Lessons for coverage expansion: A virginia primary care program for the uninsured reduced utilization and cut costs

Health Affairs

Volumn 31, Issue 2, 2012, Pages 350-359

  Bradley, Cathy J ^a   Gandhi, Sabina Ohri ^a   Neumark, David ^b   Garland, Sheryl ^c   Retchin, Sheldon M ^d  

^a VIRGINIA COMMONWEALTH UNIVERSITY   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c Health Policy and Community Relations   (United States)

^d VCU ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CONTROLLED STUDY; COST CONTROL; EMERGENCY WARD; HEALTH CARE COST; HEALTH CARE UTILIZATION; HEALTH PROGRAM; HOSPITAL ADMISSION; HUMAN; LOWEST INCOME GROUP; MAJOR CLINICAL STUDY; MEDICAL FEE; PRIMARY MEDICAL CARE; UNITED STATES;

ADULT; COST CONTROL; FEMALE; HEALTH CARE COSTS; HEALTH SERVICES; HUMANS; INSURANCE COVERAGE; MALE; MEDICALLY UNINSURED; POVERTY; VIRGINIA;

EID: 84858592706     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2011.0857     Document Type: Article

References (27)

1. Hadley J. Sicker and poorer-the consequences of being uninsured: a review of the research on the relationship between health insurance, medical care use, health, work, and income. Med Care Res Rev. 2003; 60(2 Suppl):3S-75S; discussion 76S-112S.
2. Abelson R. Uninsured put a strain on hospitals. New York Times. 2008 Dec 8.
3. Banerjee R, Ziegenfuss JY, Shah ND. Impact of discontinuity in health insurance on resource utilization. BMC Health Serv Res. 2010;10:195.
4. Antos J, Bertko J, Chernew M, Cutler D, de Brantes F, Goldman D, et al. Bending the curve through health reform implementation. Am J Manag Care. 2010;16(11):804-12.
5. Shortell SM, Casalino LP. Implementing qualifications criteria and technical assistance for accountable care organizations. JAMA. 2010; 303(17):1747-8.
6. Kaiser Family Foundation. Medicaid's new "health home" option [Internet]. Menlo Park (CA): KFF; 2011 Jan [cited 2012 Jan 3]. Available from: http://www.kff.org/Medicaid/upload/8136.pdf
7. Hurley RE, Freund DA, Paul JE. Managed care in Medicaid: lessons for policy and program design. Ann Arbor (MI): Health Administration Press; 1993.
8. Zuckerman S, Brennan N, Yemane A. Has Medicaid managed care affected beneficiary access and use? Inquiry. 2002;39(3):221-42.
9. Witek JE, Hostage JL. Medicaid managed care: problems and promise. J Ambul Care Manage. 1994; 17(1):61-9.
10. Garrett B, Davidoff AJ, Yemane A. Effects of Medicaid managed care programs on health services access and use. Health Serv Res. 2003; 38(2):575-94.
11. Macri J, Coyer C, Lynch V, Kenney G. (Urban Institute, Washington, DC). Profile of Virginia's uninsured, 2010 [Internet]. Richmond (VA): Virginia Health Care Foundation; 2011 Apr [cited 2012 Jan 3]. Map 3. Available from: http://www.vhcf.org/wpcontent/uploads/2010/10/Profileof-Virginias-Uninsured-2010.pdf
12. Statehealthfacts.org. Virginia: Medicaid/CHIP eligibility [Internet]. Washington (DC): Kaiser Family Foundation; [cited 2012 Jan 3]. Available from: http://www.statehealthfacts.org/profileind.jsp?cat=4&sub=5&rgn=48
13. Retchin SM, Garland SL, Anum EA. The transfer of uninsured patients from academic to community primary care settings. Am J Manag Care. 2009;15(4):245-52.
14. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis. 1987; 40(5):373-83.
15. Billings J, Parikh N, Mijanovich T. (New York University, New York, NY). Emergency department use in New York City: a substitute for primary care? [Internet]. New York (NY): Commonwealth Fund; 2000 Nov [cited 2012 Jan 3]. (Issue Brief). Available from: http://www.commonwealthfund.org/usr_doc/billings_eduse_433.pdf
16. Center for Health and Public Service Research. NYU Ed Algorithm [Internet]. New York (NY): The Center; [cited 2012 Jan 3]. Available from: http://wagner.nyu.edu/chpsr/index.html?p=25
17. Ballard DW, Price M, Fung V, Brand R, Reed MR, Fireman B, et al. Validation of an algorithm for categorizing the severity of hospital emergency department visits. Med Care. 2010;48(1):58-63.
18. Bureau of Labor Statistics. Consumer Price Index [Internet]. Washington (DC): The Bureau; [cited 2012 Jan 3]. Available for download from: http://www.bls.gov/cpi/
19. Census Bureau. Current Population Survey (CPS) table creator [Internet]. Washington (DC): Census Bureau; [last revised 2011 Dec 22; cited 2012 Jan 3]. Available for download from: http://www.census.gov/hhes/www/cpstc/cps_table_creator.html
20. State Health Access Data Assistance Center. When 133 equals 138: FPL calculations in the Affordable Care Act. SHADAC Blog [blog on the Internet]. Minneapolis (MN): SHADAC; 2011 Jan 13 [cited 2012 Jan 18]. Available from: http://www.shadac.org/blog/when-133-equals-138-fpl-calculations-inaffordable-care-act
21. Holahan J, Headen I (Urban Institute, Washington, DC). Medicaid coverage and spending in health reform: national and state-by-state results for adults at or below 133% [Internet]. Washington (DC): Kaiser Commission on Medicaid and the Uninsured; 2010 May [cited 2012 Jan 18]. Available from: http://www.kff.org/healthreform/upload/Medicaid-Coverage-and-Spendingin-Health-Reform-National-and-State-By-State-Results-for-Adults-ator-Below-133-FPL.pdf
22. Baicker K, Finkelstein A. The effects of Medicaid coverage-learning from the Oregon experiment. N Engl J Med. 2011;365(8):685-7.
23. Millett C, Chattopadhyay A, Bindman AB. Unhealthy competition: consequences of health plan choice in California Medicaid. Am J Public Health. 2010;100:2235-40.
24. Carlson MJ, DeVoe J, Wright BJ. Short-term impacts of coverage loss in a Medicaid population: early results from a prospective cohort study of the Oregon Health Plan. Ann Fam Med. 2006;4(5):391-8.
25. Sommers BD, Rosenbaum S. Issues in health reform: how changes in eligibility may move millions back and forth between Medicaid and insurance exchanges. Health Aff (Millwood). 2011;30(2):228-36.
26. Short PF, Swartz K, Uberoi N, Graefe D. (Pennsylvania State University, State College, PA). Realizing health reform's potential: maintaining coverage, affordability, and shared responsibility when income and employment change [Internet]. New York (NY): Commonwealth Fund; 2011 May [cited 2012 Jan 12]. (Issue Brief). Available from: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/May/1503_Short_maintaining_coverage_affordability_reform_brief.pdf
27. Weinberg M, Haase LW (New America Foundation, Washington, DC). State-based coverage solutions: the California Health Benefit Exchange [Internet]. New York (NY); Commonwealth Fund; 2011 May 31 [cited 2012 Jan 4]. Available from: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/May/1507_Weinberg_california_hlt_benefit_exchange_ib.pdf