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Former CMMI Leader Liz Fowler Cites Rigid Federal Scoring Rules and Bureaucratic Impatience for Pilot Failures
2026 Expanding Access to Health Care Research Grants Announced
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Each year, Penn LDI awards small research grants focused on improving access to health insurance and health care. The goal is to strengthen Penn’s research capacity in this area and support work that advances access to coverage and care. These are the two Expanding Access to Health Care grants for 2026.
Evaluating the Association of Expanded Access to Medigap and Medicaid Coverage With Clinical Outcomes for Patients With End-Stage Renal Disease
Principal Investigator: Yuvaram Reddy, MBBS, MPH | Perelman School of Medicine
Patients with end-stage renal disease (ESRD) often require dialysis to survive. However, they face high out-of-pocket costs because outpatient dialysis treatments are paid through Medicare Part B, which covers only 80% of outpatient costs. Patients cover the remaining 20% through secondary insurance plans, including supplemental Medigap plans or Medicaid coverage, or by paying out of pocket.
Many states do not require Medigap plans to be offered to patients with ESRD younger than 65 at affordable rates. In addition, some states have not expanded Medicaid coverage to all individuals with incomes at or below 138% of the federal poverty level. The varied availability of Medigap and Medicaid coverage may influence whether patients delay or defer dialysis care, resulting in costly hospitalizations and higher mortality.
This project will assess whether state-level Medigap and Medicaid coverage policies are associated with kidney care outcomes. Findings will inform legislative and regulatory efforts to enhance access to affordable Medigap coverage.
Variations in Maternity Care Access in Pennsylvania, 1999–2024: Understanding Access Impacts and Opportunities for Innovation
Principal Investigator: Rebecca Clark, PhD, RN | Penn School of Nursing
Access to maternity care is a critical public health issue in the U.S. One-third of Pennsylvania’s counties do not have hospital-based maternity services. While some unit closures may result in women accessing higher-quality care, maternity care deserts are also associated with poor health outcomes and disproportionately affect marginalized patient populations, including women from racial and ethnic minority groups and rural communities.
We propose to (1) examine the effects of maternity unit closures on closure-adjacent hospitals’ organizational resources and on birth outcomes, including spontaneous vaginal birth and severe maternal morbidity and mortality, in Pennsylvania from 1999 to 2024, and (2) explore how one hospital has successfully maintained critical access in a rural area while offering evidence-based, high-quality care. We intend that this work will inform organizational decision-making for closure-adjacent hospitals and provide an example of a successful approach to improving access.
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