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Patient Protection and Affordable Care Act

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1. Improving the Patient Protection and Affordable Care Act's Insurance Coverage Provisions: A Position Paper From the American College of Physicians. (PubMed)

Improving the Patient Protection and Affordable Care Act's Insurance Coverage Provisions: A Position Paper From the American College of Physicians. The coverage reforms of the Patient Protection and Affordable Care Act have fundamentally changed the U.S. health care system. The law's health insurance regulations, which include protections for persons with preexisting conditions, have made health insurance more accessible. The premium tax credit and cost-sharing subsidies have made nongroup (...) coverage more affordable. The essential health benefit package and coverage for preventive services without cost sharing have made insurance more comprehensive. Perhaps most important, the Medicaid expansion extended coverage to millions of low-income adults. Despite these gains, more needs to be done to bring the United States closer to achieving universal coverage. In this position paper, the American College of Physicians recommends action to enhance and expand eligibility for health insurance

2019 Annals of Internal Medicine

2. Associations Between the Patient Protection and Affordable Care Act Medicaid Primary Care Payment Increase and Physician Participation in Medicaid. (PubMed)

Associations Between the Patient Protection and Affordable Care Act Medicaid Primary Care Payment Increase and Physician Participation in Medicaid. The Patient Protection and Affordable Care Act (ACA) increased 2013 to 2014 Medicaid payment rates for qualifying primary care physicians (PCPs) and services to higher Medicare payment levels, with the goal of improving primary care access for Medicaid enrollees.To evaluate the payment increase policy and to assess whether it was associated (...) . Regression models were used to test whether outcomes differed in months subject to higher payment rates relative to months before the increase and after the expiration of the increase in some states. The models controlled for time-invariant physician characteristics and time-varying characteristics, such as Medicaid enrollment. Interaction terms were included to estimate differential associations in subgroups of states (eg, by Medicaid managed care penetration) and physicians (eg, by specialty).Physician

2018 JAMA Internal Medicine

3. A review of the literature: differences in outcomes for uninsured versus insured critically ill patients: opportunities and challenges for critical care nurses as the patient protection and affordable care act begins open enrollment for all americans. (PubMed)

A review of the literature: differences in outcomes for uninsured versus insured critically ill patients: opportunities and challenges for critical care nurses as the patient protection and affordable care act begins open enrollment for all americans. The US health care system stands alone in its uniqueness compared with other industrialized nations. Unlike other developed nations, the United States does not provide universal health care coverage to its citizens. America relies primarily (...) and Guidelines. 2nd ed. Indianapolis, IN: Sigma Theta Tau International; 2012), 6 articles (level III and IV) were reviewed and summarized. After reviewing all the evidence, it is apparent that there are poorer patient outcomes, more specifically death in the critically ill patient population, if the patient does not have private health insurance. Current recommendations from these studies support the Patient Protection and Affordable Care Act (http://www.ehealthinsurance.com), which will take effect in 2014

2017 Dimensions of critical care nursing

4. Patient Protection and Affordable Care Act Medicaid expansion and gains in health insurance coverage and access among cancer survivors. (PubMed)

Patient Protection and Affordable Care Act Medicaid expansion and gains in health insurance coverage and access among cancer survivors. The Patient Protection and Affordable Care Act extends Medicaid coverage to millions of low-income adults, including many survivors of cancer who were unable to purchase affordable health insurance coverage in the individual health insurance market.Using data from the 2011 to 2015 Behavioral Risk Factor Surveillance System, the authors compared changes (...) found that relative gains in coverage and access were larger among those individuals residing in states with expanded Medicaid compared with those residing in nonexpansion states.The results of the current study suggest that the Patient Protection and Affordable Care Act Medicaid expansion has improved coverage and access for cancer survivors. Cancer 2018;124:2645-52. © 2018 American Cancer Society.© 2018 American Cancer Society.

