2025
The Shadow Price of Uncertainty: Consequences of Unpredictable Insurance Coverage for Access, Care, and Financial Security
SCHLESINGER M, BHAUMIK D. The Shadow Price of Uncertainty: Consequences of Unpredictable Insurance Coverage for Access, Care, and Financial Security. Milbank Quarterly 2025, 103: 440-479. PMID: 40292705, PMCID: PMC12185371, DOI: 10.1111/1468-0009.70006.Peer-Reviewed Original ResearchConceptsHealth insurance reformInsurance reformAmerican householdsInsurance coverageHealth care reform strategiesMedical expensesPrice of uncertaintyHealth insurance coverageReducing financial insecurityPatient Protection and Affordable Care ActAffordable Care ActReform strategiesAnd Affordable Care ActShadow pricesInsurance provisionEstimate regressionsStructural reformsCoverage shortfallsHealth insuranceHousehold characteristicsCare ActFinancial securityInsurancePolicy purchaseHouseholdsQuality of gastrointestinal surgical oncology care according to insurance status
Butensky S, Kerekes D, Bakkila B, Billingsley K, Ahuja N, Johnson C, Khan S. Quality of gastrointestinal surgical oncology care according to insurance status. Journal Of Gastrointestinal Surgery 2025, 29: 101961. PMID: 39800081, DOI: 10.1016/j.gassur.2025.101961.Peer-Reviewed Original ResearchConceptsMedicare-insured patientsNational Cancer DatabaseAdequate lymphadenectomyNegative marginsCancer DatabaseRetrospective study of adult patientsStudy of adult patientsSurvival analysisInsurance statusReceipt of lymphadenectomyCurative-intent resectionGastrointestinal (GI) cancersIncreased risk of deathMultivariate survival analysisAdequacy of lymphadenectomyCox proportional hazards modelsRisk of deathProportional hazards modelResection marginsSurgical oncology careAdjuvant therapyRetrospective studyAdult patientsBiliary organismsLymphadenectomy
2023
Insurance-Based Disparities in Stroke Center Access in California: A Network Science Approach
Zachrison K, Hsia R, Schwamm L, Yan Z, Samuels-Kalow M, Reeves M, Camargo C, Onnela J. Insurance-Based Disparities in Stroke Center Access in California: A Network Science Approach. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009868. PMID: 37746725, PMCID: PMC10592016, DOI: 10.1161/circoutcomes.122.009868.Peer-Reviewed Original ResearchConceptsInsurance-based disparitiesStroke centersEmergency departmentHospital clustersInitial emergency departmentIschemic stroke admissionsHospital emergency departmentClusters of hospitalsLogistic regression modelsStroke admissionsUninsured patientsPatient insuranceLower oddsPatientsLess strokeCenter accessOddsCenter transferHospitalLikelihood of transferInsurance groupsRegression modelsLower proportionDepartmentAssociationThe Cost Shifting Economics of United States Emergency Department Professional Services (2016–2019)
Pines J, Zocchi M, Black B, Carr B, Celedon P, Janke A, Moghtaderi A, Oskvarek J, Venkatesh A, Venkat A, Group A. The Cost Shifting Economics of United States Emergency Department Professional Services (2016–2019). Annals Of Emergency Medicine 2023, 82: 637-646. PMID: 37330720, DOI: 10.1016/j.annemergmed.2023.04.026.Peer-Reviewed Original ResearchMeSH KeywordsAgedCost AllocationEmergency Service, HospitalHumansInsurance, HealthMedicaidMedically UninsuredMedicareUnited StatesConceptsNationwide Emergency Department SampleED visitsCommercial insuranceUninsured ED visitsEmergency Department SampleHealth Care Cost InstituteUnreimbursed careED cliniciansMedicaid visitsPatientsInsurance sourceMedicare visitsVisitsMedicaidHealth insuranceLongstanding effectsMedicareCliniciansProfessional servicesInsuranceMultidimensional financial hardship among uninsured and insured young adult patients with metastatic breast cancer
Wheeler S, Spencer J, Manning M, Samuel C, Reeder‐Hayes K, Greenup R, Spees L, Rosenstein D. Multidimensional financial hardship among uninsured and insured young adult patients with metastatic breast cancer. Cancer Medicine 2023, 12: 11930-11940. PMID: 37148550, PMCID: PMC10242847, DOI: 10.1002/cam4.5885.Peer-Reviewed Original ResearchAvailability of Specific Programs and Medications for Addiction Treatment to Vulnerable Populations: Results from the Addiction Treatment Locator, Assessment, and Standards (ATLAS) Survey
