Importance: More than 4 million Medicare beneficiaries have enrolled in dual-eligible Special Needs Plans (D-SNPs), and coordination-only D-SNPs are common. Little is known about the impact of coordination-only D-SNPs on Medicaid-covered services and spending, including long-term services and supports, which are financed primarily by Medicaid.
Objective: To evaluate changes in Medicaid fee-for-service (FFS) spending before and after new enrollment in coordination-only D-SNPs vs new enrollment in non-D-SNP Medicare Advantage (MA) plans among community-living beneficiaries enrolled in both Medicare and North Carolina Medicaid.
In anticipation of the end of the COVID-19 public health emergency, Congress ended the Medicaid continuous coverage requirement on March 31, 2023, allowing states to terminate coverage for ineligible people and resume eligibility determinations through a process known as unwinding. Although administrative data have documented substantial declines in Medicaid enrollment since April 2023, the impact on uninsurance is unknown. Using data from the Census Bureau's Household Pulse Survey, we estimated the early effect of Medicaid unwinding on insurance coverage among people ages 19-64.
View Article and Find Full Text PDFObjectives: The high costs of cancer care can cause significant harm to patients and society. Prostate cancer, the leading nonskin malignancy in men, is responsible for the second-highest out-of-pocket (OOP) payments among all malignancies. Multiple first-line treatment options exist for metastatic castration-resistant prostate cancer (mCRPC); although their costs vary substantially, comparative effectiveness data are limited.
View Article and Find Full Text PDFImportance: The long-term effect of interventions that assist patients with establishing their end-of-life care preferences among patients with cancer remain relatively unknown.
Objective: To evaluate the association of a long-term intervention of a lay health worker-led advance care planning intervention among patients with advanced stages of cancer with overall survival and end-of-life health care use and costs.
Design, Setting, And Participants: This follow-up study of the EPAC randomized clinical trial conducted between August 2013 and February 2015 used data from 9.
J Am Coll Emerg Physicians Open
December 2023
Objective: To determine whether changes in emergency department use associated with Medicaid expansions differed between states undergoing waiver and traditional expansions.
Methods: Design: This study was a cross-sectional difference-in-difference and event studies of Medicaid Expansion among states that expanded during or after 2014. Setting: We used a nationally representative cross-sectional survey from all 50 United States and the District of Columbia from 2010 to 2016.