Affordable Care Act Provision Leads to More
Efficient ED Use, New Study Suggests
A new study indicates that the Affordable Care Act’s expansion of
coverage for dependents has increased the efficiency of medical care delivery by
reducing non-urgent emergency department (ED) use among young adults. The study
by a team of researchers, including one from AHRQ, found that the Affordable
Care Act’s dependent coverage provision, which allows young adults to stay on
their parents’ private health plan until age 26, was associated with a modest
decrease in the use of hospital EDs. In the study, researchers examined data
from more than 17 million ED visits over a 5-year period (2007–2011) from AHRQ’s
Healthcare Cost and Utilization Project. They found that the quarterly ED-visit
rate decreased by a small but statistically significant amount (1.6 per 1,000
population) among young adults after the implementation of the Affordable Care
Act provision. The study, “Changes in Emergency Department Use Among Young
Adults After the ACA’s Dependent Coverage Provision,” was published March 10 in
the journal Annals of Emergency Medicine.
Expanding Medicaid to Parents Is Associated With
Increased Coverage for Children, According to AHRQ Study
An AHRQ-funded study published in the journal
JAMA Pediatrics found that children whose parents applied for and
received Medicaid insurance had a higher probability of also being covered. The
study assessed results of Oregon’s expansion of Medicaid in 2008 when uninsured,
low-income individuals were randomly selected to apply for coverage. The study
found that parents selected to apply for Medicaid conveyed 18 percent higher
odds of their children also getting coverage within the first six months.
Children of parents who both applied for and later obtained Medicaid had more
than double the odds of receiving coverage compared with children whose parents
were not selected. These results demonstrate a causal link between parents’
access to Medicaid coverage and their children’s coverage, researchers said. The
study, “Effect of Expanding Medicaid for Parents on Children’s Health Insurance
Coverage: Lessons From the Oregon Experiment,” and abstract were published January 5.
Study Finds No Awareness of Home Health Agency Quality Reports
Despite state and federal efforts in
publishing quality and satisfaction ratings designed to assist consumers when
choosing health care providers, a recent AHRQ-funded study found no awareness of
the existence of such reports on home health agencies. This study examined how
patients selected a home health agency for care following hospital discharge.
The study and abstract, “A Qualitative Study of Choosing Home
Health Care After Hospitalization: The Unintended Consequences of ‘Patient
Choice’ Requirements,” appeared online January 9 in the Journal of General
Internal Medicine. Thirteen consumers and 28 case managers from five
hospitals participating in the study were all unaware of existing state or
Medicare home health agency public reports, thereby limiting consumers’ ability
to make informed decisions and their case managers’ ability to assist them. Case
managers felt unable to respond to consumers’ requests for help in choosing a
home health agency because they did not have additional information and feared
violating federal laws concerning patient choice. Authors noted that public
reports can be marketed as tools that case managers can use to help patients
choose among providers, while supporting patient autonomy.
Announces Funding Opportunity for Ambulatory, Long-Term Care Patient Safety
AHRQ is launching a major initiative to
expand patient safety research beyond hospitals. To that end, AHRQ recently
released a Funding Opportunity Announcement (FOA) for
research in ambulatory and long-term care settings. There is a growing need to
generate new knowledge and reexamine available evidence for improving patient
safety in ambulatory settings and resident safety in long-term care settings. To
address this need, AHRQ is seeking grant proposals to expand the scientific
evidence, strategies and tools available for improving safety in ambulatory
and/or long-term care settings. It is expected that the results of these
projects will add to the existing knowledge base as AHRQ seeks to make care
safer in all health care settings. The FOA features a call for proposals with a
specific research focus on understanding and eliminating disparities in
ambulatory patient and resident safety. Submissions are due by April 27 and can
be accepted as early as March 27. Total costs awarded under this announcement
are capped at $500,000 a year and $1.5 million for the entire project period.
The project period may not exceed three years. For more information, contact
AHRQ’s Center for Quality Improvement and
Patient Safety or phone 301-427-1515.
AHRQ is offering TeamSTEPPS Master Training
online as free accredited continuing education for health care professionals
interested in improving patient safety and health care quality. TeamSTEPPS is an
evidence-based teamwork approach to improve communication and teamwork skills
among health care professionals. Spaces are available now in the virtual course.
In order to review course options, register and enroll in a course, health care
professionals must create an account. Registration is open.
AHRQ in the Professional
Butler JM, Carter M, Hayden C, et al.
Understanding adoption of a personal health record in rural health care clinics:
revealing barriers and facilitators of adoption including attributions about
potential patient portal users and self-reported characteristics of early
adopting users. AMIA Annu Symp Proc. 2013 Nov 16; 2013:152-61. Select
to access the abstract on PubMed®.
Dixon BE, Lai PT, Grannis SJ. Variation in
information needs and quality: implications for public health surveillance and
biomedical informatics. AMIA Annu Symp Proc. 2013 Nov 16; 2013:670-9.
Select to access the abstract on PubMed®.
Bleser WK, Miller-Day M, Naughton D, et al.
Strategies for achieving whole-practice engagement and buy-in to the
patient-centered medical home. Ann Fam Med. 2014 Jan-Feb;12(1):37-45.
Select to access the abstract on PubMed®.
Barocas DA, Chen V, Cooperberg M, et al.
Using a population-based observational cohort study to address difficult
comparative effectiveness research questions: the CEASAR study. J Comp Eff
Res. 2013 Jul; 2(4):445-60. Select to access the abstract on PubMed®.
Cooper WO, Cheetham TC, Li DK, et al. Brief
report: Risk of adverse fetal outcomes associated with immunosuppressive
medications for chronic immune-mediated diseases in pregnancy. Arthritis
Rheumatol. 2014 Feb;66(2):444-50. Select to access the abstract on PubMed®.
Raju MG, Pachika A, Punnam SR, et al. Statin
therapy in the reduction of cardiovascular events in patients undergoing
intermediate-risk noncardiac, nonvascular surgery. Clin Cardiol. 2013
Aug;36(8):456-61. Epub 2013 May 13. Select to access the abstract on PubMed®.
Campbell NL, Unverzagt F, LaMantia MA, et al.
Risk factors for the progression of mild cognitive impairment to
dementia. Clin Geriatr Med. 2013 Nov;29(4):873-93. Select to access the
abstract on PubMed®.
Palar K, Mendel P, Derose KP. The
organization of HIV and other health activities within urban religious
congregations.J Urban Health. 2013 Oct;90(5):922-33. Select to access
the abstract on PubMed®.
Please address comments and questions about
the AHRQ Electronic Newsletter to Jeff Hardy at: (301) 427-1248 or Jeff.Hardy@ahrq.hhs.gov.