•Background: The Affordable Care Act's Medicaid expansion increased insurance coverage and access to care for endocrine cancers, though impact on benign endocrine disease is unknown. •Methods: Patients undergoing operations for benign thyroid, parathyroid, and adrenal disease were collected from the Vizient® Clinical Data Base from 2009 to 2016 and grouped by state Medicaid expansion status in January 2014. Insurance coverage was analyzed by difference-in-differences analysis, and logistic regression evaluated odds of operation by insurance status. •Results: 134,242 patients were included. Medicaid coverage in expansion states increased for all operations (Adj-DD 5.78%, p < 0.001) with decreases in uninsured and private insurance. Medicaid patients had increased odds of undergoing thyroid operations (OR 1.56, p < 0.001) and decreased odds of parathyroid (OR 0.68, p < 0.001) or adrenal operations (OR 0.70, p < 0.001) versus private insurance. •Conclusion: Medicaid expansion increased insurance coverage for benign endocrine disease, however, barriers remain for Medicaid patients with parathyroid and adrenal disease.
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http://dx.doi.org/10.1016/j.amjsurg.2022.10.046 | DOI Listing |
Drug Alcohol Depend
January 2025
University of Miami Miller School of Medicine, Department of Public Health Sciences, United States.
Introduction: Prevalence estimates of opioid use disorder (OUD) at local levels are critical for public health planning and surveillance, yet largely unavailable across the US especially at the local county level.
Methods: We used a Bayesian evidence synthesis approach to estimate the prevalence of OUD for 57 counties across New York State for 2017-2019 and compare rates of OUD across counties as well as assess the extent of undiagnosed OUD. We developed a generative model to assess conditional probabilistic relations between different subgroups of the OUD population defined by diagnosis, treatment, and overdose fatality.
Cancers (Basel)
December 2024
City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA.
Background: This study addresses the lack of research on Medicaid expansion's impact on melanoma staging, treatment utilization, and outcomes by evaluating its effects under the Affordable Care Act (ACA), particularly focusing on staging at diagnosis, treatment use, and 3-year mortality outcomes. The objective is to determine whether Medicaid expansion led to earlier melanoma diagnosis and improved survival rates among non-elderly adults (ages 40-64) by analyzing data from the National Cancer Database (NCDB).
Methods: A total of 12,667 patients, aged 40-64, diagnosed with melanoma from 2010 to 2020 were identified using the NCDB.
Ann Thorac Surg Short Rep
December 2024
Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Background: Medicaid expansion began in 2014 after passage of the Affordable Care Act; however, the impact and durability of the effects on lung cancer treatment utilization are poorly defined. We aimed to determine whether there is a persistent difference in utilization of lung resection, lung biopsy, and nonoperative treatment of lung cancer in states participating in Medicaid expansion compared with states that are not.
Methods: A retrospective cohort study was completed analyzing the difference in utilization between Medicaid expansion states and non-expansion states in 2012-2013, 2016-2017, and 2019.
Health Justice
January 2025
Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, 190 Madison Ave, New York, NY, 10016, USA.
Background: Medicaid expansion via the Affordable Care Act, more recent legislation and Medicaid 1115 waivers offer opportunity to increase health care access among individuals involved in the carceral system. Effective enrollment of new beneficiaries and temporary suspension and reactivation of existing Medicaid benefits upon release is key to the success of these efforts. This study aims to characterize how jails, prisons and Medicaid agencies are implementing Medicaid suspension and enrollment programs and identifies barriers and facilitators to implementation.
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