and Find Full Text PDFThe Affordable Care Act (ACA) provides assistance to low-income consumers through both premium subsidies and cost-sharing reductions (CSRs). Low-income consumers' lack of health insurance literacy or information regarding CSRs may lead them to not take-up CSR benefits for which they are eligible. We use administrative data from 2014 to 2016 on roughly 22 million health insurance plan choices of low-income individuals enrolled in ACA Marketplace coverage to assess whether they behave in a manner consistent with being aware of the availability of CSRs.
View Article and Find Full Text PDFA growing body of literature describes how the Affordable Care Act (ACA) has expanded health insurance coverage. What is less well known is how these coverage gains have affected populations that are at risk for high health spending. To investigate this issue, we used prescription transaction data for a panel of 6.
View Article and Find Full Text PDFImportance: The Affordable Care Act (ACA) completed its second open enrollment period in February 2015. Assessing the law's effects has major policy implications.
Objectives: To estimate national changes in self-reported coverage, access to care, and health during the ACA's first 2 open enrollment periods and to assess differences between low-income adults in states that expanded Medicaid and in states that did not expand Medicaid.
Background: The Affordable Care Act (ACA) established nationwide eligibility for young adults 19 to 25 years of age to retain coverage under their parents' private health plans. We conducted a study to determine how the implementation of this provision changed rates of insurance coverage for young adults seeking medical care for major emergencies.
Methods: We evaluated more than 480,000 nondiscretionary visits made to emergency departments from 2009 through 2011, as recorded in a large, geographically diverse data set of hospital claims, to estimate how the ACA provision affected private insurance coverage of such visits by young adults (19 to 25 years of age).
The Affordable Care Act's expansion of insurance coverage is expected to increase demand for primary care services. We estimate that the national increase in demand for such services will require 7,200 additional primary care providers, or 2.5 percent of the current supply.
View Article and Find Full Text PDFJ Natl Med Assoc
December 2004
Recent years have seen shifts in health insurance coverage associated with economic fluctuations and changes in health policy. The analysis presented here uses data from the National Survey of America's Families to examine changes in health insurance coverage and respondent-reported health status by race and ethnicity. The data indicate that public coverage increased for black, Hispanic and white children between 1997 and 2002.
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