Medical Care Research and Review最新文献_第2页

Insurance Coverage Disruptions and Associated Access and Utilization, 2008 to 2022. 保险覆盖中断和相关的访问和利用，2008 - 2022。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-01 DOI: 10.1177/10775587261484437

Natalie Schwehr Mac Arthur, Jean M Abraham, Julia A Rivera Drew, Lynn A Blewett

{"title":"Insurance Coverage Disruptions and Associated Access and Utilization, 2008 to 2022.","authors":"Natalie Schwehr Mac Arthur, Jean M Abraham, Julia A Rivera Drew, Lynn A Blewett","doi":"10.1177/10775587261484437","DOIUrl":"https://doi.org/10.1177/10775587261484437","url":null,"abstract":"U.S. nonelderly adults rely on a patchwork of private and public sources for health insurance. Without universal coverage, changes in employment, income, and public policy can increase individuals' risk of coverage disruptions. Using data from the Medical Expenditure Panel Survey-Household Component, we examine changes in patterns of coverage, including transitions between sources and discontinuities (temporary or prolonged uninsurance), during three policy-relevant time periods: pre-Affordable Care Act (ACA), 2008 to 2009; post-ACA, 2015 to 2016; and the COVID-19 public health emergency, 2021 to 2022. We also examine associations of coverage patterns with health care access and utilization. Despite coverage gains, relatively high rates of coverage discontinuities persisted across the study periods, affecting 25.3% of adults in 2021 to 2022. Relative to those with continuous private coverage, individuals with coverage discontinuities were less likely to receive any office visits or prescriptions. Rates of delayed or forgone care due to cost among those with coverage discontinuities also grew significantly over time.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261484437"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Innovative Use of Rapid Qualitative Methods to Inform Neurological Services at the Department of Veterans Affairs. 创新使用快速定性方法通知退伍军人事务部神经服务。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-10-01 Epub Date: 2026-05-14 DOI: 10.1177/10775587261445776

Jacquelyn N Heuer, Andrea Kalvesmaki, Sarah Matson, Carin S Waslo, Samin Panahi, Robert George, Mary Jo Pugh

引用次数: 0

Cost-Sharing and Long Episodes of Care: The Impact of Timing of Pregnancy and Delivery on Out-of-Pocket Spending. 费用分摊和长期护理：怀孕和分娩时间对自费支出的影响。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-09-29 DOI: 10.1177/10775587261485642

Kaitlyn Camacho Orona, Rebecca A Gourevitch, Tara Shakley, Sung Min Park, Mark W Friedberg, Mary Beth Landrum, Meredith B Rosenthal, Anna D Sinaiko

{"title":"Cost-Sharing and Long Episodes of Care: The Impact of Timing of Pregnancy and Delivery on Out-of-Pocket Spending.","authors":"Kaitlyn Camacho Orona, Rebecca A Gourevitch, Tara Shakley, Sung Min Park, Mark W Friedberg, Mary Beth Landrum, Meredith B Rosenthal, Anna D Sinaiko","doi":"10.1177/10775587261485642","DOIUrl":"https://doi.org/10.1177/10775587261485642","url":null,"abstract":"Affordability of maternity care for commercially insured people is a significant policy challenge. Health insurance plan deductibles and coinsurance percentages typically apply uniformly to individuals for a 12-month \"health plan year.\" Timing of long episodes of care may not align with the health plan year, with implications for patient cost-sharing and affordability. Using detailed enrollment, benefit design, and medical claims data for a commercially insured pregnant population and adjusting for differences in patient demographic and clinical characteristics, we show that delivery timing during a patient's plan year affects their out-of-pocket spending for their maternity episode by as much as 30%. This result is most pronounced for people in high-deductible health plans, who also had higher out-of-pocket spending overall. Ensuring patients do not face additional financial burden if their pregnancy spans two benefit periods, by eliminating or restructuring cost-sharing for maternity care, is one strategy to improve affordability for patients with commercial insurance.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261485642"},"PeriodicalIF":2.7,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recommendations for Implementing the Principles of Managed Competition in an Era of Delivery System and Market Consolidation. 在递送系统和市场整合的时代实施有管理竞争原则的建议。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-09-28 DOI: 10.1177/10775587261471943

