The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Robin K Yabroff - One of the best experts on this subject based on the ideXlab platform.
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Health Insurance Coverage disruptions and access to care and affordability among cancer survivors in the united states
Cancer Epidemiology Biomarkers & Prevention, 2020Co-Authors: Jingxuan Zhao, Zhiyuan Zheng, Xuesong Han, Ahmedin Jemal, Leticia Nogueira, Robin K YabroffAbstract:Background: Lack of Health Insurance is associated with having problems with access to high-quality care. We estimated prevalence and evaluated associations of Insurance Coverage disruptions and access to Health care and affordability among cancer survivors in the United States. Methods: Adult cancer survivors ages 18 to 64 years with current private or public Health Insurance were identified from the 2011 to 2018 National Health Interview Survey (n = 7,186). Health Insurance Coverage disruption was measured as self-reports of any time in the prior year without Coverage. Outcomes included preventive services use, problems with care affordability, and cost-related medication nonadherence in the prior year. We used separate multivariable logistic models to evaluate associations between Coverage disruptions and study outcomes by current Insurance Coverage. Results: Among currently insured survivors, 3.7% [95% confidence interval (95% CI), 3.0%–4.4%] with private, and 7.8% (95% CI, 6.5%–9.4%) with public Insurance reported Coverage disruptions in 2011 to 2018. We estimated that approximately 260,000 survivors ages 18 to 64 years had Coverage disruptions in 2018. Among privately and publicly insured survivors, those with Coverage disruptions were less likely to report all preventive services use (16.9% vs. 36.2%; 14.6% vs. 25.3%, respectively) and more likely to report any problems with care affordability (55.0% vs. 17.7%; 71.1% vs. 38.4%, respectively) and any cost-related medication nonadherence (39.4% vs. 10.1%; 36.5% vs. 16.3%, respectively) compared with those continuously insured (all P Conclusions: Coverage disruptions in the prior year were associated with problems with Health care access and affordability among currently insured survivors. Impact: Reducing Coverage disruptions may help improve access and affordability for survivors.
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Health Insurance Coverage disruptions and cancer care and outcomes systematic review of published research
Journal of the National Cancer Institute, 2020Co-Authors: Robin K Yabroff, Katherine E Reederhayes, Jingxuan Zhao, Michael T Halpern, Ana Maria Lopez, Leon Bernalmizrachi, Anderson B Collier, Joan M Neuner, Jonathan Phillips, William BlackstockAbstract:Background Lack of Health Insurance Coverage is associated with poor access and receipt of cancer care and survival in the United States. Disruptions in Coverage are common among low-income populations, but little is known about associations of disruptions with cancer care, including prevention, screening, and treatment, as well as outcomes of stage at diagnosis and survival. Methods We conducted a systematic review of studies of Health Insurance Coverage disruptions and cancer care and outcomes published between 1980 and 2019. We used the PubMed, EMBASE, Scopus, and CINAHL databases and identified 29 observational studies. Study characteristics and key findings were abstracted and synthesized qualitatively. Results Studies evaluated associations between Coverage disruptions and prevention or screening (31.0%), treatment (13.8%), end-of-life care (10.3%), stage at diagnosis (44.8%), and survival (20.7%). Coverage disruptions ranged from 4.3% to 32.8% of patients age-eligible for breast, cervical, or colorectal cancer screening. Between 22.1% and 59.5% of patients with Medicaid gained Coverage only at or after cancer diagnosis. Coverage disruptions were consistently statistically significantly associated with lower receipt of prevention, screening, and treatment. Among patients with cancer, those with Medicaid disruptions were statistically significantly more likely to have advanced stage (odds ratios = 1.2-3.8) and worse survival (hazard ratios = 1.28-2.43) than patients without disruptions. Conclusions Health Insurance Coverage disruptions are common and adversely associated with receipt of cancer care and survival. Improved data infrastructure and quasi-experimental study designs will be important for evaluating the associations of federal and state policies on Coverage disruptions and care and outcomes.
