Pills in a row

Effects of Medicare Part D on guideline-concordant pharmacotherapy for bipolar 1 disorder among dually enrolled beneficiaries

Effects of Medicare Part D on guideline-concordant pharmacotherapy for bipolar 1 disorder among dually enrolled beneficiaries

Marguerite Burns et al. examined the effect of an insurance coverage transition that occured in 2006, which shifted coverage from Medicaid to Medicare Part D private drug plans for individuals who were enrolled in both programs. In this study, the authors investigated the receipt of guideline-concordant pharmacotherapy for biopolar I disorder after the transition and found that 16 months after the transition to Part D, the number of people with any recommended use of anti-manic drugs was higher than expected, and the number of ED visits per month temporarily increased by 19% immediately after the transition.

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Diabetes sugar testing

Minority status and diabetes screening in an ambulatory population

Minority status and diabetes screening in an ambulatory population

Ethnicity has been identified as a risk factor for type 2 diabetes, as well as increased morbidity and mortality with the disease. This study looked at the effect of minority status on diabetes screening practices in an ambulatory, insured population. The authors found that minority status did not independently lead to recommended diabetes screening. Factors other than insurance or access to care may affect preventive care for minorities.

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Pills on dollar bill

Why some disabled adults in Medicaid face large out-of-pocket expenses

Why some disabled adults in Medicaid face large out-of-pocket expenses

Marguerite Burns et al. used Medical Expenditure Panel survey data to examine out-of-pocket health care spending for Medicaid enrollees aged 18-64 with disabilities. They found that the Medicaid program effectively limited out-of-pocket health costs for the majority of community-dwelling enrollees and that most of the spending is concentrated on prescription medications. However, for 10% of these enrollees, annual out-of-pocket spending was $1,200 or higher, which can be a significant cost burden for low-income individuals.

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Nurse holding a tablet and smiling

Physician assistants and nurse practitioners as a usual source of care

Physician assistants and nurse practitioners as a usual source of care

This article published in The Journal of Rural Health used Wisconsin Longitudinal study data to identify characteristics and outcomes of patients who primarily see physician assistants (PAs) or nurse practitioners (NPs). Populations served most by PA/NPs tend to live in rural areas and have public insurance or no insurance coverage. They are also more likely to be women, younger, and have lower extroversion scores. There were few differences in utilization and no reported differences in difficulties/delays in care or outcomes compared to patients that primarily see doctors. 

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Nurse pushing man in wheelchair

Medicaid managed care and health care access for adult beneficiaries with disabilities

Medicaid managed care and health care access for adult beneficiaries with disabilities

Marguerite Burns used Medical Expenditure Panel Survey and Area Resources File data in combination with Medicaid data for adults with disabilities to analyze the impact of Medicaid managed care organizations (MCOs) on health care access for adults with disabilites. She found that mandatory MCO enrollees were 25% more likely to wait over 30 minutes to see a provider, 32% more likely to report a problem with accessing a specialist, and 10% less likely to receive a flu shot. 

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Young man in wheelchair

Medicaid managed care and cost containment in the adult disabled population

Medicaid managed care and cost containment in the adult disabled population

Marguerite Burns studied the effect of Medicaid managed care organizations (MCOs) on health care expenditures for working age adults with disabilities by comparing individual monthly Medicaid expenditures across beneficiaries who reside in counties with mandatory, voluntary, and no MCOs. She found that on average, the total monthly expenditures did not differ between fee-for-service and MCO counties; however, there were some service-specific spending differences. Average monthly spending per beneficiary was higher for prescription medications in voluntary and mandatory MCO counties, and spending for other medical care and dental care was $4-11 higher per beneficiary in MCO relative to FFS counties.

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Health insurance form

Insurance disruption due to spousal Medicare transitions

Insurance disruption due to spousal Medicare transitions

In this study, researchers looked at the care of married women under age 65 from the Wisconsin Longitudinal Study. The authors found that despite consistent insurance coverage, the insurance disruption that accompanies a spouse's Medicare transition has adverse access and health care utilization consequences for women, including a greater probability of experiencing a change in usual clinic/provider, delaying filling medications or taking fewer medications than prescribed because of cost, going to the emergency room, and having lower average mental health scores than women who did not experience an insurance disruption. 

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