Medicine and Health Sciences Commons^™

Health Insurance Co-Ops: Product Availability And Premiums In Rural Counties, Erika C. Ziller Phd, Zachariah T. Croll Ba, Andrew F. Coburn Phd

Access / Insurance

Created by the Affordable Care Act (ACA), Consumer Operated and Oriented Plans (CO-OPs) are private, non-profit health insurers that were designed to increase insurance plan choice and lower premiums in the Health Insurance Marketplaces. Early analyses of the ACA suggested that CO-OPs may be particularly beneficial for rural communities, where fewer individual and small group health insurance options have traditionally been available.

This Research and Policy Brief, authored by research staff at the Maine Rural Health Research Center, explores the early availability and role of CO-OPs in rural and urban counties. We describe the regional distribution and market prevalence of …

Pharmacy Use By Dual-Eligible Non-Elderly Veterans With Private Healthcare Insurance, Brian C. Lund, Mary E. Charlton, Alan N. West

Dartmouth Scholarship

The Veterans Health Administration (VHA) is the largest nationally integrated healthcare system in the United States, operating 168 medical centers and more than 1000 community based outpatient clinics. However, many veterans seek care outside the VHA system, particularly when they are also covered by state or federal programs such as Medicare or Medicaid, or have access to private health insurance, often through employment. Concerted efforts have been made to facilitate communication and coordinate care between VHA and private sector healthcare, but concurrent use of these systems adds to an already fragmented U.S health care system.

Getting Ready For Open Enrollment: Supporting Clients Living With Hiv, Juli Powers, Mira Levinson, Naima Cozier

9th Annual Rural HIV Research and Training Conference (2014-2019)

Open Enrollment for 2017 Marketplace plans begins on November 1, 2016. Programs should prepare now to engage unenrolled and newly-eligible clients, and support clients who enrolled in previous years to compare options and find affordable, quality plans for 2017 that meet their needs. This interactive session will include strategies to engage and enroll people living with HIV in health coverage.

Palliative Chemotherapy Among People Living In Poverty With Metastasised Colon Cancer: Facilitation By Primary Care And Health Insurance, Kevin M. Gorey, Emma Bartfay, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty, Nancy L. Richter, Madhan K. Balagurusamy

Social Work Publications

Background: Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California.

Methods: We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies. Poor neighbourhoods were oversampled and the criterion was receipt of chemotherapy. Effects were described with rate ratios (RR) and tested with logistic regression models.

Results: Palliative chemotherapy was received by less than half of the participants …

Economic Windfalls And The Affordable Care Act: A Policy Proposal, Joshua Congdon-Hohman, Victor Matheson

Economics Department Working Papers

This paper identifies a major issue with windfall payments under either possible interpretation of the ACA as it currently stands. Several alternatives are proposed that would eliminate the windfalls. We advocate the establishment of a tort award funded “Federal Stabilization Fund” to improve the economic efficiency of future health care awards in the age of the Affordable Care Act

Acute Post-Disaster Medical Needs Of Patients With Diabetes: Emergency Department Use In New York City By Diabetic Adults After Hurricane Sandy., David C. Lee, Vibha K. Gupta, Brendan G. Carr, Sidrah Malik, Brandy Ferguson, Stephen P. Wall, Silas W. Smith, Lewis R. Goldfrank

Department of Emergency Medicine Faculty Papers

OBJECTIVE: To evaluate the acute impact of disasters on diabetic patients, we performed a geospatial analysis of emergency department (ED) use by New York City diabetic adults in the week after Hurricane Sandy.

RESEARCH DESIGN AND METHODS: Using an all-payer claims database, we retrospectively analyzed the demographics, insurance status, and medical comorbidities of post-disaster ED patients with diabetes who lived in the most geographically vulnerable areas. We compared the patterns of ED use among diabetic adults in the first week after Hurricane Sandy's landfall to utilization before the disaster in 2012.

RESULTS: In the highest level evacuation zone in New …

Disparities Among Minority Women With Breast Cancer Living In Impoverished Areas Of California, Sundus Haji-Jama, Kevin M. Gorey, Isaac N. Luginaah, Guangyong Zou, Caroline Hamm, Eric J. Holowaty

Social Work Publications

Background: Interaction effects of poverty and health care insurance coverage on overall survival rates of breast cancer among women of color and non-Hispanic white women were explored. Methods: We analyzed California registry data for 2,024 women of color (black, Hispanic, Asian, Pacific Islander, American Indian, or other ethnicity) and 4,276 non-Hispanic white women (Anglo-European ancestries and no Hispanic-Latin ethnic backgrounds) diagnosed with breast cancer between the years 1996 and 2000 who were then followed until 2011. The 2000 US census categorized rates of neighborhood poverty. Health care insurance coverage was either private, Medicare, Medicaid, or none. Cox regression was used …

Village Health Insurance, Michaela Domaratzky, Sean Roget

The International Undergraduate Journal For Service-Learning, Leadership, and Social Change

No abstract provided.

