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Agency for Healthcare Research Quality

Health Insurance/Access to Care

Tools & Resources

AHRQ Analyses of Medical Expenditure Survey Panel (MEPS) Data Inform Estimates of the Number of Long-Term Uninsured
AHRQ Analyses of MEPS Data Inform HHS Report on Declining Employer-Sponsored Insurance Coverage
AHRQ Analyses of MEPS Data Inform HHS Report on Health Insurance Reform and Costs for Small Businesses
Checkup on Health Insurance Choices
Health Insurance Coverage
Medical Expenditure Survey Panel (MEPS)
Theory and Reality of Value-Based Purchasing: Lessons from the Pioneers

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Research Findings

Women at High Risk for Diabetes: Access and Quality of Health Care, 2003-2006

Agency Press Releases

Date   Title
4/20/12 Disparities Report Highlights Health Care Challenges For Racial and Ethnic Minorities

Research Activities, September 2012:
The financial burden from prescription drugs has declined for the nonelderly, but remains a problem for some groups
Despite more widespread prescribing of antiretroviral therapy for HIV infection, disparities remain

Research Activities, August 2012:
New study counters the urban legend that insurers won't cover patients who leave the hospital prematurely

Research Activities, July 2012:
Black male prisoners in North Carolina have considerably lower mortality rates than black residents of that State
Having a usual source of care promotes preventive health counseling for children
Rise in prescription copays puts different patients at risk for nonadherence to medications
Hard-of-hearing individuals more likely to report difficulties in accessing care
Study projects savings by Affordable Care Act to individual health insurance policyholders

Research Activities, June 2012:
Disparities Report highlights health care challenges for minorities, underscores importance of Affordable Care Act
Vulnerable populations with heart failure less likely to receive early physician followup after discharge
Dual Veterans Administration/Medicare users are not hospitalized more for ambulatory care sensitive conditions

Research Activities, May 2012:
Study outlines factors associated with untreated diabetes
Children whose parents lack a usual source of care are more likely to have unmet medical needs
Children with special health care needs with disabilities have greater unmet health care needs than those without disabilities

Research Activities, April 2012:
Majority of conditions treated in emergency departments are treatable in primary care clinics

Research Activities, March 2012:
Study identifies attributes of surgeons more willing to provide charity care

Research Activities, February 2012:
Adults with individual and employment-related health insurance report similar, often good, access to care
Being foreign-born affects access to care
Children's unmet health needs similar for low- and middle-income families with either public or private insurance

Research Activities, January 2012:
Bundled payments for heart failure disease management programs can save money while reducing readmissions
Breast cancer is associated with higher health care use and costs for women covered by fee-for-service Medicaid
Many Texas residents cross Mexican border to obtain health care services

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Research Activities, September 2011:
Where low-wage employees work, who their colleagues are, and spouses' wage level affect health insurance coverage and cost
Rising health care costs may have spurred more individuals to use complementary and alternative medicine
Uninsured patients respond well to paying a monthly retainer for primary care services
Children's underenrollment in State health insurance programs may be due in part to parents' confusion about coverage
Low- and middle-income children with public and private insurance have similar rates of unmet health care needs

Research Activities, August 2011:
Having a usual source of care as well as insurance reduces unmet health needs
A usual source of care may be more important than insurance on children's receipt of preventive health counseling
Certain Americans pay more than 10 percent of their family income to pay for medical expenses
Employees' share of health plan premium costs up dramatically
Six of every 10 rural emergency departments visits made by poor patients
Up to $500 million in Affordable Care Act funding will help health providers improve care

Research Activities, July 2011:
Health care quality gaps and disparities persist in every State
Americans, especially blacks, spend substantial periods of time uninsured
Health insurance is necessary but not sufficient for children's access to care

Research Activities, June 2011:
Community hubs ensure better care for the most vulnerable
Immigrants to the United States and Canada have worse access to care than native-born counterparts
Increasing premiums and other costs in Oregon's Medicaid program in 2003 led many to drop out
Patients with chronic diseases who pay coinsurance less likely to refill their medication than those with fixed copayments

Research Activities, May 2011:
Practice setting, ownership, and specialty all affect volume of charity care provided by physicians
Inhaler costs contribute to medication nonadherence for Medicare patients with chronic pulmonary disease
Uninsured hospital stays surged from 2003 to 2008
Diabetes testing plummets among poor, minority, and inner-city adults

