Health Insurance/Access to Care

Adults with Diagnosed and Untreated Diabetes: Who Are They? How Can We Reach Them? S. Hill, G. Miller, M. Sing, Journal of Health Care for the Poor and Underserved, November 2011; 22(4):1221-1238. Assesses factors related to lack of treatment for diabetes using 2000-2006 data from the Medical Expenditure Panel Survey (MEPS) Diabetes Care Supplement. (AHRQ 12-R025)

Adverse Selection and the Effect of Health Insurance on Utilization of Prescribed Medicine Among Patients with Chronic Conditions. Y. Pylypchuk, Advances in Health Economics and Health Services Research, 2010; 22:233-272. Examines the effects of health insurance types on the use of prescribed medications among patients with hypertension, diabetes, and asthma. (AHRQ 11-R011)

Changes in Hospital Readmissions for Diabetes-Related Conditions: Differences by Payer. H. Jiang, B. Friedman, R. Andrews, Managed Care Interface, July 2008; 21(1):24-30. Examines changes in hospital readmissions for diabetes-related conditions in light of evidence showing improvements in the quality of diabetes care in the United States. Includes adult, nonmaternal patients covered by private, Medicare, or Medicaid insurance who were hospitalized for diabetes-related conditions in six States between 1999 and 2003. (AHRQ 09-R013)

Characteristics of Employers Offering Dental Coverage in the United States. R. Manski, P. Cooper, Journal of the American Dental Association, June 2010; 141(6):700-711. Describes the current market for dental benefit offerings by employers, including the number and percentage of establishments that offer dental care coverage. (AHRQ 10-R077)

CMS's Landmark Decision on CT Colonography: Examining the Relevant Data. S. Dhruva, S. Phurrough, M. Salive, et al., New England Journal of Medicine, June 2009; 360(26):2699-2701. Discusses the decision by the Centers for Medicare & Medicaid Services to deny coverage of computed tomographic colonography for cancer screening, based on the lack of evidence, and examines the ramifications of this decision for national coverage decisions. (AHRQ 09-R075)

Connecting Those at Risk to Care: A Guide to Building a Community "HUB" to Promote a System of Collaboration, Accountability, and Improved Outcomes. Agency for Healthcare Research and Quality, September 2010, 88 pp. Provides guidance to help improve the system by which at-risk individuals within a community are identified and connected to appropriate health care and social services. (AHRQ 09(10)-0088)

Connecting Those at Risk to Care: The Quick Start Guide to Developing Community Care Coordination Pathways. Agency for Healthcare Research and Quality, December 2011, 31 pp. Describes a “Pathways Community HUB,” a new type of infrastructure that provides the beginning tools and strategies needed to ensure that at-risk individuals can access timely and coordinated health and social services in the community. (AHRQ 09(12)-0088-1)

Diffusion of New Technology and Payment Policies: Coronary Stents. C. Shih, E. Berliner, Health Affairs, November/December 2008; 27(6):1566-1576. Discusses the role of Medicare payment as a driver of medical technology diffusion and access to new technologies, using the case of coronary stents as an example. (AHRQ 09-R012)

Do Medicare Advantage Enrollees Tend to Be Admitted to Hospitals with Better or Worse Outcomes Compared with Fee-for-Service Enrollees? B. Friedman, H. Jiang, International Journal of Health Care Finance and Economics, February 2010; 10(2):171-185. Discusses the effects of enrollment in a Medicare Advantage plan on choice of hospital for Medicare beneficiaries, taking into account attributes of the plan and the tradeoffs of consumer preferences for annual premium vs. outcomes of care in the hospital. (AHRQ 10-R042)

Effects of Immigration on the Health Insurance Status of Natives. Y. Pylypchuk, Journal of Health Economics, June 2009; 28:1028-1037. Estimates the effects of immigration on employers' decisions to offer health benefits and natives' probability of having private coverage and being uninsured. (AHRQ 10-R007)

Families with Mixed Eligibility for Public Coverage: Navigating Medicaid, CHIP, and Uninsurance. J. Hudson, Health Affairs, June 2009; e-pub:w697-w709. Discusses the role that Medicaid and the Children's Health Insurance Program (CHIP) play in the high uninsurance rates that are prevalent among eligible children in families where children are eligible for different programs. (AHRQ 09-R074)

The Financing of Mental Health and Substance Abuse Services: Insurance, Managed Care, and Reimbursement. S. Zuvekas. In: Mental Health Services: A Public Health Perspective, 3rd Edition, B. Levin, K. Hennessy, J. Petrila, editors, 2010; chapter 2, pp. 13-41. Discusses how private-sector insurance models, including Medicare and Medicaid, operate in delivering and financing mental health and substance abuse services and examines the implications of increasing strains on public and employer-based private health insurance systems for the future of these services. (AHRQ 11-R007)

A Game-Theoretical Interpretation of Guaranteed Renewability in Health Insurance. S. Abdus, Risk Management and Insurance Review, Fall 2010; 13(2):195-206. Identifies and discusses the reasons why the premiums of health insurance contracts in the individual health insurance market do not vary much over time, even in the absence of any legal restriction on premiums. (AHRQ 11-R024)