Oldfield B, Chen K, Joudrey P, Biegacki E, Fiellin D. Availability of Specific Programs and Medications for Addiction Treatment to Vulnerable Populations: Results from the Addiction Treatment Locator, Assessment, and Standards (ATLAS) Survey. Journal Of Addiction Medicine 2023, 17: 477-480. PMID: 37579115, DOI: 10.1097/adm.0000000000001158.Peer-Reviewed Original Research
2022
Racial/Ethnic Disparities in Postpartum Health Insurance Coverage Among Rural and Urban U.S. Residents
Kozhimannil K, Interrante J, Ibrahim B, Chastain P, Millette M, Daw J, Admon L. Racial/Ethnic Disparities in Postpartum Health Insurance Coverage Among Rural and Urban U.S. Residents. Journal Of Women's Health 2022, 31: 1397-1402. PMID: 36040353, PMCID: PMC9618367, DOI: 10.1089/jwh.2022.0169.Peer-Reviewed Original ResearchMeSH KeywordsEthnicityFemaleHumansInfant, NewbornInsurance CoverageInsurance, HealthMedicaidMedically UninsuredPostpartum PeriodPregnancyUnited StatesConceptsHealth insurance coverageUrban U.S. residentsInsurance coverageMedicaid coveragePregnancy Risk Assessment Monitoring SystemHealth-related outcomesTime of childbirthUrban U.S. countiesU.S. residentsWhite peoplePolicy effortsMaternal deathsRacial/ethnic disparitiesPostpartum yearMeasure continuityInsurance disruptionsChildbirthRural residentsReduce inequalitiesPostpartumUrban residentsPrivate insuranceThree-quartersMedicaidU.S. countiesInsurance and Health Care Outcomes in Regions Where Undocumented Children Are Medicaid-Eligible.
Rosenberg J, Shabanova V, McCollum S, Sharifi M. Insurance and Health Care Outcomes in Regions Where Undocumented Children Are Medicaid-Eligible. 2022, 150 PMID: 36004541, PMCID: PMC10171371, DOI: 10.1542/peds.2022-057034.Peer-Reviewed Original ResearchConceptsHealth care utilizationStates/territoriesCare utilizationPreventive health care utilizationNon-English primary languageHealth care utilization measuresMultivariable Poisson regressionUS states/territoriesHealth care outcomesPositive health outcomesAssociation of residencePreventive visitsPublic health insuranceDental careRelative riskChild healthCare outcomesHealth outcomesPoisson regressionInsurance eligibilityUtilization measuresHealth insuranceUninsuranceChildrenHigher uninsurancePatient cost consciousness in the emergency department
Gaylor JM, Chan E, Parwani V, Ulrich A, Rothenberg C, Venkatesh A. Patient cost consciousness in the emergency department. The American Journal Of Emergency Medicine 2022, 61: 61-63. PMID: 36054987, DOI: 10.1016/j.ajem.2022.08.039.Peer-Reviewed Original ResearchMeSH KeywordsConsciousnessEmergency Service, HospitalFees and ChargesHumansMedically UninsuredMedicareUnited StatesConceptsEmergency departmentPocket costsED patientsLarge academic hospital systemAcademic hospital systemCertain patient demographicsEmergency department settingPerceptions of patientsCost of careMedicare/MedicaidPatient demographicsED careUnscheduled careUninsured patientsDepartment settingPatients' estimatesPatient's abilityEmergency careHigh school educationPatientsPrivate insuranceFinal analysisHospital systemCareConvenience sampleUniversal healthcare as pandemic preparedness: The lives and costs that could have been saved during the COVID-19 pandemic
Galvani AP, Parpia AS, Pandey A, Sah P, Colón K, Friedman G, Campbell T, Kahn JG, Singer BH, Fitzpatrick MC. Universal healthcare as pandemic preparedness: The lives and costs that could have been saved during the COVID-19 pandemic. Proceedings Of The National Academy Of Sciences Of The United States Of America 2022, 119: e2200536119. PMID: 35696578, PMCID: PMC9231482, DOI: 10.1073/pnas.2200536119.Peer-Reviewed Original ResearchCharges for Initial Visits for Uninsured Patients at Musculoskeletal Urgent Care Centers in the US
Yousman LC, Hsiang WR, Khunte A, Najem M, Jin G, Mosier-Mills A, Jain S, Wiznia D. Charges for Initial Visits for Uninsured Patients at Musculoskeletal Urgent Care Centers in the US. JAMA Network Open 2022, 5: e229968. PMID: 35503219, PMCID: PMC9066286, DOI: 10.1001/jamanetworkopen.2022.9968.Peer-Reviewed Original ResearchMeSH KeywordsAmbulatory Care FacilitiesFees and ChargesHumansInsurance CoverageMedicaidMedically UninsuredUnited StatesConceptsNew patient visitsUrgent care centersUninsured patientsCare centerPatient visitsPocket chargesClinic policiesZip codesMedicaid reimbursementUrgent care center visitsState Medicaid expansion statusPatient office visitsMedicaid expansion statusMedian incomePrimary outcomeInitial visitMedicaid insuranceOffice visitsEmergency departmentUrgent careMAIN OUTCOMEUnderinsured patientsCenter visitsState Medicaid reimbursement ratesPatientsThe extent to which geography explains one of trauma’s troubling trends: Insurance-based differences in appropriate interfacility transfer