2018 Cancer

5. Spillovers from the Patient Protection and Affordable Care Act to employer-sponsored dental insurance enrollment. (PubMed)

Spillovers from the Patient Protection and Affordable Care Act to employer-sponsored dental insurance enrollment. Previous study results have indicated that the Patient Protection and Affordable Care Act (ACA) health insurance expansion for dependents (called the dependent coverage expansion) also led to a dental insurance expansion for dependents. In this study, the author examines whether this expansion is due to changes in employer-sponsored dental insurance.The author compared enrollment (...) and oral health care use between 2 groups of young adults in employer-sponsored dental plans managed by Delta Dental of Michigan before and after the initial implementation of the ACA: adults aged 20 through 24 years (eligible for the expansion) and adults aged 30 through 34 years (ineligible).The ACA dependent coverage expansion led to an increase in both dental plan enrollment rates (5.38%; P < .01) and oral health care use rates (3.57%; P < .1) among adults aged 20 through 24 years relative

2018 Journal of the American Dental Association

6. Association of the Patient Protection and Affordable Care Act With Insurance Coverage for Head and Neck Cancer in the SEER Database. (PubMed)

Association of the Patient Protection and Affordable Care Act With Insurance Coverage for Head and Neck Cancer in the SEER Database. Patients with head and neck squamous cell cancer (HNSCC) are often uninsured or underinsured at the time of their diagnosis. This access to care has been shown to influence treatment decisions and survival outcomes.To examine the association of the Patient Protection and Affordable Care Act (ACA) health care legislation with rates of insurance coverage and access (...) to care among patients with HNSCC.Prospectively gathered data from the Surveillance, Epidemiology, and End Results (SEER) database were used to examine rates of insurance coverage and access to care among 89 038 patients with newly diagnosed HNSCC from January 2007 to December 2014. Rates of insurance were compared between states that elected to expand Medicaid coverage in 2014 and states that opted out of the expansion. Statistical analysis was performed from January 1, 2007, to December 31, 2014

2018 JAMA otolaryngology-- head & neck surgery

7. The Effects of the Patient Protection and Affordable Care Act on Children's Health Coverage. (PubMed)

The Effects of the Patient Protection and Affordable Care Act on Children's Health Coverage. Prior research of the impacts of the Patient Protection and Affordable Care Act (PPACA) on children's health coverage has been largely descriptive and focused on the Medicaid expansions.This study examined the causal impacts of the PPACA Medicaid expansions and of the PPACA as a whole on children's health coverage through 2016.We utilized quasiexperimental difference in differences designs to estimate

2018 Medical Care

8. Changes in Reimbursement to Emergency Physicians After Medicaid Expansion Under the Patient Protection and Affordable Care Act. (PubMed)

Changes in Reimbursement to Emergency Physicians After Medicaid Expansion Under the Patient Protection and Affordable Care Act. We examine the effect of Medicaid expansion on reimbursement for emergency physicians' professional services.We conducted a retrospective study using data from a national emergency medicine group in a sample of 50 emergency departments (EDs) from July 1, 2012, to June 30, 2015. We categorized facilities in 14 states into full-expansion (23), partial-expansion (17 (...) % confidence interval 3.7% to 15.7%) in full-expansion versus nonexpansion states. Changes in payments were driven by higher reimbursement per relative value unit; relative value units per visit declined slightly in full-expansion compared with nonexpansion states.In this sample, full Medicaid expansion increased payments for emergency physicians' professional services compared with reimbursement in nonexpansion states. Higher reimbursement was driven primarily by lower proportions of uninsured patients

2018 Annals of Emergency Medicine

9. Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act? (PubMed)

Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act? A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA).(1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private insurance (...) in a blinded survey? (2) What are the surveyed state-by-state Medicaid acceptance rates for adult orthopaedic practices in the current era of Medicaid expansion set forth by the PPACA? (3) Do surveyed rates of access to orthopaedic care in the adult patient population vary across practice setting (private vs academic) or vary with different Medicaid physician reimbursement rates? (4) Are there differences in the surveyed Medicaid acceptance rates for adult orthopaedic practices in states that have expanded

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2017 Clinical Orthopaedics and Related Research