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the affordable care act and access to care across the cancer control continuum a review at 10 years
CA: A Cancer Journal for Clinicians, 2020Co-Authors: Jingxuan Zhao, Robin K Yabroff, Stacey A Fedewa, Ahmedin Jemal, Leticia Nogueira, Ziling Mao, Xuesong HanAbstract:Lack of Health Insurance Coverage is strongly associated with poor cancer outcomes in the United States. The uninsured are less likely to have access to timely and effective cancer prevention, screening, diagnosis, treatment, survivorship, and end-of-life care than their counterparts with Health Insurance Coverage. On March 23, 2010, the Patient Protection and Affordable Care Act (ACA) was signed into law, representing the largest change to Health care delivery in the United States since the introduction of the Medicare and Medicaid programs in 1965. The primary goals of the ACA are to improve Health Insurance Coverage, the quality of care, and patient outcomes, and to maintain or lower costs by catalyzing changes in the Health care delivery system. In this review, we describe the main components of the ACA, including Health Insurance expansions, Coverage reforms, and delivery system reforms, provisions within these components, and their relevance to cancer screening and early detection, care, and outcomes. We then highlight selected, well-designed studies examining the effects of the ACA provisions on Coverage, access to cancer care, and disparities throughout the cancer control continuum. Finally, we identify research gaps to inform evaluation of current and emerging Health policies related to cancer outcomes.
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cancer history Health Insurance Coverage and cost related medication nonadherence and medication cost coping strategies in the united states
Value in Health, 2019Co-Authors: Jingxuan Zhao, Zhiyuan Zheng, Xuesong Han, Amy J Davidoff, Matthew P Banegas, Ashish Rai, Ahmedin Jemal, Robin K YabroffAbstract:Abstract Objectives To evaluate the relationship between cancer history and cost-related medication nonadherence (CRN) as well as cost-coping strategies, by Health Insurance Coverage. Methods We used the 2013 to 2016 National Health Interview Survey to identify adults aged 18 to 64 years with (n = 3599) and without (n = 56 909) a cancer history. Cost-related changes in medication use included (1) CRN, measured as skipping, taking less, or delaying medication because of cost, and (2) cost-coping strategies, measured as requesting lower cost medication or using alternative therapies to save money. Separate multivariable logistic regressions were used to calculate the adjusted odds ratios (AORs) of CRN and cost-coping strategies associated with cancer history, stratified by Insurance. Results Cancer survivors were more likely than adults without a cancer history to report CRN (AOR 1.26; 95% confidence interval [CI] 1.10-1.43) and cost-coping strategies (AOR 1.10; 95% CI 0.99-1.19). Among the privately insured, the difference in CRN by cancer history was the greatest among those enrolled in high-deductible Health plans (HDHPs) without Health savings accounts (HSAs) (AOR 1.78; 95% CI 1.30-2.44). Among adults with HDHP and HSA, cancer survivors were less likely to report cost-coping strategies (AOR 0.62; 95% CI 0.42-0.90). Regardless of cancer history, CRN and cost-coping strategies were the highest for those uninsured, enrolled in HDHP without HSA, and without prescription drug Coverage under their Health plan (all P Conclusions Cancer survivors are prone to CRN and more likely to use cost-coping strategies. Expanding options for Health Insurance Coverage, use of HSAs for those with HDHP, and enhanced prescription drug Coverage may effectively address CRN.
