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Evaluation of a Medicaid Lock-in Program: Increased Use of Opioid Use Disorder Treatment but No Impact on Opioid Overdose Risk: Erratum.

Med Care (Medical care)
[2020, 58(3):293]

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Depression and Uptake of Oral Anticoagulation Therapy in Patients With Atrial Fibrillation: A Danish Nationwide Cohort Study.

Morten Fenger-Grøn, Claus H Vestergaard, Lars Frost, Dimitry S Davydow, Erik T Parner, Bo Christensen, Anette R Ribe,

BACKGROUND:Oral anticoagulation therapy (OAT) in patients with atrial fibrillation (AF) is a highly important preventive intervention, perhaps especially in those with comorbid depression, who have a worse prognosis. However, OAT may pose particular challenges in depressed patients. OBJECTIVES:To assess whether AF patients with depression have lower OAT uptake. METHODS:This nationwide ... Read more >>

Med Care (Medical care)
[2020, 58(3):216-224]

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Evaluating Race and Ethnicity Reported in Hospital Discharge Data and Its Impact on the Assessment of Health Disparities.

Renata E Howland, Tsu-Yu Tsao,

BACKGROUND:Improving the collection and quality of race and ethnicity reported in hospital data is a key step in identifying disparities in health service utilization and outcomes and opportunities for quality improvement. OBJECTIVE:The objective of this study was to assess the quality of race/ethnicity reported in hospital discharge data and examine ... Read more >>

Med Care (Medical care)
[2020, 58(3):280-284]

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Politics and Policymaking in Medicare Part C.

Emily R Adrion,

BACKGROUND:Once just a small part of the Medicare program, private managed care plans now cover over one-third of all Medicare beneficiaries and cost the Federal government ~$210 billion each year. Importantly, the evolution of Medicare managed care policy has been far from linear; for several decades there have been dramatic ... Read more >>

Med Care (Medical care)
[2020, 58(3):285-292]

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The Prevalence and Incidence of Attention-deficit/Hyperactivity Disorder in the Veterans Health Administration From 2009 to 2016.

Andrew C Hale, Kipling M Bohnert, Robert J Spencer, Dara Ganoczy, Paul N Pfeiffer,

BACKGROUND:The prevalence and incidence of attention-deficit/hyperactivity disorder (ADHD) have increased substantially among children and adolescents over the past decade; however, little is known regarding trends in adult populations. OBJECTIVE:The objective of this study was to explore trends in the prevalence, incidence, and correlates of adult ADHD in a national sample ... Read more >>

Med Care (Medical care)
[2020, 58(3):273-279]

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Weight Loss for Patients With Obesity: An Analysis of Long-Term Electronic Health Record Data.

Natalie Liu, Jen Birstler, Manasa Venkatesh, Lawrence P Hanrahan, Guanhua Chen, Luke M Funk,

BACKGROUND:Numerous studies have reported that losing as little as 5% of one's total body weight (TBW) can improve health, but no studies have used electronic health record data to examine long-term changes in weight, particularly for adults with severe obesity [body mass index (BMI) ≥35 kg/m]. OBJECTIVE:To measure long-term weight changes ... Read more >>

Med Care (Medical care)
[2020, 58(3):265-272]

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2018 American Public Health Association's Medical Care Section Student Awardees.

Julie M Zito, Katherine S Virgo, Linda D Green,

Med Care (Medical care)
[2020, 58(3):193]

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Characteristics and Operational Performance of Hospital-affiliated Freestanding Emergency Departments.

Avi Baehr, Caroline Ledbetter, Kelly J Bookman, Yang Wang, Adit A Ginde, Jennifer L Wiler,

BACKGROUND:As there has been increasing pressure on acute care services to redefine how their care is delivered, hospital-affiliated freestanding emergency departments (FREDs) have rapidly expanded in some markets. Little is known about the populations served or the quality of care provided by these facilities. OBJECTIVE:The objective of this study was ... Read more >>

Med Care (Medical care)
[2020, 58(3):234-240]

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Drivers of High-cost Medical Complexity in a Medicaid Population.

David Labby, Bill Wright, Lauren Broffman, Megan Holtorf,

BACKGROUND:Efforts to improve outcomes for the 10% of patients using two thirds of health care expenditures increasingly include addressing social determinants. Empiric evidence is needed to identify the highest impact nonmedical drivers of medical complexity and cost. OBJECTIVES:This study examines whether complex, highest cost patients have different patterns of critical ... Read more >>

Med Care (Medical care)
[2020, 58(3):208-215]

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Risk of Frequent Emergency Department Use Among an Ambulatory Care Sensitive Condition Population: A Population-based Cohort Study.