Research Activities, April 2011:
Health care quality still improving slowly, but disparities and gaps in access to care persist
Regional poverty boosts adults' chances of having unmet health care needs
Some adults with disabilities covered by Medicaid have significant out-of-pocket health expenses
Medicare Part D enrollees have higher cost-sharing amounts for brand name prescription drugs than those in employer plans
Many patients with diabetes who reach the Medicare Part D drug coverage gap don't talk about drug costs with their doctors
Payment reform highlighted in special journal issue
Nearly 4 million adults reported being treated for kidney disease between 2003 and 2007
Patients' income and where they live influence hospitalization for chronic lung disease

Research Activities, March 2011:
When health plans share physicians, they may have less incentive to improve care quality
Even with universal health insurance, the homeless in Canada encounter barriers to obtaining health care
Growth in Medicaid patient hospital admissions outpace those for privately insured patients
One-fifth of the U.S. population has no doctor or other usual source of medical care

Research Activities, February 2011:
Many factors are likely to slow the adoption of pay for performance in dentistry
Emergency departments have increasingly become the health care safety net for adults insured by Medicaid
Poorer patients less likely to receive specific treatment for head and neck cancer

Research Activities, January 2011:
More than half of U.S. employers offered health insurance and about one-third offered dental insurance in 2006

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Research Activities, December 2010:
Fragmentation of care for complex diabetes patients may be associated with greater use of the emergency department
Uncontrolled asthma events among Massachusetts patients declined between 2002 and 2007
Blacks have longer PSA screening intervals than whites

Research Activities, November 2010:
Black and Hispanic Medicare patients with hip fracture wait longer for surgery than white patients
Premiums for some family plans cost $20,000 or more
Potentially avoidable hospitalizations high among Medicare and Medicaid patients

Research Activities, October 2010:
Health plan choices are associated with lower premiums for employees
For elderly patients with depression, cost-sharing insurance policies reduce drug use without increasing use of care
Patients with financial worries or no insurance delay going to the hospital for a heart attack
Rural elderly with dementia are hospitalized more often for conditions that primary care visits might have caught
Project helps those with spinal cord injury identify community and environmental barriers

Research Activities, September 2010:
AHRQ State Snapshots expanded to include new data on health insurance
Geographic information system reveals primary care needs of Hispanics
Public insurance linked to longer perception of disease burden among children with asthma
Physicians report care barriers for young adults with childhood onset chronic diseases
Certain patients with lupus are more likely to end up in the emergency department three or more times a year
Relative inefficiency of rural critical access hospitals must be balanced against their contributions to care access and quality
Requiring proof of citizenship cuts participation in Oregon's Medicaid family planning program
Cost of family coverage provided by employers 1.5 times more in 2009 than in 2000

Research Activities, August 2010:
Consider local health care systems when designing services for the uninsured
Men shy away from routine medical appointments
Employees in small businesses more likely to have high-premium health plans

Research Activities, July 2010:
Health plans vary widely in the prescribing of antibiotics
Community health center collaboratives improve care quality but have little impact on disparities

Research Activities, June 2010:
Annual quality and disparities reports include data on health care-associated infections, obesity, and health insurance
Medicaid MCOs don't boost care access for the disabled or lower Medicaid expenditures
Black children are more likely to be hospitalized for a ruptured appendix than white children

Research Activities, May 2010:
Hospital charges for the uninsured have soared
Children with health insurance are less likely to receive needed services if their parents are uninsured

Research Activities, April 2010:
Rural and urban residents have similar perceptions of health care quality, despite differences in care delivery
Veterans who use pharmacy services at VA facilities tend to be sicker, poorer, and have no alternative insurance
Older black women with breast cancer do not receive beneficial chemotherapy as often as white women
Many minority patients do not receive or complete colorectal cancer screening tests in urban, primary care settings
Two-thirds of State and local government workers get their health plans from their employers

Research Activities, March 2010:
Creating networks to provide social support for the homeless may improve health outcomes
Increasing the number of coronary angiography facilities led to a reduction in racial disparities in New Jersey
Neighborhood demographics play a role in access to health care for immigrant and U.S.-born Mexican Americans
Two-thirds of State and local government workers get their health plans from their employers