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colorectal cancer screening in the united states trends from 2008 to 2015 and variation by Health Insurance Coverage
Preventive Medicine, 2018Co-Authors: Janet S De Moor, Robin K Yabroff, Robin A Cohen, Jean A Shapiro, Marion R Nadel, Susan A Sabatino, Stacey A Fedewa, Richard Lee, Paul V Doriarose, Cheryl AlticeAbstract:Abstract Regular colorectal cancer (CRC) screening is recommended for reducing CRC incidence and mortality. This paper provides an updated analysis of CRC screening in the United States (US) and examines CRC screening by several features of Health Insurance Coverage. Recommendation-consistent CRC screening was calculated for adults aged 50–75 in 2008, 2010, 2013 and 2015 using data from the National Health Interview Survey. CRC screening prevalence in 2015 was described overall and by sociodemographic subgroups. CRC screening by Health Insurance Coverage was further examined using multivariable logistic regression, stratified by age (50–64 years and 65–75 years) and adjusted for age, race/ethnicity, sex, education, income, time in US, and comorbid conditions. Recommendation-consistent screening increased from 51.6% in 2008 to 58.3% in 2010 (p CRC screening rates have increased over time, but certain segments of the population, especially the uninsured, continue to screen below recommended levels.
Stephen A Woodbury - One of the best experts on this subject based on the ideXlab platform.
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Health Insurance tax credits the earned income tax credit and Health Insurance Coverage of single mothers
Health Economics, 2014Co-Authors: Merve Cebi, Stephen A WoodburyAbstract:SUMMARY The Omnibus Budget Reconciliation Act of 1990 enacted a refundable tax credit for low‐income working families who purchased Health Insurance Coverage for their children. This Health Insurance tax credit (HITC) existed during tax years 1991, 1992, and 1993, and was then rescinded. A difference‐in‐differences estimator applied to Current Population Survey data suggests that adoption of the HITC, along with accompanying increases in the Earned Income Tax Credit (EITC), was associated with a relative increase of about 4.7 percentage points in the private Health Insurance Coverage of working single mothers with high school or less education. Also, a difference‐in‐difference‐in‐differences estimator, which attempts to net out the possible influence of the EITC increases but which requires strong assumptions, suggests that the HITC was responsible for about three‐quarters (3.6 percentage points) of the total increase. The latter estimate implies a price elasticity of Health Insurance take‐up of −0.42. Copyright © 2013 John Wiley & Sons, Ltd.
Helen Levy - One of the best experts on this subject based on the ideXlab platform.
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the aca s impact on racial and ethnic disparities in Health Insurance Coverage and access to care
Health Affairs, 2020Co-Authors: Thomas C Buchmueller, Helen LevyAbstract:Large disparities in Health Insurance Coverage and access to Health services have long persisted in the US Health care system. We considered how the Insurance Coverage expansions of the Affordable Care Act have affected disparities related to race and ethnicity. In the years since the law went into effect, Insurance Coverage has increased significantly for all racial/ethnic groups. Because Coverage increased more for non-Hispanic blacks and Hispanics than for non-Hispanic whites, disparities in Coverage have decreased. Despite these improvements, a large number of adults remain uninsured, and the unInsurance rate among blacks and Hispanics is substantially higher than the rate among whites.
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effect of the affordable care act on racial and ethnic disparities in Health Insurance Coverage
American Journal of Public Health, 2016Co-Authors: Thomas C Buchmueller, Helen Levy, Zachary Levinson, Barbara L WolfeAbstract:Objectives. To document how Health Insurance Coverage changed for White, Black, and Hispanic adults after the Affordable Care Act (ACA) went into effect.Methods. We used data from the American Community Survey from 2008 to 2014 to examine changes in the percentage of nonelderly adults who were uninsured, covered by Medicaid, or covered by private Health Insurance. In addition to presenting overall trends by race/ethnicity, we stratified the analysis by income group and state Medicaid expansion status.Results. In 2013, 40.5% of Hispanics and 25.8% of Blacks were uninsured, compared with 14.8% of Whites. We found a larger gap in private Insurance, which was partially offset by higher rates of public Coverage among Blacks and Hispanics. After the main ACA provisions went into effect in 2014, Coverage disparities declined slightly as the percentage of adults who were uninsured decreased by 7.1 percentage points for Hispanics, 5.1 percentage points for Blacks, and 3 percentage points for Whites. Coverage gains...