Sara J Singer, Alain C Enthoven

引用次数: 0

Primary Care Physician Organization Affiliations With Health Systems Between 2014 and 2019 Were Associated With Modest Improvements in Quality of Care. 2014年至2019年间，初级保健医生组织与卫生系统的联系与护理质量的适度改善有关。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-09-28 DOI: 10.1177/10775587261472554

Justin W Timbie, Maria DeYoreo, Denis Agniel, Shiyuan Zhang, José J Escarce

{"title":"Primary Care Physician Organization Affiliations With Health Systems Between 2014 and 2019 Were Associated With Modest Improvements in Quality of Care.","authors":"Justin W Timbie, Maria DeYoreo, Denis Agniel, Shiyuan Zhang, José J Escarce","doi":"10.1177/10775587261472554","DOIUrl":"10.1177/10775587261472554","url":null,"abstract":"We examined whether affiliation of independent primary care physician organizations (POs) with vertically-integrated health systems improved quality of care or service utilization for Original Medicare enrollees overall and for groups of POs expected to benefit from affiliation. Using national Medicare claims, Provider Enrollment, Chain, and Ownership System (PECOS), and Internal Revenue Service (IRS) Form 990 data from 2013 to 2019, we estimated changes in 13 quality and utilization measures following affiliation. We found that affiliation was not consistently associated with meaningful improvements in preventive care, chronic disease management, or utilization. Modest gains were observed in diabetic eye exams and organization-level care continuity, whereas primary care visits and specialist visits declined. Small POs exhibited additional gains in breast cancer screening relative to large POs, while low-quality POs and rural POs experienced lower relative performance on at least one other measure. These results suggest that health system affiliation alone does not yield broad improvements in quality across diverse types of primary care POs.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261472554"},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Community Characteristics Associated With Health System Penetration. 与卫生系统渗透相关的社区特征。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-09-28 DOI: 10.1177/10775587261469029

Haoyu Bi, Mark Louie Ramos, Jeannette A Rogowski, Charleen Hsuan

{"title":"Community Characteristics Associated With Health System Penetration.","authors":"Haoyu Bi, Mark Louie Ramos, Jeannette A Rogowski, Charleen Hsuan","doi":"10.1177/10775587261469029","DOIUrl":"10.1177/10775587261469029","url":null,"abstract":"Health systems have become a dominant form of health care organization in the United States, yet little is known about how their presence varies across communities. This study examined the association between the community-level characteristics and health system penetration, defined as the percentage of general acute care hospital beds affiliated with a health system in a geographic market. We found that communities with higher health system penetration tended to have lower levels of competition. In rural areas, greater insurance coverage was associated with greater penetration. In urban areas, communities without health system presence were more likely to have larger Black populations relative to White populations. However, among communities with some system presence, those with larger Black populations tended to have higher levels of penetration. Policymakers should adopt context-specific policies that encourage investment in underserved communities, promote equitable access to high-quality care, and guard against the potential adverse effects of consolidation.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"10775587261469029"},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13622977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Health Care Merger Enforcement in the 2020s: Policy Changes and Enforcement Continuity. 20世纪20年代的医疗保健合并执行：政策变化和执行连续性。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-09-28 DOI: 10.1177/10775587261472541

Cory Capps, Leyla Karakas, Matt Wohlleben

引用次数: 0

The Relationship Between Physician Organization and Health Care Use in Traditional Medicare and Medicare Advantage. 传统医疗保险和医疗保险优势中医师组织与医疗保健使用的关系。

IF 2.7 3区医学

Medical Care Research and Review Pub Date : 2026-09-28 DOI: 10.1177/10775587261477554

Laurence Baker, M Kate Bundorf, Daniel P Kessler, William Shipman

引用次数: 0

Hospital-Physician Integration and the Comprehensive Care for Joint Replacement Program. 医院-医生整合和关节置换术的综合护理。