Health Insurance Enrollment Decisions: Preferences for Coverage, Worker Sorting, and Insurance Take-Up. A. Monheit, J. Vistnes, Inquiry, Summer 2008; 45:153-167. Examines decisions by single workers to seek out and enroll in employer-sponsored health insurance plans. (AHRQ 09-R008)

The Health Insurance Status of Low-Wage Workers: The Role of Workplace Composition and Marital Status. J. Vistnes, A. Monheit, Medical Care Research and Review, May 2011; e-pub. Uses data from the 2006 Medical Expenditure Panel Survey to examine offers of coverage and cost-sharing requirements by the wage distribution and firm size dimensions of employers and describes the household circumstances of low-wage workers. (AHRQ 11-R051)

The Impact of Increased Tax Subsidies on the Insurance Coverage of Self-Employed Families: Evidence from the 1996-2004 Medical Expenditure Panel Survey. T. Selden, Journal of Human Resources, Winter 2009; 44(1):115-139. Using data from the Medical Expenditure Panel Survey, shows effects of tax subsidies on the expansion of health insurance coverage among self-employed families during the period 1996-2004. (AHRQ 09-R023)

The Impact of National Health Care Reform on Adults with Severe Mental Disorders. R. Garfield, S. Zuvekas, J. Lave, American Journal of Psychiatry, May 2011; 168(5):486-494. Examines current and predicted sources of insurance coverage and use of mental health services among adults with and without severe mental disorders and models post-reform changes. (AHRQ 12-R018)

Individual Insurance and Access to Care. S. Hill, Inquiry, Summer 2011; 48(2):155-168. Compares access to care for those with individual insurance and those who have employment-related insurance. (AHRQ 12-R002)

The Influence of Changes in Dental Care Coverage on Dental Care Utilization Among Retirees and Near-Retirees in the United States, 2004-2006. R. Manski, J. Moeller, P. St. Clair, et al., American Journal of Public Health, October 2011; 101(10):1882-1891. Examines dental care utilization transition dynamics between 2004 and 2006 in the context of changing dental coverage status. (AHRQ 12-R016)

Partially Identifying Treatment Effects with an Application to Covering the Uninsured. B. Kreider, S. Hill, Journal of Human Resources, Spring 2009; 44(2):409-449. Uses analytical tools and results to describe the impact of universal health insurance on provider visits and medical expenditures across the nonelderly population. (AHRQ 09-R058)

Payer Perspectives on Pharmacogenomics Testing and Drug Development. R. Epstein, F. Frueh, D. Geren, et al., Pharmacogenomics, January 2009; 10(1):149-151. Presents the results of a workshop held to elicit the opinions of health plan, government, and employer representatives on important considerations for study design around coverage determination. (AHRQ 09-R034)

Payment Reform. I. Fraser, W. Encinosa, L. Baker, Health Services Research, December 2010; 45(6 Part II):1847-1853. Introduces a themed issue of the journal that provides new information about how to best design and implement health care payment reforms. (AHRQ 11-R027)

Poor People, Poor Places and Access to Health Care in the United States. J. Kirby, Social Forces, September 2008; 87(1):325-355. Describes the negative relationship that exists between the prevalence of poverty in communities and access to health care and discusses the effects of this relationship on individuals at various income levels. (AHRQ 09-R047)

Premium Growth and Its Effect on Employer-Sponsored Insurance. J. Vistnes, T. Selden, International Journal of Health Care Finance and Economics, March 2011; 11(1):55-81. Examines the effect of premium growth on the likelihood that an employer offers insurance, eligibility rates among employees, continuous measures of employee premium contributions for single and family coverage, and deductibles. (AHRQ 11-R064).

Unhealthy and Uninsured: Exploring Racial Differences in Health and Health Insurance Coverage Using a Life Table Approach. J. Kirby, T. Kaneda, Demography, November 2010; 47(4):1035-1051. Uses a life-table approach to calculate health- and insurance-specific life expectancies for whites and blacks to provide estimates of the duration of exposure to different insurance and health states over a typical lifetime. (AHRQ 11-R0037)

The Utility of Prediction Models to Oversample the Long-Term Uninsured. S. Cohen, W. Yu, Medical Care, January 2009; 47(1):80-87. Evaluates the performance of prediction models in identifying the long-term uninsured and the usefulness of the models for oversampling purposes in national health care surveys. (AHRQ 09-R029)

Value-Based Insurance Design in Medicare. W. Encinosa, Applied Health Economics and Health Policy, 2009; 7(3):149-154. Discusses the financial implications of value-based insurance design for the Medicare program, as well as its benefits in terms of improved outcomes and hospitalizations avoided. (AHRQ 10-R025)

Wealth, Income, and the Affordability of Health Insurance. D. Bernard, J. Banthin, Health Affairs, May/June 2009; 28(3):887-896. Examines the difference in assets between the privately insured and uninsured to explore the relationship between assets and affordability of health insurance. (AHRQ 09-R059)

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