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recent trends in employer sponsored Health Insurance Coverage are bad jobs getting worse
Social Science Research Network, 1998Co-Authors: Henry S Farber, Helen LevyAbstract:We examine whether the decline in the availability of employer-provided Health Insurance is a phenomenon common to all jobs or is concentrated only on certain jobs. In particular, we investigate the extent to which employers have continued to provide Health Insurance on what we term reducing the availability of Health Insurance on jobs. We consider two dimensions on which jobs may be considered peripheral: if they are new (tenure less than one year) or part-time. We consider three outcomes whose product is the Health Insurance Coverage rate: 1) the fraction of workers who are in firms that offer Health Insurance to at least some workers (the offer rate); 2) the fraction of workers who are eligible for Health Insurance, conditional on being in a firm where it is offered (the eligibility rate); and 3) the fraction of workers who enroll in Health Insurance when they are eligible for it (the takeup rate). We find that declines in own-employer Insurance Coverage over the 1988-1997 period are driven primarily by declines in takeup for core workers and declines in eligibility for peripheral workers. We also look at trends by workers' education level and see how much of the decline is offset by an increase in Coverage through a spouse's policy. Our findings are consistent with the view that employers are continuing to make Health Insurance available to their core long-term employees but are restricting access to Health Insurance by their peripheral short-term and pa
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recent trends in employer sponsored Health Insurance Coverage are bad jobs getting worse
Research Papers in Economics, 1998Co-Authors: Henry S Farber, Helen LevyAbstract:We examine whether the decline in the availability of employer-provided Health Insurance is a phenomenon common to all jobs or is concentrated only on certain jobs. In particular, we investigate the extent to which employers have continued to provide Health Insurance on what we term core jobs while reducing the availability of Health Insurance on peripheral jobs. We consider two dimensions on which jobs may be considered peripheral: if they are new (tenure less than one year) or part-time. We consider three outcomes whose product is the Health Insurance Coverage rate: 1) the fraction of worker who are in firms that offer Health Insurance to at least some workers (the offer rate); 2) the fraction of workers who are eligible for Health Insurance, conditional on being in a firm where it is offered (the eligibility rate); and 3) the fraction of workers who enroll in Health Insurance when they are eligible for it (the take up rate). We find that declines in own-employer Insurance Coverage over the 1988-1997 period are driven primarily by declines in take up for core workers and declines in eligibility for peripheral workers. We also look at trends by workers' education level, and see how much of the decline in is offset by an increase in Coverage through a spouse's policy. Our findings are consistent with the view that employers are continuing to make Health Insurance available to their core long-term, full-time employees but are restricting access to Health Insurance by their peripheral short-term and part-time employees.
Jingxuan Zhao - One of the best experts on this subject based on the ideXlab platform.
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Health Insurance Coverage disruptions and access to care and affordability among cancer survivors in the united states
Cancer Epidemiology Biomarkers & Prevention, 2020Co-Authors: Jingxuan Zhao, Zhiyuan Zheng, Xuesong Han, Ahmedin Jemal, Leticia Nogueira, Robin K YabroffAbstract:Background: Lack of Health Insurance is associated with having problems with access to high-quality care. We estimated prevalence and evaluated associations of Insurance Coverage disruptions and access to Health care and affordability among cancer survivors in the United States. Methods: Adult cancer survivors ages 18 to 64 years with current private or public Health Insurance were identified from the 2011 to 2018 National Health Interview Survey (n = 7,186). Health Insurance Coverage disruption was measured as self-reports of any time in the prior year without Coverage. Outcomes included preventive services use, problems with care affordability, and cost-related medication nonadherence in the prior year. We used separate multivariable logistic models to evaluate associations between Coverage disruptions and study outcomes by current Insurance Coverage. Results: Among currently insured survivors, 3.7% [95% confidence interval (95% CI), 3.0%–4.4%] with private, and 7.8% (95% CI, 6.5%–9.4%) with public Insurance reported Coverage disruptions in 2011 to 2018. We estimated that approximately 260,000 survivors ages 18 to 64 years had Coverage disruptions in 2018. Among privately and publicly insured survivors, those with Coverage disruptions were less likely to report all preventive services use (16.9% vs. 36.2%; 14.6% vs. 25.3%, respectively) and more likely to report any problems with care affordability (55.0% vs. 17.7%; 71.1% vs. 38.4%, respectively) and any cost-related medication nonadherence (39.4% vs. 10.1%; 36.5% vs. 16.3%, respectively) compared with those continuously insured (all P Conclusions: Coverage disruptions in the prior year were associated with problems with Health care access and affordability among currently insured survivors. Impact: Reducing Coverage disruptions may help improve access and affordability for survivors.