Catherine Hudon, Josiane Courteau, Yohann M Chiu, Maud-Christine Chouinard, Marie-France Dubois, Nicole Dubuc, Nicolas Elazhary, Francois Racine-Hemmings, Isabelle Dufour, Alain Vanasse,

BACKGROUND:A small fraction of patients use a disproportionately large amount of emergency department (ED) resources. Identifying these patients, especially those with ambulatory care sensitive conditions (ACSC), would allow health care professionals to enhance their outpatient care. OBJECTIVE:The objectives of the study were to determine predictive factors associated with frequent ED ... Read more >>

Med Care (Medical care)
[2020, 58(3):248-256]

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Estimating the Net Benefit of Improvements in Hospital Performance: G-Computation With Hierarchical Regression Models.

Peter C Austin, Douglas S Lee,

BACKGROUND:It is important to be able to estimate the anticipated net population benefit if the performance of hospitals is improved to specific standards. OBJECTIVE:The objective of this study was to show how G-computation can be used with random effects logistic regression models to estimate the absolute reduction in the number ... Read more >>

Med Care (Medical care)
[2020, :]

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Financial Performance of Medicare Advantage Contracts in 2014 and Plan Renewal, Consolidation, and Termination Rates in the Subsequent Year.

Brent A Langellier, Sungchul Park,

BACKGROUND:Starting in 2014, the Affordable Care Act mandated that Medicare Advantage (MA) contracts spend at least 85% of total revenue on claims and quality improvement [ie, the medical loss ratio (MLR)] and submit revenue and cost data annually in MLR reports. These reports can improve transparency of the financial performance ... Read more >>

Med Care (Medical care)
[2020, :]

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County-level Variation in Low-birth Weight and Preterm Birth: An Evaluation of State Medicaid Expansion Under the Affordable Care Act.

Clare C Brown, Jennifer E Moore, Holly C Felix, M Kathryn Stewart, J Mick Tilford,

BACKGROUND:Rates of low-birth weight and prematurity vary 2-fold across states in the United States, with increased rates among states with higher concentrations of racial minorities. Medicaid expansion may serve as a mechanism to reduce geographic variation within states that expanded, by improving health and access to care for vulnerable populations. ... Read more >>

Med Care (Medical care)
[2020, :]

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All-payer Spending on Common Hospital-based Services in California.

Christopher P Childers, Melinda Maggard-Gibbons, Sharon M Weber, Sean M Ronnekleiv-Kelly, Daniel E Abbott,

BACKGROUND:Hospital-based care accounts for one third of US health spending or over $1 trillion annually, yet a detailed all-payer assessment of what services contribute to this spending is not available. STUDY DESIGN:Cross-sectional and longitudinal evaluation of hospital financial statements from acute-care general hospitals in California between fiscal years 2007 and ... Read more >>

Med Care (Medical care)
[2020, :]

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Payment for Contraceptive Services in Safety Net Clinics: Roles of ACA, Title X, and State Programs.

Blair G Darney, Frances M Biel, Maria I Rodriguez, R Lorie Jacob, Erika K Cottrell, Jennifer E DeVoe,

OBJECTIVES:We describe payor for contraceptive visits 2013-2014, before and after Medicaid expansion under the Affordable Care Act (ACA), in a large network of safety-net clinics. We estimate changes in the proportion of uninsured contraceptive visits and the independent associations of the ACA, Title X, and state family planning programs. METHODS:Our ... Read more >>

Med Care (Medical care)
[2020, :]

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Bundling Rapid Human Immunodeficiency Virus and Hepatitis C Virus Testing to Increase Receipt of Test Results: A Randomized Trial.

Jemima A Frimpong, Karen Shiu-Yee, Susan Tross, Thomas D'Aunno, David C Perlman, Shiela M Strauss, Bruce R Schackman, Daniel J Feaster, Lisa R Metsch,

BACKGROUND:The overlapping human immunodeficiency virus (HIV) and hepatitis C virus (HCV) epidemics disproportionately affect people with substance use disorders. However, many people who use substances remain unaware of their infection(s). OBJECTIVE:The objective of this study was to examine the efficacy of an on-site bundled rapid HIV and HCV testing strategy ... Read more >>

Med Care (Medical care)
[2020, :]

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Transforming the Veterans Affairs to a Whole Health System of Care: Time for Action and Research.

Barbara G Bokhour, Jolie N Haun, Justeen Hyde, Martin Charns, Benjamin Kligler,

Med Care (Medical care)
[2020, :]

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Does the Encounter Type Matter When Defining Diabetes Complications in Electronic Health Records?

