Patients Hospitalized for Complications of Cirrhosis may Have Benefited From Medicaid Expansion Under the Affordable Care Act

Wang, Xiao Jing; Borah, Bijan J.; Rojas, Ricardo L.; Kamath, Marielle J; Moriarty, James P.; Allen, Alina M.; Kamath, Patrick S.

doi:10.1016/j.mayocpiqo.2022.05.002

Cited by 2 publications

(1 citation statement)

References 20 publications

(24 reference statements)

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“…With regards to liver disease-related mortality, 8.3 (95% CI, 1.6-15.1) fewer liver-related deaths per 1,000,000 adult residents per year occurred in ME states compared with what would have been expected to occur if those states followed the same trajectory as non-ME states [85]. Cirrhosis-related hospitalization rates, complications of cirrhosis, readmissions, and costs were all lower in ME states when compared to those in non-ME states [86]. With respect to HCC care, patients in ME states were more likely to be diagnosed with early HCC, more likely to receive curative therapy, and less likely to die (HR = 0.68; 95% CI = 0.54-0.86) [87].…”

Section: Impact Of Medicaid Policies On Safety-net Institutionsmentioning

confidence: 90%

Care for Vulnerable Populations with Chronic Liver Disease: A Safety-Net Perspective

Wang,

Bangaru,

Zhou

2023

Healthcare

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Safety-net hospitals (SNHs) and facilities are the cornerstone of healthcare services for the medically underserved. The burden of chronic liver disease—including end-stage manifestations of cirrhosis and liver cancer—is high and rising among populations living in poverty who primarily seek and receive care in safety-net settings. For many reasons related to social determinants of health, these individuals often present with delayed diagnoses and disease presentations, resulting in higher liver-related mortality. With recent state-based policy changes such as Medicaid expansion that impact access to insurance and critical health services, an overview of the body of literature on SNH care for chronic liver disease is timely and informative for the liver disease community. In this narrative review, we discuss controversies in the definition of a SNH and summarize the known disparities in the cascade of the care and management of common liver-related conditions: (1) steatotic liver disease, (2) liver cancer, (3) chronic viral hepatitis, and (4) cirrhosis and liver transplantation. In addition, we review the specific impact of Medicaid expansion on safety-net systems and liver disease outcomes and highlight effective provider- and system-level interventions. Lastly, we address remaining gaps and challenges to optimizing care for vulnerable populations with chronic liver disease in safety-net settings.

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Section: Impact Of Medicaid Policies On Safety-net Institutionsmentioning

confidence: 90%