10. Editor’s Spotlight/Take 5: Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act? (PubMed)

Editor’s Spotlight/Take 5: Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act? 28337651 2017 11 20 2018 12 02 1528-1132 475 6 2017 06 Clinical orthopaedics and related research Clin. Orthop. Relat. Res. Editor's Spotlight/Take 5: Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act? 1523-1526 10.1007/s11999-017-5320-y Leopold Seth (...) S SS Clinical Orthopaedics and Related Research®, 1600 Spruce St., Philadelphia, PA, 19103, USA. sleopold@clinorthop.org. eng Editorial Comment 2017 03 23 United States Clin Orthop Relat Res 0075674 0009-921X AIM IM Clin Orthop Relat Res. 2017 Jun;475(6):1527-1536 28224441 Adult Health Services Accessibility Humans Insurance, Health Medicaid Orthopedics Patient Protection and Affordable Care Act United States 2017 03 06 2017 03 10 2017 3 25 6 0 2017 11 29 6 0 2017 3 25 6 0 ppublish 28337651

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2017 Clinical Orthopaedics and Related Research

11. The Patient Protection and Affordable Care Act dependent coverage expansion: Disparities in impact among young adult oncology patients. (PubMed)

The Patient Protection and Affordable Care Act dependent coverage expansion: Disparities in impact among young adult oncology patients. Private health insurance is associated with improved outcomes in patients with cancer. However, to the authors' knowledge, little is known regarding the impact of the Patient Protection and Affordable Care Act Dependent Coverage Expansion (ACA-DCE), which extended private insurance to young adults (to age 26 years) beginning in 2010, on the insurance status (...) of young adults with cancer.The current study was a retrospective, population-based analysis of hospitalized young adult oncology patients (aged 22-30 years) in California during 2006 through 2014 (11,062 patients). Multivariable regression analyses examined factors associated with having private insurance. Results were presented as adjusted odds ratios and 95% confidence intervals. A difference-in-difference analysis examined the influence of the ACA-DCE on insurance coverage by race/ethnicity

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2017 Cancer

12. Areas of Potential Impact of the Patient Protection and Affordable Care Act on EMS: A Synthesis of the Literature (PubMed)

Areas of Potential Impact of the Patient Protection and Affordable Care Act on EMS: A Synthesis of the Literature This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes.We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal (...) law pertaining to EMS.Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems. New Medicaid enrollees and changes to existing coverage plans may alter EMS transport volumes. Reimbursement changes such as adjustments to the ambulance inflation factor (AIF) alter the yearly increases in EMS reimbursement by incorporating the multifactor productivity value into yearly reimbursement adjustments. New initiatives, funded by the Center for Medicare

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2017 Western Journal of Emergency Medicine

13. A systems thinking approach to analysis of the Patient Protection and Affordable Care Act. (PubMed)

A systems thinking approach to analysis of the Patient Protection and Affordable Care Act. The public health community is challenged with understanding the many complexities presented by systems thinking and its applications in systems modeling. The model presented encompasses multiple variables needed (eg, model building) for the construction of a conceptual system model of the Patient Protection and Affordable Care Act (ACA). The model tracks the ACA from inception, through passage, March (...) 2010, to its current state. Justification for the need to reform the current health care system rests, in part, on the heels of social justice. Proponents of the ACA have long argued that health reform was needed by the millions of uninsured person who suffered from health disparities, took little advantage of health prevention advice, and faced issues of access to providers as well as insurers. In addition the ACA seeks to address our uncontrollable spending on health care delivery. This article

2017 Journal of Public Health Management and Practice

14. Integrating community health workers within Patient Protection and Affordable Care Act implementation. (PubMed)

Integrating community health workers within Patient Protection and Affordable Care Act implementation. The Patient Protection and Affordable Care Act's (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation (...) implementation of PPACA if the capacity and potential of CHWs to serve as cultural brokers and bridges among medically underserved communities and health care delivery systems is fully tapped. Patient Protection and Affordable Care Act and current payment structures provide an unprecedented and important vehicle for integrating and sustaining CHWs as part of these new delivery and enrollment models.

