Model Safety-Net Programs Could Care For The Uninsured At One-Half The Cost Of Medicaid Or Private Insurance

Hall, Mark A.; Hwang, Wenke; Jones, Alison Snow

doi:10.1377/hlthaff.2010.0946

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…It is possible that this fact may have contributed to the findings of this study. Safety-net hospitals make primary and specialty care more economical and accessible to uninsured and under-insured patients [30][31][32]. Additionally, the hospital-sponsored insurance program offers affordable healthcare to indigent county residents who are not eligible for other state-or federally funded healthcare programs, and are at or just above the federal poverty income level [14].…”

Section: Discussionmentioning

confidence: 99%

The Influence of Insurance Status on Extensor Tendon Repair Outcomes

Dalton,

Maharjan,

Yousuf

et al. 2024

Surgeries

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Background: Little is known regarding how patient insurance status influences outcomes after extensor tendon-injury repair. We aim to establish a relationship between the outcomes of primarily repaired extensor tendon injuries and patient insurance status. We hypothesize that commercially insured patients will achieve superior outcomes due to more facile access to postoperative hand therapy and fewer barriers to appropriate postoperative care. Methods: A retrospective chart review was conducted of patients who underwent primary extensor tendon repair in any zone, excluding the thumb, at a single large safety-net hospital. Inclusion criteria included a minimum of eight weeks of follow-up, complete data available for review, and an extensor tendon injury requiring primary surgical repair. Four cohorts were examined: patients with commercial insurance, patients with Medicare/Medicaid, patients with county hospital-sponsored insurance, and uninsured patients. Statistical analysis was performed using Chi-Square and ANOVA analyses, with significance defined as p ≤ 0.05. Results: Of the 62 patients (100 digits) included, 20 had commercial insurance, 12 had Medicare/Medicaid, 13 had hospital-sponsored insurance, and 17 were uninsured. Except for mean age, there were no significant differences between groups in terms of demographic data, medical comorbidities, or digit characteristics. There were also no significant differences in mean follow-up, time to return to full activity, or surgical complications among groups. Procedure duration differed significantly between groups, with procedures lasting longer in uninsured patients. Postoperative final flexion total arc of motion (TAM) and extension measurements were similar across all groups. Additionally, hand therapy visits did not differ significantly between groups. Conclusions: Following extensor tendon repair, patient insurance status did not affect outcomes in terms of final range of motion, return to full activity, or postoperative complications.

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Section: Discussionmentioning

confidence: 99%

The Influence of Insurance Status on Extensor Tendon Repair Outcomes

Dalton,

Maharjan,

Yousuf

et al. 2024

Surgeries

View full text Add to dashboard Cite

show abstract

“…A 2008 cost evaluation of four ‘model’ county-level access to care programs for the uninsured in four states carefully measured these programs’ costs, including the value of referred, donated, and in-kind services. The study found that the access to care programs were between 25-50% less expensive when compared to risk-adjusted public or private insurance premiums for similar populations [30]. …”

Section: Hospital Use and Costsmentioning

confidence: 99%

Access to Care Outcomes: A Telephone Interview Study of a Suburban Safety Net Program for the Uninsured

et al. 2013

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Access DuPage (AD) currently provides primary care for about 14,000 low income, uninsured residents of suburban DuPage County, IL, an area with a very limited healthcare safety net infrastructure. A telephone interview survey evaluated health care utilization, satisfaction, and health status outcomes and compared recent enrollees to individuals in the program for at least one year. Sequential new AD enrollees (n=158) were asked about the previous year when uninsured, while randomly selected established AD enrollees (n=135) were asked the same questions about the previous year when actively enrolled in AD. Established enrollees reported being more likely to get ‘any kind of tests or treatment’ (96.3% versus 46.2%, p<0.0001), fewer cost (78.5% versus 21.3%, p<0.0001) and transportation barriers to care, more preventive and mental health services, and better self-management care. However, established enrollees also reported 14% greater use of hospital inpatient and 9% greater use of emergency room care, as well as continued difficulty in accessing needed specialty and dental care services. Despite more (diagnosed) conditions, established enrollees were over 2.5 times more likely to report good to excellent health status and over three times more likely to rate their satisfaction with health care as good to excellent. Findings illustrate the substantial benefits of assuring access to care for the uninsured, but do not reflect immediate savings from reduced hospital utilization. Access to care programs will be an important tool to address the needs of the 30 million people who will continue to be uninsured in the United States.

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“…12 Recent research on similar programs not included in the Community Tracking Study found that their patient costs were 25-50 percent lower than for patients enrolled in local Medicaid programs or through private insurance. 7 …”

Section: Benefits Of Safety-net Coordinationmentioning

confidence: 99%

Safety-Net Providers In Some US Communities Have Increasingly Embraced Coordinated Care Models

2012

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Safety-net organizations, which provide health services to uninsured and low-income people, increasingly are looking for ways to coordinate services among providers to improve access to and quality of care and to reduce costs. In this analysis, a part of the Community Tracking Study, we examined trends in safety-net coordination activities from 2000 to 2010 within twelve communities in the United States and found a notable increase in such activities. Six of the twelve communities had made formal efforts to link uninsured people to medical homes and coordinate care with specialists in 2010, compared to only two communities in 2000. We also identified key attributes of safety-net coordinated care systems, such as reliance on a medical home for meeting patients' primary care needs, and lingering challenges to safety-net integration, such as competition among hospitals and community health centers for Medicaid patients.

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Model Safety-Net Programs Could Care For The Uninsured At One-Half The Cost Of Medicaid Or Private Insurance

Cited by 8 publications

References 7 publications

The Influence of Insurance Status on Extensor Tendon Repair Outcomes

The Influence of Insurance Status on Extensor Tendon Repair Outcomes

Access to Care Outcomes: A Telephone Interview Study of a Suburban Safety Net Program for the Uninsured

Safety-Net Providers In Some US Communities Have Increasingly Embraced Coordinated Care Models

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