Dongzhe Hong, Yun Shen, Alisha Monnette, Shuqian Liu, Hui Shao, Elizabeth Nauman, Eboni Price-Haywood, Gang Hu, Lizheng Shi,

BACKGROUND:Electronic health records (EHRs) and claims records are widely used in defining type 2 diabetes mellitus (T2DM) complications across different types of health care encounters. OBJECTIVE:This study investigates whether using different EHR encounter types to define diabetes complications may lead to different results when examining associations between diabetes complications and ... Read more >>

Med Care (Medical care)
[2020, :]

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The Association Between the Supply of Nonpharmacologic Providers, Use of Nonpharmacologic Pain Treatments and High-risk Opioid Prescription Patterns Among Medicare Beneficiaries With Persistent Musculoskeletal Pain.

Ruchir N Karmali, Asheley C Skinner, Justin G Trogdon, Morris Weinberger, Steven Z George, Kristen Hassmiller Lich,

BACKGROUND:Opioids are prescribed more frequently than nonpharmacologic treatments for persistent musculoskeletal pain (MSP). We estimate the association between the supply of physical therapy (PT) and mental health (MH) providers and early nonpharmacologic service use with high-risk opioid prescriptions among Medicare beneficiaries with persistent MSP. RESEARCH DESIGN:We retrospectively studied Medicare beneficiaries ... Read more >>

Med Care (Medical care)
[2020, :]

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Health Profile and Health Care Access of Mexican Migration Flows Traversing the Northern Border of Mexico.

Ana P Martinez-Donate, Niko Verdecias, Xiao Zhang, Gonzalez-Fagoaga Jesús Eduardo, Ahmed A Asadi-Gonzalez, Sylvia Guendelman, Catalina Amuedo-Dorantes, Gudelia Rangel,

BACKGROUND:The health of Latino migrants is most often studied with samples of immigrants settled in the United States or returned migrants in Mexico. We examine health outcomes and health care access of Mexican migrants traversing the Mexican border region to gain a better understanding of migrant health needs as they ... Read more >>

Med Care (Medical care)
[2020, :]

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A Comparison of Health Risk and Costs Across Private Insurance Markets.

Brett Lissenden, Krutika Amin, Kelly Drury, Gregory C Pope, John Kautter, Erin Sutton, Yolanda Peele,

BACKGROUND:The Patient Protection and Affordable Care Act (PPACA) established new parameters for the individual and small group health insurance markets starting in 2014. We study these 2 reformed markets by comparing health risk and costs to the more mature large employer market. STUDY DATA:For 2017, claims data for all enrollees ... Read more >>

Med Care (Medical care)
[2020, 58(2):146-153]

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Changes in Medicaid Acceptance by Substance Abuse Treatment Facilities After Implementation of Federal Parity.

Kimberley H Geissler, Elizabeth A Evans,

BACKGROUND:Adequate access for mental illness and substance use disorder (SUD) treatment, particularly for Medicaid enrollees, is challenging. Policy efforts, including the Mental Health Parity and Addiction Equity Act (MHPAEA), have targeted expanded access to care. With MHPAEA, more Medicaid plans were required to increase their coverage of SUD treatment, which ... Read more >>

Med Care (Medical care)
[2020, 58(2):101-107]

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Health Care Access and Utilization for Latino Youth in the United States: The Roles of Maternal Citizenship and Distress.

Cinthya K Alberto, Jessie Kemmick Pintor, Ana P Martínez-Donate, Jie Chen, Alexander N Ortega,

OBJECTIVES:We sought to determine the associations between maternal citizenship and health care access and utilization for US-born Latino youth and to determine whether maternal distress is a moderator of the associations. METHODS:Using 2010-2017 Integrated Public Use Microdata Series National Health Interview Survey data, multivariable logistic regressions were run to examine ... Read more >>

Med Care (Medical care)
[2020, :]

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Changes in Preventative Health Care After Medicaid Expansion.

Sri Lekha Tummalapalli, Salomeh Keyhani,

BACKGROUND:Medicaid expansion substantially increased health insurance coverage, but its effect on the delivery of preventative health care is unclear. OBJECTIVE:The objective of this study was to assess the impact of Medicaid expansion on the receipt of 15 different measures of preventive care including cancer screening, cardiovascular risk reduction, diabetes care, ... Read more >>

Med Care (Medical care)
[2020, :]

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The Impact of Massachusetts Health Reform on Colorectal and Breast Cancer Stage at Diagnosis.

Lindsay M Sabik, Kirsten Y Eom, Bassam Dahman, Jie Li, Nengliang Yao, G J van Londen, Cathy J Bradley,

BACKGROUND:This study examines the expansion of health insurance coverage in Massachusetts under state health reform as a natural experiment to investigate whether expanded insurance coverage reduced the likelihood of advanced stage colorectal cancer (CRC) and breast cancer (BCA) diagnosis. METHODS:Our study populations include CRC or BCA patients aged 50-64 years ... Read more >>

Med Care (Medical care)
[2020, 58(2):183-191]

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