The Future Of Healthcare In The United States, Aaron James Deyo

Chancellor’s Honors Program Projects

No abstract provided.

A Comparison Of Hospital Utilization In Urban And Rural Areas Of South Carolina, Vivian G. Dicks

Journal of the Georgia Public Health Association

Background: Previous studies have described health care utilization based on insurance status and ethnicity. Few investigations, however, have looked at rural populations in relation to distance in securing health care.

Methods: The 2008 to 2009 Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) for South Carolina was used to assess the relationship of living in rural versus urban communities and the demographic variables related to insurance coverage. By use of bivariate and multivariate analyses, patient socio-demographic characteristics were explored for working-aged groups in relation to their income and for payer status (Medicaid or uninsured) relative to those privately …

Georgia Latino Enrollment In The Affordable Care Act: A Qualitative, Key Informant Analysis, Audrey Mcculloch, Dabney P. Evans

Journal of the Georgia Public Health Association

Background: Prior to implementation of the Affordable Care Act (ACA) in 2010, one in three Latinos in the United States were uninsured. In Georgia, a state that established a federal Marketplace, nearly half of Latinos lacked health insurance coverage going into the initial enrollment period of October 1, 2013 to April 15, 2014. The ACA provided an opportunity for these uninsured Latinos to gain health insurance coverage, thus increasing their access to necessary medical services. The purpose of this qualitative study was to explore, from the perspective of key informants, knowledge of Georgia Latinos about the ACA and perceived barriers …

The Economic Burden Attributable To A Child’S Inpatient Admission For Diarrheal Disease In Rwanda, Fidele Ngabo, Mercy Mvundura, Lauren Gazley, Maurice Gatera, Celse Rugambwa, Eugene Kayonga, Yvette Tuyishme, Jeanne Niyibaho, Jason M. Mwenda, Philippe Donnen, Philippe Lepage, Agnes Binagwaho, Deborah Atherly

Dartmouth Scholarship

Backround:

Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction.

Methods:

This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and …

Gender Differences On The Interacting Effects Of Marital Status And Health Insurance On Long-Term Colon Cancer Survival In California, 1995-2014, Derek Campbell, Kevin M. Gorey, Isaac N. Luginaah, Guangyong Zou, Caroline Hamm, Eric J. Holowaty

Social Work Publications

Objectives. Long-term colon cancer survival is not well explained by main effects. We explored the interaction of age, gender, marital status, health insurance and poverty on 10-year colon cancer survival.

Methods. California registry data were analyzed for 5,776 people diagnosed from 1995 to 2000; followed until 2014. Census data classified neighborhood poverty. We tested interactions with regressions and described them with standardized rates and rate ratios (RR).

Results. The 5-way interaction was significant, suggesting larger 4-way disadvantages among non-Medicare-eligible people. A significant 4-way interaction was a 3-way interaction in non-high poverty neighborhoods only. Private insurance was protective for unmarried …

Disparities In Access To Preventive Health Care Services Among Insured Children In A Cross Sectional Study, Christian King

Department of Nutrition and Health Sciences: Faculty Publications

Children with insurance have better access to care and health outcomes if their parents also have insurance. However, little is known about whether the type of parental insurance matters. This study attempts to determine whether the type of parental insurance affects the access to health care services of children. I used data from the 2009–2013 Medical Expenditure Panel Survey and estimated multivariate logistic regressions (N=26,152). I estimated how family insurance coverage affects the probability that children have a usual source of care, well-child visits in the past year, unmet medical and prescription needs, less than 1 dental visit per year, …

Young Adults’ Attitudes And Perceptions On Health Insurance And Their Health Insurance Literacy Levels, Law Yang

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to determine health insurance literacy levels and assess attitudes and perceptions about health insurance among young adults aged 18 – 24 years. Data for this quantitative descriptive research was collected using the Health Insurance Literacy Measurement (HILM) tool in addition to 15 developed survey items. The survey was distributed to 233 student Minnesota State University, Mankato students. Overall findings of this research indicated that among sample young adults, most of the participants had positive attitudes and perceptions towards health insurance, such viewing health insurance as something important to them and important to their health. …