Access to Care

The extent to which someone can gain access to the health care system, and the financial, social, and organizational factors that affect a person’s ability to get needed care in a timely way.

What State Legislators Say About Medicaid, and Why It Matters

May. 29, 2018

Medicaid’s federal-state partnership structure has long permitted states to adopt modifications to coverage design, including benefits and cost-sharing. That structure, combined with an Administration signaling its support for greater state flexibility and funding constraints, could produce substantial shifts in state Medicaid policy.

Safeguards Needed in Medicaid Work Requirements

May. 10, 2018

In a push to encourage “personal responsibility,” the Centers for Medicare and Medicaid Services (CMS) has approved work requirements as a condition for receiving Medicaid benefits in four states - Kentucky, Indiana, Arkansas, and most recently New Hampshire, with applications from other states pending.

Being Uninsured in America

Apr. 26, 2018

For the nearly 30 million people in the United States who have no health insurance, gaining access to care and paying for that care can be a challenge.  A new “secret shopper” study explores whether the uninsured can get a new primary care appointment, and at what price.

A Qualitative Exploration of Co-location as an Intervention to Strengthen Home Visiting Implementation in Addressing Maternal Child Health

Feb. 28, 2018

Katherine S. Kellom, Meredith Matone, Aderinola Adejare, Frances K. Barg, David M. Rubin, Peter F. Cronholm

Abstract [from journal]

Objectives: The aim of this paper is to explore the process and impact of co-locating evidence-based maternal and child service models to inform future implementation efforts.

Methods: As part of a state-wide evaluation of maternal and child home visiting programs, we conducted semi-structured interviews with administrators and home visitors from home visiting agencies across Pennsylvania. We collected 33 interviews from 4 co-located agencies. We used the Consolidated Framework for...

The Impact of AIDS Treatment on Savings and Human Capital Investment in Malawi

Feb. 21, 2018

Victoria Baranov and Hans-Peter Kohler

In American Economic Journal: Applied Economics, Hans-Peter Kohler and Victoria Baranov study the impact of antiretroviral therapy (ART), a treatment for AIDS, on savings and human capital investment in Malawi. In particular, they use spatial and temporal differences in ART availability to evaluate the impact of ART provision on cash savings, education expenditures, and children’s schooling.

The authors find that ART availability increases savings, expenditures on education, and children’s schooling significantly, even amongst those who are HIV-negative and thus, do not...

Association of Rideshare-Based Transportation Services and Missed Primary Care Appointments: A Clinical Trial

Research Brief
Feb. 7, 2018

In a pragmatic trial, offering complimentary ridesharing services broadly to Medicaid patients did not reduce rates of missed primary care appointments. The uptake of free rides was low, and rates of missed appointments remained unchanged at 36%. Efforts to reduce missed appointments due to transportation barriers may require more targeted approaches.

Evaluating the association between the built environment and primary care access for new Medicaid enrollees in an urban environment using Walk and Transit Scores

Jan. 24, 2018

Krisda H. Chaiyachati, Jeffrey K. Hom, Rebecca A. Hubbard, Charlene Wong, and ...

In Preventive Medicine Reports, Krisda Chaiyachati and colleagues, including Jeffrey Hom and David Grande, describe the association between the quality of an individual’s built environment, as reflected by Walk Score™ (a measure of walkability to neighborhood resources) and Transit Score™ (a measure of transit access), with having a usual source of care among low-income adults in Philadelphia. They ascertained usual source of care (other than a hospital or emergency department) with the question: “Is there a particular doctor's office, clinic, health center, or other place that...

Association of Patient Out-of-Pocket Costs With Prescription Abandonment and Delay in Fills of Novel Oral Anticancer Agents

Research Brief
Jan. 19, 2018

High out-of-pocket (OOP) costs may limit access to novel oral cancer medications. In a retrospective study, nearly one third of patients whose OOP costs were $100 to $500 and nearly half of patients whose OOP costs were more than $2,000 failed to pick up their new prescription for an oral cancer medication, compared to 10% of patients who were required to pay less than $10 at the time of purchase. Delays in picking up prescriptions were also more frequent among patients facing higher OOP costs. 

Pages