Lifetime Consequences of Early-Life and Midlife Access to Health Insurance: A Review

Gaudette, Étienne; Pauley, Gwyn; Zissimopoulos, Julie

doi:10.1177/1077558717740444

Cited by 12 publications

(5 citation statements)

References 164 publications

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“…We used an estimate by Saltzman (48) due to its recency, its focus on the ACA Marketplace, and its estimation of elasticity by age group, which we felt was important given age-related differences in morbidity and mortality. While the weight of evidence demonstrates that extending health insurance coverage reduces morbidity and mortality, estimates of that effect vary widely (73)(74)(75)(76). We chose the midpoint of a range of 239-316 individuals needed to gain insurance to avert one death for those newly covered by Medicaid expansions in California and Washington estimated by Sommers (49).…”

Section: Discussionmentioning

confidence: 99%

A Health Opportunity Cost Threshold for Cost-Effectiveness Analysis in the United States

2021

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Background: Cost-effectiveness analysis is an important tool for informing treatment coverage and pricing decisions, yet no consensus exists about what threshold for the incremental cost-effectiveness ratio (ICER) in dollars per quality-adjusted life year gained (QALY) indicates whether treatments are likely to be cost-effective in the United States (US).Objective: To estimate a US cost-effectiveness threshold based on health opportunity costs.Design: Simulation of short-term mortality and morbidity attributable to individuals dropping health insurance due to increased healthcare expenditures passed though as premium increases. Model inputs came from demographic data and the literature; 95% uncertainty intervals (UI) were constructed.

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Section: Discussionmentioning

confidence: 99%

A Health Opportunity Cost Threshold for Cost-Effectiveness Analysis in the United States

2021

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“…Access to care , specifically provision of insurance, is tied tightly to reimbursement. A prioritization of this specific social need may result in better care for patients and, concomitantly, improve health care reimbursement and reduce health care costs for the medical system, a financial “win–win.” 22,23 As a result, it is conceivable that financial support for studies aiming to decrease unreimbursed care may be more prevalent and accessible than that which is available for other SDoH domains. Similarly, from a funding perspective, grants for programs addressing exposure to violence / crime have become increasingly available, including from the U.S. Department of Justice, since the 1994 Violence Against Women Act and the Victims of Trafficking and Violence Protection Act of 2000 24–27 .…”

Section: Discussionmentioning

confidence: 99%

Emergency department–based interventions affecting social determinants of health in the United States: A scoping review

Walter

Schoenfeld

Smith

et al. 2021

Academic Emergency Medicine

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Background Social determinants of health (SDoH) have significant implications for health outcomes in the United States. Emergency departments (EDs) function as the safety nets of the American health care system, caring for many vulnerable populations. ED‐based interventions to assess social risk and mitigate social needs have been reported in the literature. However, the breadth and scope of these interventions have not been evaluated. As the field of social emergency medicine (SEM) expands, a mapping and categorization of previous interventions may help shape future research. We sought to identify, summarize, and characterize ED‐based interventions aimed at mitigating negative SDoH. Methods We conducted a scoping review to identify and characterize peer‐reviewed research articles that report ED‐based interventions to address or impact SDoH in the United States. We designed and conducted a search in Medline, CINAHL, and Cochrane CENTRAL databases. Abstracts and, subsequently, full articles were reviewed independently by two reviewers to identify potentially relevant articles. Included articles were categorized by type of intervention and primary SDoH domain. Reported outcomes were also categorized by type and efficacy. Results A total of 10,856 abstracts were identified and reviewed, and 596 potentially relevant studies were identified. Full article review identified 135 articles for inclusion. These articles were further subdivided into three intervention types: a) provider educational intervention (18%), b) disease modification with SDoH focus (26%), and c) direct SDoH intervention (60%), with 4% including two “types.” Articles were subsequently further grouped into seven SDoH domains: 1) access to care (33%), 2) discrimination/group disparities (7%), 3) exposure to violence/crime (34%), 4) food insecurity (2%), 5) housing issues/homelessness (3%), 6) language/literacy/health literacy (12%), 7) socioeconomic disparities/poverty (10%). The majority of articles reported that the intervention studied was effective for the primary outcome identified (78%). Conclusion Emergency department–based interventions that address seven different SDoH domains have been reported in the peer‐reviewed literature over the past 30 years, utilizing a variety of approaches including provider education and direct and indirect focus on social risk and need. Characterization and understanding of previous interventions may help identify opportunities for future interventions as well as guide a SEM research agenda.

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“…Increasing access to health care improves health outcomes. 1,2 An effective health insurance program adjusts coverage to respond to emerging needs of the people it serves. Medicaid is the largest insurer in the United States, 3 and states have considerable flexibility in structuring their Medicaid programs.…”

Section: Introductionmentioning

confidence: 99%

States' use of Medicaid to meet the needs of autistic individuals

Shea

Miller

Verstreate

et al. 2021

Health Services Research

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Objective: To assess the use of Medicaid programs, including waivers, to address the needs of aging autistic individuals. Data sources: We gathered data on Medicaid programs in place between 2004 and 2015 for 50 states and the District of Columbia from the Centers for Medicare and Medicaid Services website, by contacting state Medicaid administrators and advocacy groups, and by reviewing the Medicaid Analytic eXtract Waiver Crosswalk. Study design: This retrospective analysis classified each Medicaid program and documented state changes over time in eligibility criteria: those serving autism spectrum disorder only, autism spectrum disorder or intellectual disability, and intellectual disability only. Data collection/extraction methods: We captured age and diagnosis eligibility criteria for Medicaid programs serving any of the three target groups. Principal findings: A total of 269 Medicaid programs met our criteria and most programs (51%) were 1915(c) waivers. The number of autism-specific 1915(c) waivers grew more than fivefold during the study period, outpacing increases in waivers serving individuals with intellectual disability. Conclusions: States varied in their use of Medicaid to address the needs of the aging autism population. Further study of characteristics of states that changed their Medicaid programs, and of the health care use and outcomes associated with these changes, are needed to identify opportunities to replicate effective approaches to meeting the needs of this population.

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Lifetime Consequences of Early-Life and Midlife Access to Health Insurance: A Review

Cited by 12 publications

References 164 publications

A Health Opportunity Cost Threshold for Cost-Effectiveness Analysis in the United States

A Health Opportunity Cost Threshold for Cost-Effectiveness Analysis in the United States

Emergency department–based interventions affecting social determinants of health in the United States: A scoping review

States' use of Medicaid to meet the needs of autistic individuals

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