Research Roundup: Health Debate’s Impact On Views Of ACA; Treating Opioid Addiction In Medicaid
Each week, KHN compiles a selection of recently released health policy studies and briefs.
The New England Journal of Medicine:
Public Opinion About The Future Of The Affordable Care Act
Our analysis of 27 national opinion polls by 12 survey organizations provides background on four critical issues relevant to the previous House and recent Senate health care decisions: the public favorability of the current law, the public values underlying the debate about the future, support for various health policy changes in the proposed Republican legislation, and support for the overall Republican proposals debated in the House and Senate. ... On most specific policy issues in the debate, Republicans and Democrats disagreed, but there is one major exception. The two parties’ adherents agree that the number of people covered by Medicaid should not be reduced in any replacement bill. Finally, the most important change over time was not the increase in public approval of the ACA, but rather the increase in overall support for universal coverage. (Blendon and Benson, 8/31)
JAMA:
Medication-Assisted Treatment And Opioid Use Before And After Overdose In Pennsylvania Medicaid
For every fatal opioid overdose, there are approximately 30 nonfatal overdoses. Nonfatal overdoses that receive medical attention represent intervention opportunities for clinicians to mitigate risk by reducing opioid prescribing or advocating addiction treatment. Studies evaluating commercially insured patients suggest these potential interventions are underutilized. ... However, little is known about how opioid prescribing and medication-assisted treatment (MAT) changes from before to after overdose among Medicaid enrollees, who have a 3-times higher risk of opioid overdose. We used data from a large Medicaid program to compare (1) prescription opioid use, (2) duration of opioid use, and (3) rates of MAT (buprenorphine, methadone, or naltrexone) among enrollees before and after an overdose event. ... Despite receiving medical attention for an overdose, these patients in Pennsylvania Medicaid continued to have persistently high prescription opioid use. (Frazier et al., 8/22)
The Kaiser Family Foundation:
Coverage And Care Pathways For People With HIV: A New Baseline
This new baseline provides a snapshot of access to care for people with HIV today and serves as marker for gauging changes going forward. It reflects coverage gains associated with the ACA’s expansions as well as access through traditional insurance pathways and the Ryan White program. As the debate over the future of the Affordable Care Act (ACA) continues, we sought to develop a baseline of current health insurance coverage and access specific to people with HIV, a population that saw significant gains in insurance coverage under the healthcare law. (Dawson and Kates, 8/29)
Annals of Internal Medicine:
Accuracy of Cardiovascular Risk Prediction Varies by Neighborhood Socioeconomic Position: A Retrospective Cohort Study
First, [researchers sought] to evaluate the spatial relationship between neighborhood disadvantage and major atherosclerotic cardiovascular disease (ASCVD)–related events; second, to evaluate the relative extent to which neighborhood disadvantage and physiologic risk account for neighborhood-level variation in ASCVD event rates. ... [They undertook an] observational cohort analysis of geocoded longitudinal electronic health records [using 109 793 patients from the Cleveland Clinic Health System]. ... Neighborhood disadvantage may be a powerful regulator of ASCVD event risk. In addition to supplemental risk models and clinical screening criteria, population-based solutions are needed to ameliorate the deleterious effects of neighborhood disadvantage on health outcomes. (Dalton et al., 8/29)