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2017 Journal of Public Health Management and Practice

15. Support for Government Provision of Health Care and the Patient Protection and Affordable Care Act (PubMed)

Support for Government Provision of Health Care and the Patient Protection and Affordable Care Act Since the 1930s, US politicians have argued about whether healthcare should be the responsibility of the federal government. Both major political parties have cited public opinion concerning Americans' support for or rejection of government provision of healthcare to support their position. With the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, however, the political

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2016 Public Opinion Quarterly

16. Implications of the Patient Protection and Affordable Care Act on Insurance Coverage and Rehabilitation Use Among Young Adult Trauma Patients. (PubMed)

Implications of the Patient Protection and Affordable Care Act on Insurance Coverage and Rehabilitation Use Among Young Adult Trauma Patients. Trauma is the leading cause of death and disability among young adults, who are also among the most likely to be uninsured. Efforts to increase insurance coverage, including passage of the Patient Protection and Affordable Care Act (ACA), were intended to improve access to care and promote improvements in outcomes. However, despite reported gains (...) in coverage, the ACA's success in promoting use of high-quality care and enacting changes in clinical end points remains unclear.To assess for observed changes in insurance coverage and rehabilitation use among young adult trauma patients associated with the ACA, including the Dependent Coverage Provision (DCP) and Medicaid expansion/open enrollment, and to consider possible insurance and rehabilitation differences between DCP-eligible vs -ineligible patients and among stratified demographic and community

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2016 JAMA surgery

17. Early impact of the Patient Protection and Affordable Care Act on insurance among young adults with cancer: Analysis of the dependent insurance provision. (PubMed)

Early impact of the Patient Protection and Affordable Care Act on insurance among young adults with cancer: Analysis of the dependent insurance provision. The Patient Protection and Affordable Care Act (ACA) included provisions to extend dependent health care coverage up to the age of 26 years in 2010. The authors examined the early impact of the ACA (before the implementation of insurance exchanges in 2014) on insurance rates in young adults with cancer, a historically underinsured group.Using (...) insurance after the ACA among young adults who were eligible (those aged 18-25 years) and ineligible (those aged 26-29 years) for policy changes.Among 39,632 young adult cancer survivors, the authors found an increase in overall insurance rates in those aged 18 to 25 years after the dependent provisions (83.5% for pre-ACA vs 85.4% for post-ACA; P<.01), but not among individuals aged 26 to 29 years (83.4% for pre-ACA vs 82.9% for post-ACA; P = .38). After adjusting for patient sociodemographics

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2016 Cancer

18. Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings. (PubMed)

Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings. To conduct a systematic literature review of selected major provisions of the Affordable Care Act (ACA) pertaining to expanded health insurance coverage. We present and synthesize research findings from the last 5 years regarding both the immediate and long-term effects of the ACA. We conclude with a summary and offer a research agenda for future studies.We (...) of health insurance continues to be a concern for many people and disparities persist by geography, race/ethnicity, and income. Early evidence also indicates improvements in access to and affordability of health care. All of these changes are certain to ultimately impact state and federal budgets.The ACA will either directly or indirectly affect almost all Americans. As new and comprehensive data become available, more rigorous evaluations will provide further insights as to whether the ACA has been

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2016 Health Services Research

19. Vulnerable Hospitals and Cancer Surgery Readmissions: Insights into the Unintended Consequences of the Patient Protection and Affordable Care Act. (PubMed)

Vulnerable Hospitals and Cancer Surgery Readmissions: Insights into the Unintended Consequences of the Patient Protection and Affordable Care Act. Penalties from the Hospital Readmission Reduction Program can push financially strained, vulnerable patient-serving hospitals into additional hardship. In this study, we quantified the association between vulnerable hospitals and readmissions and examined the respective contributions of patient- and hospital-related factors.A total of 110,857 (...) patients who underwent major cancer operations were identified from the 2004-2011 State Inpatient Database of California. Vulnerable hospitals were defined as either self-identified safety net hospitals (SNHs) or hospitals with a high percentage of Medicaid patients (high Medicaid hospitals [HMHs]). We used multivariable logistic regression to determine the association between vulnerable hospitals and readmission. Patient and hospital contributions to the elevation in odds of readmission were assessed

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2016 Journal of the American College of Surgeons

20. Patient Protection and Affordable Care Act

Patient Protection and Affordable Care Act Patient Protection and Affordable Care Act Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Patient Protection and Affordable Care Act Patient Protection and Affordable Care Act Aka: Patient Protection and Affordable Care Act , Affordable Care Act , Health Insurance Marketplace II. Definitions Affordable Care Act Most U.S. citizens will require enrollment in a health insurance plan by 2014 Those without a health plan will be penalized Low income assistance (e.g. individuals making less than $45,000/year) Very low-income assistance via Medicare Health Insurance Marketplace (health insurance

2018 FP Notebook

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