220 results match your criteria: "Center for Financing[Affiliation]"

Access to Pediatric Bed Capacity According to Social Determinants of Health: All Beds Are Not Created Equal.

J Pediatr

December 2024

Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA; Department of Cardiology, Boston Children's Hospital, Boston, MA, USA; Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA. Electronic address:

Objective: To study pediatric inpatient hospital capacity and resources, characterizing differences according to social determinants of health (SDoH) using market share techniques.

Study Design: This cross-sectional study uses non-elective inpatient discharges (≥1 month to ≤19 years) from Healthcare Cost and Utilization Project and American Hospital Association surveys to derive hospital capacity and resources/capability. We include US hospitals with ≥1 pediatric bed and ≥1 pediatric discharge and calculate per bed capital, expenditure, and staffing, transfer rates, payer-mix, and adjusted central line-associated blood stream infection (CLABSI) rate.

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The association between smoking, chronic pain, and prescription opioid use: 2013-2021.

J Pain

October 2024

Agency for Healthcare Research and Quality, Rockville, MD, United States.

It is known that smoking is associated with greater chronic pain. However, little is known about the magnitude of this relationship and its association with prescription opioid use. We examine the association between smoking status and three sets of outcomes: (1) starting and discontinuing opioids, (2) intensity of opioid use, and (3) opioid use and pain outcomes after quitting smoking.

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Objective: To decompose the mental health disparities between breast cancer patients and survivors (hereafter survivors) of racial and ethnic minority groups and non-Hispanic White survivors into the contributions of individual-, interpersonal-, community-, and societal-level determinants.

Data Sources And Study Setting: We used data from the 2010-2020 Medical Expenditure Panel Survey Household Component (MEPS-HC). Our primary outcome was whether the person had mental health conditions or not.

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GLP-1 Medication Use for Type 2 Diabetes Has Soared.

JAMA

September 2024

Manager and Senior Medical Illustrator, Editorial Graphics, JAMA and JAMA Network.

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Racial and Ethnic Disparities in Attendance to Well-Child Visit Recommendations during COVID-19.

Acad Pediatr

August 2024

Division of Research and Modeling, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Department of Health and Human Services, Rockville, Md.

Objective: To measure the impact of the COVID-19 pandemic on racial and ethnic disparities in attendance to well-child visit recommendations.

Methods: We used the nationally representative Medical Expenditure Panel Survey (MEPS) to compare pre-pandemic (2018-2019) and pandemic (2020 and 2021) ratios of well-child visits to age-based recommendations, presenting both unadjusted and adjusted attendance disparities over time. We also used the 1996-2021 MEPS to place the pandemic changes in an historical context.

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The consequences of firm scope and scale on patient access to healthcare.

Health Serv Res

April 2024

Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends, Rockville, Maryland, USA.

Article Synopsis
  • The study aimed to analyze changes in the market structure of primary care physicians and its impact on access to care from 2008 to 2019 using Medicare claims and survey data.
  • Findings revealed a significant rise in concentrated ZIP codes and multispecialty firms, leading to decreased access to immediate care, particularly for Medicaid beneficiaries.
  • The relationship between market concentration and usual care sources or annual checkups was not significant, indicating mixed results regarding how market structure affects different aspects of healthcare access.
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Availability of off-marketplace plans with lower premiums for higher-income families.

Am J Manag Care

July 2023

Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, 5600 Fishers Ln, Mail Stop 07W41A, Rockville, MD 20857. Email:

Article Synopsis
  • Before 2021, families making more than 400% of the federal poverty level couldn't get tax credits for health insurance, but this changed temporarily.
  • A study looked at how much it costs to buy health insurance plans either on the marketplace or outside of it and found that prices can be different depending on the state and plan type.
  • The results showed that in many areas, some cheaper plans were only available off the marketplace and those prices varied, suggesting higher-income families might save money by choosing off-marketplace plans.
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Primary Care Spending in the US Population.

JAMA Intern Med

August 2023

Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland.

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Medicaid reimbursement rates for primary care services and behavioral health outcomes.

Health Econ

April 2023

Bloomberg Distinguished Professor of Health Economics, Carey Business School and the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.

We study the effects of changing Medicaid reimbursement rates for primary care services on behavioral health outcomes-defined here as mental illness and substance use disorders. Medicaid enrollees are at elevated risk for these, and other, chronic conditions and are likely to have unmet treatment needs. We apply two-way fixed-effects regressions to survey data specifically designed to measure behavioral health outcomes over the period 2010-2016.

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Racial-Ethnic Disparities in Outpatient Mental Health Care in the United States.

Psychiatr Serv

July 2023

Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Olfson, Wall); Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland (Zuvekas, McClellan); Department of Psychiatry and Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, New York City (Hankerson); National Institute on Drug Abuse, Bethesda (Blanco).