Zogg CK, Schuster KM, Maung AA, Davis KA. The extent to which geography explains one of trauma’s troubling trends: Insurance-based differences in appropriate interfacility transfer. Journal Of Trauma And Acute Care Surgery 2022, 93: 686-694. PMID: 35293375, PMCID: PMC9470786, DOI: 10.1097/ta.0000000000003605.Peer-Reviewed Original ResearchMeSH KeywordsAdultGeographyHumansInsurance CoverageMedically UninsuredPatient TransferRetrospective StudiesTrauma CentersUnited StatesConceptsNontrauma centersEmergency departmentMajor injuriesTrauma centerSignificant geographic variationInsurance-based differencesRisk-adjusted oddsLarge trauma centersNeighborhood socioeconomic disadvantageHierarchical logistic regressionInsured adultsTransfer patientsInsurance statusInterfacility transferStratified analysisED claimsUninsured adultsLevel IIISecondary objectiveTriage patternsDeprived populationsLogistic regressionInjurySocioeconomic disadvantageAdmission differencesPayer-Level Care Coordination and Re-admission to Acute Mental Health Care for Uninsured Individuals
Proctor SL, Gursky-Landa B, Kannarkat JT, Guimaraes J, Newcomer JW. Payer-Level Care Coordination and Re-admission to Acute Mental Health Care for Uninsured Individuals. The Journal Of Behavioral Health Services & Research 2022, 49: 385-396. PMID: 35194730, DOI: 10.1007/s11414-022-09789-1.Peer-Reviewed Original ResearchConceptsAcute care episodeCare coordinationCare episodesAcute mental health careCare coordination programAcute care servicesLong-term outcomesAcute care settingAdministrative claims dataMental health careSafety net systemUsual careCare settingsClaims dataCare servicesUninsured individualsCoordination programHealth careCarePatientsResidential servicesEpisodesReduced ratesSignificant cost savingsCost savingsEmergency Department Use by Children and Youth with Mental Health Conditions: A Health Equity Agenda
Hoge MA, Vanderploeg J, Paris M, Lang JM, Olezeski C. Emergency Department Use by Children and Youth with Mental Health Conditions: A Health Equity Agenda. Community Mental Health Journal 2022, 58: 1225-1239. PMID: 35038073, PMCID: PMC8762987, DOI: 10.1007/s10597-022-00937-7.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentChildEmergency Service, HospitalHealth EquityHumansMedically UninsuredMental HealthReferral and ConsultationConceptsMental health conditionsEmergency departmentHealth conditionsEmergency department useReferral of childrenBehavioral health professionalsED visitsED useDepartment useHealth equity agendaEvidence-based assessmentHealth professionalsForm of careHealth inequitiesHealth equityMental healthHealthcare qualityWhite childrenSuch childrenChildrenReferralAfrican AmericansFact sheetsCompelling evidenceLatinx childrenUnderstanding the Implications of Medicaid Expansion for Cancer Care in the US
Ermer T, Walters SL, Canavan ME, Salazar MC, Li AX, Doonan M, Boffa DJ. Understanding the Implications of Medicaid Expansion for Cancer Care in the US. JAMA Oncology 2022, 8: 139-148. PMID: 34762101, DOI: 10.1001/jamaoncol.2021.4323.Peer-Reviewed Original ResearchMeSH KeywordsHumansInsurance CoverageInsurance, HealthMedicaidMedically UninsuredNeoplasmsPatient Protection and Affordable Care ActUnited StatesConceptsUS cancer populationCancer careMedicaid expansionCancer populationEligibility criteriaHealth policy initiativesHealth policy factorsOncology teamAffordable Care ActInsurance statusOncological careMedicaid coverageExpansion of MedicaidUninsured individualsCancer treatmentInsurance profileCareInterpretation of findingsPatient ProtectionHealth insuranceMedicaidCare ActSignificant changes
2021
Meeting Dermatologic Needs in an Uninsured Population: Lessons Learned from a Referrals Cohort at a Student-Run Free Clinic.
