The impact of the Affordable Care Act on provision of endodontic services within a dental school setting in Oregon

2019 ◽  
Vol 79 (2) ◽  
pp. 175-180
Author(s):  
Joseph Peck ◽  
Christine M. Sedgley ◽  
Eli Schwarz ◽  
Karan J. Replogle
Keyword(s):  
Affordable Care Act ◽  
School Setting ◽  
Dental School ◽  
The Affordable Care Act ◽  
The Impact

The Impact of the Affordable Care Act Insurance Expansions on Opioid‐Related Emergency Department Visits

2021 ◽  
Vol 56 (S2) ◽  
pp. 64-64
Author(s):  
Sandra Decker ◽  
Michael Dworsky ◽  
Teresa Gibson ◽  
Rachel Henke ◽  
Kimberly McDermott
Keyword(s):  
Emergency Department ◽  
Affordable Care Act ◽  
Emergency Department Visits ◽  
The Affordable Care Act ◽  
The Impact

Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care

2021 ◽  
pp. 1-9
Author(s):  
Jacob K. Greenberg ◽  
Derek S. Brown ◽  
Margaret A. Olsen ◽  
Wilson Z. Ray
Keyword(s):  
United States ◽  
Spine Surgery ◽  
Surgical Procedures ◽  
Affordable Care Act ◽  
Surgical Care ◽  
The United States ◽  
Medicaid Expansion ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
The Impact

OBJECTIVE The Affordable Care Act expanded Medicaid eligibility in many states, improving access to some forms of elective healthcare in the United States. Whether this effort increased access to elective spine surgical care is unknown. This study’s objective was to evaluate the impact of Medicaid expansion under the Affordable Care Act on the volume and payer mix of elective spine surgery in the United States. METHODS This study evaluated elective spine surgical procedures performed from 2011 to 2016 and included in the all-payer State Inpatient Databases of 10 states that expanded Medicaid access in 2014, as well as 4 states that did not expand Medicaid access. Adult patients aged 18–64 years who underwent elective spine surgery were included. The authors used a quasi-experimental difference-in-difference design to evaluate the impact of Medicaid expansion on hospital procedure volume and payer mix, independent of time-dependent trends. Subgroup analysis was conducted that stratified results according to cervical fusion, thoracolumbar fusion, and noninstrumented surgery. RESULTS The authors identified 218,648 surgical procedures performed in 10 Medicaid expansion states and 118,693 procedures performed in 4 nonexpansion states. Medicaid expansion was associated with a 17% (95% CI 2%–35%, p = 0.03) increase in mean hospital spine surgical volume and a 23% (95% CI −0.3% to 52%, p = 0.054) increase in Medicaid volume. Privately insured surgical volumes did not change significantly (incidence rate ratio 1.13, 95% CI −5% to 34%, p = 0.18). The increase in Medicaid volume led to a shift in payer mix, with the proportion of Medicaid patients increasing by 6.0 percentage points (95% CI 4.1–7.0, p < 0.001) and the proportion of private payers decreasing by 6.7 percentage points (95% CI 4.5–8.8, p < 0.001). Although the magnitude of effects varied, these trends were similar across procedure subgroups. CONCLUSIONS Medicaid expansion under the Affordable Care Act was associated with an economically and statistically significant increase in spine surgery volume and the proportion of surgical patients with Medicaid insurance, indicating improved access to care.

scholarly journals Patterns of Coverage Gains Among Young Adult Cancer Patients Following the Affordable Care Act

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Leticia M Nogueira ◽  
Neetu Chawla ◽  
Xuesong Han ◽  
Ahmedin Jemal ◽  
K Robin Yabroff
Keyword(s):  
Young Adult ◽  
Cancer Patients ◽  
Affordable Care Act ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Temporal Patterns ◽  
Patients Âgés ◽  
The Affordable Care Act ◽  
Young Adult Cancer ◽  
The Impact

Abstract The dependent coverage expansion (DCE) and Medicaid expansions (ME) under the Affordable Care Act (ACA) may differentially affect eligibility for health insurance coverage in young adult cancer patients. Studies examining temporal patterns of coverage changes in young adults following these policies are lacking. We used data from the National Cancer Database 2003–2015 to conduct a quasi-experimental study of cancer patients ages 19–34 years, grouped as DCE-eligible (19- to 25-year-olds) and DCE-ineligible (27- to 34-year-olds). Although private insurance coverage in DCE-eligible cancer patients increased incrementally following DCE implementation (0.5 per quarter; P < .001), an immediate effect on Medicaid coverage gains was observed after ME in all young adult cancer patients (3.01 for DCE-eligible and 1.62 for DCE-ineligible, both P < .001). Therefore, DCE and ME each had statistically significant and distinct effects on insurance coverage gains. Distinct temporal patterns of ACA policies’ impact on insurance coverage gains likely affect patterns of receipt of cancer care. Temporal patterns should be considered when evaluating the impact of health policies.

Breast Cancer Stage at Presentation in Ohio: The Effect of Medicaid Expansion and the Affordable Care Act

2020 ◽  
Vol 86 (3) ◽  
pp. 195-199
Author(s):  
Dan Kirkpatrick ◽  
Margaret Dunn ◽  
Rebecca Tuttle
Keyword(s):  
Breast Cancer ◽  
Affordable Care Act ◽  
Advanced Disease ◽  
Disease Stage ◽  
Cancer Stage ◽  
Medicaid Expansion ◽  
Cancer Data ◽  
Before And After ◽  
The Affordable Care Act ◽  
The Impact

Patients presenting with localized breast cancer have a five-year survival of 99 per cent, whereas survival falls to 27 per cent in advanced disease. This obviates the importance of early diagnosis and treatment. Our study evaluates the impact of Ohio's Medicaid expansion and the passage of the Affordable Care Act (ACA) on the stage at which Ohioans were diagnosed with breast cancer. Data were collected for 3056 patients presenting with breast cancer between 2006 and 2016 in the Dayton area. Patients were divided into groups based on cancer stage. The percentage of patients presenting with advanced disease (stage 3 or 4) was compared both before and after ACA implementation and Ohio Medicaid expansion. These results were also compared with statewide data maintained by the Ohio Department of Health. Compared with pre-ACA, the number of uninsured patients post-ACA was noted to fall 83 per cent, the number of patients presenting with Medicaid increased by five times, and the proportion of patients younger than 65 years presenting with breast cancer increased by approximately 7 per cent. These changes notwithstanding, no difference was identified in the percentage of patients presenting with advanced breast cancer before and after ACA implementation or Ohio Medicaid expansion ( P = 0.56). Statewide data similarly demonstrated no change ( P = 0.88). Improved insurance access had a smaller-than-anticipated impact on the stage at which Ohioans presented with breast cancer. As significant morbidity and mortality can be avoided by earlier presentation, additional research is appropriate to identify factors affecting patients’ decision to seek breast cancer screening and care.

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