Article Synopsis
  • The study compared outpatient mental health care usage among Hispanic, non-Hispanic Black, and non-Hispanic White individuals in the U.S., using data from a national survey.
  • Results indicated that White individuals were more than twice as likely to use mental health services compared to Black and Hispanic individuals, with significant differences in the types of treatments received.
  • The authors concluded that addressing racial-ethnic disparities in mental health care access and treatment is crucial for improving equity in mental health services for Black and Hispanic individuals.
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Introduction: Although the association between health insurance coverage and access to care is well documented, it is unclear whether the deleterious effects of being uninsured are strictly contemporaneous or whether previous disruptions in coverage have persistent effects. This study addresses this issue using nationally representative data covering 2011-2019 to estimate the extent to which disruptions in health insurance coverage continued to be associated with poor access even after coverage was regained.

Methods: Analysis was conducted in 2022.

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Contextual Considerations When Interpreting Well-Child Visit Adherence Results-Reply.

JAMA Pediatr

January 2023

Center for Financing, Access, and Cost Trends, Division of Research and Modeling, Agency for Healthcare Research and Quality, Department of Health and Human Services, Rockville, Maryland.

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Association Between Medicaid Dental Payment Policies and Children's Dental Visits, Oral Health, and School Absences.

JAMA Health Forum

September 2022

Division of Research and Modeling, Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland.

Importance: Although all state Medicaid programs cover children's dental services, less than half of publicly insured children receive recommended care.

Objective: To evaluate the association between the ratio of Medicaid payment rates to dentist charges for an index of services (fee ratio) and children's preventive dental visits, oral health, and school absences.

Design, Setting, And Participants: In this cross-sectional study, a difference-in-differences analysis was conducted between September 2021 and April 2022 of 15 738 Medicaid-enrolled children and a control group of 16 867 privately insured children aged 6 to 17 years who participated in the 2016-2019 National Survey of Children's Health.

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The Impact of Sharing Drug Rebates at the Point of Sale on Out-of-Pocket Payments for Enrollees in Employer-Sponsored Insurance.

Value Health

February 2023

Division of Research and Modeling, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD, USA.

Objectives: This study aimed to estimate the impact of sharing drug rebates at the point of sale on out-of-pocket spending by linking estimated rebates to administrative claims data for employer-sponsored insurance enrollees in 2018.

Methods: We applied the drug rebate rate to the retail price of each brand name drug fill, allocated the reductions to out-of-pocket spending based on cost-sharing provisions, and aggregated each individual's out-of-pocket spending across drug fills. We assumed that generic drugs have no rebates for employer-sponsored insurance.

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Well-Child Visit Adherence.

JAMA Pediatr

November 2022

Center for Financing, Access, and Cost Trends, Division of Research and Modeling, Department of Health and Human Services, Agency for Healthcare Research and Quality, Rockville, Maryland.

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Objective: Breast cancer is the most common cancer in Indonesia, with Indonesia's breast cancer mortality rate being the highest among Southeast Asian countries. This study aims to evaluate the cost-effectiveness and budget impacts of adding trastuzumab to chemotherapy versus chemotherapy alone for HER2-positive breast cancer patients in Indonesia.

Methods: We performed a Markov model-based economic evaluation to assess cost-effectiveness, cost-utility, and budget impact.

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This cross-sectional study examines state-level associations between severe maternal morbidity and other perinatal indicators, including prepregnancy hypertension, prepregnancy diabetes, prepregnancy obesity, low-risk cesarean delivery, preterm birth, and maternal and infant mortality.

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Importance: Surveillance of severe maternal morbidity (SMM) is critical for monitoring maternal health and evaluating clinical quality improvement efforts.

Objective: To evaluate national and state trends in SMM rates from 2012 to 2019 and potential disruptions associated with the transition to International Classification of Diseases, 10th Revision, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) in October 2015.

Design, Setting, And Participants: This repeated cross-sectional analysis examined delivery hospitalizations from 2012 through 2019 in the Healthcare Cost and Utilization Project's National Inpatient Sample and State Inpatient Databases, an all-payer compendium of hospital discharge records from community, nonrehabilitation hospitals.

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COVID-19 and global mental health service delivery and financing.

Public Health

June 2022

School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Center for Health Technology Assessment, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China.

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New evidence on geographic disparities in United States hospital capacity.

Health Serv Res

October 2022

Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland, USA.

Objective: To characterize the quantity and quality of hospital capacity across the United States.

Data Sources: We combine a 2017 near-census of US hospital inpatient discharges from the Healthcare Cost and Utilization Project (HCUP) with American Hospital Association Survey, Hospital Compare, and American Community Survey data.

Study Design: This study produces local hospital capacity quantity and care quality measures by allocating capacity to zip codes using market shares and population totals.

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