Mirza FN, Valladares HC, Richards B, Suozzi KC. Meeting Dermatologic Needs in an Uninsured Population: Lessons Learned from a Referrals Cohort at a Student-Run Free Clinic. The Yale Journal Of Biology And Medicine 2021, 94: 459-464. PMID: 34602883, PMCID: PMC8461580.Peer-Reviewed Original ResearchMeSH KeywordsCOVID-19HumansMedically UninsuredPandemicsReferral and ConsultationSARS-CoV-2Student Run ClinicUnited StatesAssociations of Medicaid Expansion With Access to Care, Severity, and Outcomes for Acute Ischemic Stroke
McGee B, Seagraves K, Smith E, Xian Y, Zhang S, Alhanti B, Matsouaka R, Reeves M, Schwamm L, Fonarow G. Associations of Medicaid Expansion With Access to Care, Severity, and Outcomes for Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007940. PMID: 34587752, DOI: 10.1161/circoutcomes.121.007940.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeLow-income cohortSkilled nursing facilitiesIschemic strokeMedicaid expansionStroke admissionsNonexpansion statesNursing facilitiesLow-income US populationHigh stroke burdenPrimary stroke preventionOdds of dischargeIschemic stroke admissionsExpansion statesSeverity of presentationLevel of disabilityReceipt of rehabilitationHealth insurance statusHealth insurance coverageHospital mortalityUninsured hospitalizationsStroke preventionDischarge dispositionStroke burdenStroke outcomeFinancial Hardship From Medical Bills Among Adults With Chronic Liver Diseases: National Estimates From the United States
Lago‐Hernandez C, Nguyen NH, Khera R, Loomba R, Asrani SK, Singh S. Financial Hardship From Medical Bills Among Adults With Chronic Liver Diseases: National Estimates From the United States. Hepatology 2021, 74: 1509-1522. PMID: 33772833, DOI: 10.1002/hep.31835.Peer-Reviewed Original ResearchConceptsChronic liver diseaseInsurance Status and Continuity for Young Adults With First-Episode Psychosis
Golberstein E, Busch SH, Sint K, Rosenheck RA. Insurance Status and Continuity for Young Adults With First-Episode Psychosis. Psychiatric Services 2021, 72: 1160-1167. PMID: 33971726, PMCID: PMC8488003, DOI: 10.1176/appi.ps.201900571.Peer-Reviewed Original ResearchConceptsFirst-episode psychosisInsurance statusPeriods of uninsurancePublic insuranceMedical Expenditure Panel StudyCoordinated care interventionQuality of careSimilar age groupLevels of uninsuranceRAISE-ETPMedication adherenceTreatment continuityCare interventionsEpisode psychosisGeneral populationAge groupsStudy participantsBivariate comparisonsYoung adultsExperimental interventionSimilar ageUninsuranceLongitudinal dataAdultsInsurance changesUrology Residency Training in Medically Underserved Areas Through the Integration of a Federally Qualified Health Center Rotation
Javier-DesLoges JF, Segal D, Khan A, Abello A, Motamedinia P, Hittelman AB, Rosoff J, Stroup R, Leapman MS. Urology Residency Training in Medically Underserved Areas Through the Integration of a Federally Qualified Health Center Rotation. Urology 2021, 149: 52-57. PMID: 33421443, DOI: 10.1016/j.urology.2020.11.057.Peer-Reviewed Original ResearchConceptsHealth professional shortage areasMedically Underserved AreasUnderserved areasUrology residency trainingResidency trainingMajority of residentsQualified health centersRetrospective reviewUnique patientsUrologic carePatient visitsHealth centersFavorable satisfactionPatientsFQHCsShortage areasCommunity-based organizationsUrology residentsExposureResidentsCystoscopySurgeryReviewClinicMajority
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