Research Activities, February 2010:
Immigrant labor negatively affects natives' health insurance coverage
One in 13 U.S. adults report access to specialists to be a "big problem"

Research Activities, January 2010:
Medicare payment caps on home care add to the family caregiving burden, especially among lower-income families
Persons with mental disorders switching from Medicaid to Medicare drug coverage may have drug access problems
Studies examine impact of drug caps and pay for performance on care costs and outcomes
Individuals who seek care for coughs and colds in emergency departments have social support

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Research Activities, December 2009:
Care is poor for diabetic patients without insurance and no regular care provider
Women in Michigan who suffer miscarriages may not be receiving patient-centered care

Research Activities, November 2009:
Older black women with breast cancer do not receive beneficial chemotherapy as often as white women
Medicare coverage gap may prompt some patients with diabetes to cut back on their medicines

Research Activities, October 2009:
New methods estimate the costs of covering the uninsured
Factors other than gender are associated with poor growth in urban children
Blacks are less likely than whites to receive lung cancer treatments
Premiums for some family plans cost $20,000 or more
Lack of insurance among full-time, low-income workers jumped in the past decade
Four in 10 emergency department visits are billed to public insurance
Patients are increasingly leaving hospitals against medical advice

Research Activities, September 2009:
Family insurance premiums topped $12,000 a year in 2008
Bigger tax breaks for insurance premiums expands private coverage for self-employed workers and their spouses
Studies examine the impact of both health insurance and a usual source of care on access to health care
Uninsured and partially insured patients with diabetes are less likely to be screened at Federally Qualified Health Centers
Community health workers can help poor and minority groups access some cancer screening services
Blacks and Hispanics are less likely to receive outpatient rehabilitation after hip fractures
Perceived racism among blacks boosts the odds of getting tested for HIV
Disparities persist in primary care referrals to cardiologists for cardiovascular disease

Research Activities, August 2009:
Availability of primary care results in better mental health for rural residents
Many young adults have no health insurance and no regular doctor

Research Activities, July 2009:
Fewer families can afford to purchase their own health insurance than previously thought
Underresourced clinics with more challenging patients may underlie poor chronic disease outcomes of minorities
The time spent in office visits with psychiatrists has equalized among blacks and whites in recent years
Studies explore survival and treatment disparities among black and white elderly patients with cancer
Quality and accessible primary care is linked to fewer emergency department visits by Medicaid-insured children
Family and insurance factors are linked to poorer control of children's asthma

Research Activities, June 2009:
Reports show few health care disparities eliminated, persistent variations in care, and slow pace of improvement
Medicare beneficiaries with cancer do not frequently use National Cancer Institute Cancer Centers for care
Minority children from disadvantaged families use more urgent care and less preventive care for their asthma
Use of heath care among the uninsured increases over time during the first year without insurance

Research Activities, May 2009:
State Medicaid programs vary in prior authorization policies for use of costly biologic antirheumatic drugs

Research Activities, April 2009:
Design of the public insurance plan can reduce the time to a child's first dental visit after enrollment
Some patients choose safer hospitals when an insurer offers an incentive program
More black than white women receive mammograms in St. Louis
Young women with diabetes do not receive recommended preventive services
Enrollment in a program of all-inclusive elderly care is largely a matter of luck
Depression and substance abuse treatment hospitalizations declined for Medicare beneficiaries over a decade
Children in rural areas must travel far distances to receive pediatric specialty care
Older patients stop using inhalers and end up in the hospital when insurers enact deductibles and copayments
Negative effects are seen when patients reach drug benefit thresholds in Medicare Part D
Immigrants use fewer preventive services than U.S. natives
Uninsured Americans with asthma are less likely to take daily preventive medicine

Research Activities, March 2009:
People with insurance use more health care services and have better health outcomes
Economic and housing instability are linked to poor access to health care and higher rates of hospitalization

Research Activities, February 2009:
Minority children with asthma frequently use emergency departments for care
Older black women do not receive chemotherapy as often as white women after ovarian cancer surgery
Women and blacks are less likely to receive preventive care to prevent further strokes
Mental health counseling remains persistently low from adolescence into young adulthood
Subsidies and education about the value of health insurance may help encourage the uninsured to enroll in health plans

Research Activities, January 2009:
Inpatient treatment for elderly nondementia psychiatric illnesses is shifting into less expensive settings

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