Financial assistance for low-income Medicare beneficiaries: Using natural experiments to assess effects on care and health outcomes

为低收入医疗保险受益人提供经济援助：利用自然实验评估对护理和健康结果的影响

基本信息

批准号：
10355440
负责人：
Eric T Roberts
金额：
$ 12.17万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-03-07 至 2023-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10355440
关键词：
Financial assistance low income Medicare

项目摘要

PROJECT SUMMARY / ABSTRACT This AHRQ Mentored Research Scientist Career Development Award (K01) for Dr. Eric T. Roberts, an assistant professor of health policy and management at the University of Pittsburgh Graduate School of Public Health, will establish Dr. Roberts as a health economist with expertise in health insurance and health care policy for aging and low-income populations. Research proposed for this K01 award will harness natural experiments created by eligibility thresholds and policy variation within Medicare subsidy programs to rigorously evaluate how these programs affect patients' use of care, access to providers, and health. This project will focus on two subsidy programs for low-income Medicare beneficiaries: the Medicare Savings Programs (MSPs), which are partial Medicaid benefits that defray out-of-pocket costs for physician services and inpatient care, and the Part D Low-Income Subsidy (LIS), which helps to pay for prescription drugs. Using the Health and Retirement Study linked to Medicare and Medicaid claims, Dr. Roberts will examine how discontinuities in subsidy eligibility affect patients' use of care—including medication adherence, physician visits, and hospitalizations—and health status. Dr. Roberts will also examine the relationship between state Medicaid policies—specifically, provider payment rates and rules for recertifying program eligibility—with MSP enrollment and patients' access to care. Evidence generated from this research can guide reforms to increase the benefits of the MSPs and LIS to low-income Medicare beneficiaries and to the Medicare program. This project draws on Dr. Roberts' quantitative training, knowledge of Medicare and Medicaid policy, and prior research on health disparities. This work will extend Dr. Roberts' scholarship into the field of aging while incorporating methods in pharmaceutical health services research. Therefore, for this K01 award, Dr. Roberts will engage in training and career development activities that focus on acquiring expertise in aging and pharmaceutical health services research. Through mentorship from health services researchers and clinical experts, Dr. Roberts will also focus on applying training in these content areas to health policy research. This training plan complements the proposed research and will equip Dr. Roberts to establish an independent research program examining policy innovations to improve care for low-income Medicare beneficiaries, quantifying the clinical and economic impacts of policy reforms for patients, payers, and health systems.

项目概要/摘要埃里克·T·罗伯茨 (Eric T. Roberts) 博士荣获 AHRQ 指导研究科学家职业发展奖 (K01)，匹兹堡大学公共研究生院卫生政策与管理助理教授健康，将使罗伯茨博士成为一名健康经济学家，在健康保险和医疗保健方面拥有专业知识针对老龄化和低收入人口的政策。为该 K01 奖项提出的研究将利用由资格阈值创建的自然实验以及医疗保险补贴计划中的政策变化，以严格评估这些计划如何影响该项目将重点关注两个补贴计划：低收入 Medicare 受益人：Medicare 储蓄计划 (MSP)，属于部分 Medicaid 支付医生服务和住院护理的自付费用以及 D 部分低收入群体的福利补贴 (LIS)，有助于支付与健康和退休研究相关的处方药费用。医疗保险和医疗补助索赔，罗伯茨博士将研究补贴资格的不连续性如何影响患者对护理的使用（包括药物依从性、医生就诊和住院治疗）以及健康状况罗伯茨博士还将研究各州医疗补助政策之间的关系，特别是提供者之间的关系。重新认证计划资格的支付率和规则 - 包括 MSP 注册和患者获得这项研究产生的证据可以指导改革，以增加 MSP 和 LIS 的收益。低收入医疗保险受益人和医疗保险计划。该项目借鉴了罗伯茨博士的定量培训、医疗保险和医疗补助政策知识，以及这项工作将罗伯茨博士的学术研究扩展到老龄化领域。因此，罗伯茨博士获得了 K01 奖。将从事培训和职业发展活动，重点是获得老龄化和通过卫生服务研究人员和临床的指导。专家介绍，罗伯茨博士还将重点关注将这些内容领域的培训应用于卫生政策研究。培训计划补充了拟议的研究，并使罗伯茨博士能够建立独立性研究计划审查政策创新，以改善低收入医疗保险受益人的护理，量化政策改革对患者、付款人和卫生系统的临床和经济影响。

项目成果

期刊论文数量（15）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Integrating Medicare and Medicaid Coverage for Dual Eligibles-Recommendations for Reform.

整合医疗保险和医疗补助覆盖范围以实现双重资格 - 改革建议。

DOI：
10.1001/jama.2023.8879
发表时间：
2023
期刊：
JAMA
影响因子：
0
作者：
Roberts,EricT;Johnston,KentonJ;Figueroa,JoseF
通讯作者：
Figueroa,JoseF

Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.

患有糖尿病的低收入医疗保险受益人放弃处方药补贴的后果。

DOI：
10.1111/1475-6773.13990
发表时间：
2022
期刊：
Health services research
影响因子：
3.4
作者：
Glynn,Alexandra;Hernandez,Inmaculada;Roberts,EricT
通讯作者：
Roberts,EricT

Effects of a Medicaid dental coverage "cliff" on dental care access among low-income Medicare beneficiaries.

医疗补助牙科保险覆盖“悬崖”对低收入医疗保险受益人获得牙科护理的影响。

DOI：
10.1111/1475-6773.13981
发表时间：
2023
期刊：
Health services research
影响因子：
3.4
作者：
Roberts,EricT;Mellor,JenniferM;McInerny,MelissaP;Sabik,LindsayM
通讯作者：
Sabik,LindsayM

Racial and Ethnic Disparities in Insurance Coverage Among US Adults Aged 60 to 64 Years.

DOI：
10.1001/jamanetworkopen.2022.9406
发表时间：
2022-04-01
期刊：
JAMA NETWORK OPEN
影响因子：
13.8
作者：
Patterson, Anna;Robinson, Taylor J.;Roberts, Eric T.
通讯作者：
Roberts, Eric T.

The Unintended Cost of High Cost Sharing in Medicare-Assessing Consequences for Patients and Options for Policy.

医疗保险中高成本分摊的意外成本——评估患者的后果和政策选择。

DOI：
10.1001/jamahealthforum.2021.3624
发表时间：
2021
期刊：
JAMA health forum
影响因子：
0
作者：
Roberts,EricT
通讯作者：
Roberts,EricT

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Eric T Roberts其他文献

Racial and Ethnic Disparities in Satisfaction with Healthcare Access and Affordability in Medicare Advantage vs. Traditional Medicare.

医疗保险优势与传统医疗保险对医疗保健获取和负担能力的满意度存在种族和民族差异。

DOI：
发表时间：
2024
期刊：
Journal of general internal medicine
影响因子：
5.7
作者：
Eric T Roberts;Dominic A Ruggiero;Andrei Stefanesu;Syama Patel;Alexandra G Hames;Renuka Tipirneni
通讯作者：
Renuka Tipirneni