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Health Insurance Coverage disruptions and cancer care and outcomes systematic review of published research
Journal of the National Cancer Institute, 2020Co-Authors: Robin K Yabroff, Katherine E Reederhayes, Jingxuan Zhao, Michael T Halpern, Ana Maria Lopez, Leon Bernalmizrachi, Anderson B Collier, Joan M Neuner, Jonathan Phillips, William BlackstockAbstract:Background Lack of Health Insurance Coverage is associated with poor access and receipt of cancer care and survival in the United States. Disruptions in Coverage are common among low-income populations, but little is known about associations of disruptions with cancer care, including prevention, screening, and treatment, as well as outcomes of stage at diagnosis and survival. Methods We conducted a systematic review of studies of Health Insurance Coverage disruptions and cancer care and outcomes published between 1980 and 2019. We used the PubMed, EMBASE, Scopus, and CINAHL databases and identified 29 observational studies. Study characteristics and key findings were abstracted and synthesized qualitatively. Results Studies evaluated associations between Coverage disruptions and prevention or screening (31.0%), treatment (13.8%), end-of-life care (10.3%), stage at diagnosis (44.8%), and survival (20.7%). Coverage disruptions ranged from 4.3% to 32.8% of patients age-eligible for breast, cervical, or colorectal cancer screening. Between 22.1% and 59.5% of patients with Medicaid gained Coverage only at or after cancer diagnosis. Coverage disruptions were consistently statistically significantly associated with lower receipt of prevention, screening, and treatment. Among patients with cancer, those with Medicaid disruptions were statistically significantly more likely to have advanced stage (odds ratios = 1.2-3.8) and worse survival (hazard ratios = 1.28-2.43) than patients without disruptions. Conclusions Health Insurance Coverage disruptions are common and adversely associated with receipt of cancer care and survival. Improved data infrastructure and quasi-experimental study designs will be important for evaluating the associations of federal and state policies on Coverage disruptions and care and outcomes.
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the affordable care act and access to care across the cancer control continuum a review at 10 years
CA: A Cancer Journal for Clinicians, 2020Co-Authors: Jingxuan Zhao, Robin K Yabroff, Stacey A Fedewa, Ahmedin Jemal, Leticia Nogueira, Ziling Mao, Xuesong HanAbstract:Lack of Health Insurance Coverage is strongly associated with poor cancer outcomes in the United States. The uninsured are less likely to have access to timely and effective cancer prevention, screening, diagnosis, treatment, survivorship, and end-of-life care than their counterparts with Health Insurance Coverage. On March 23, 2010, the Patient Protection and Affordable Care Act (ACA) was signed into law, representing the largest change to Health care delivery in the United States since the introduction of the Medicare and Medicaid programs in 1965. The primary goals of the ACA are to improve Health Insurance Coverage, the quality of care, and patient outcomes, and to maintain or lower costs by catalyzing changes in the Health care delivery system. In this review, we describe the main components of the ACA, including Health Insurance expansions, Coverage reforms, and delivery system reforms, provisions within these components, and their relevance to cancer screening and early detection, care, and outcomes. We then highlight selected, well-designed studies examining the effects of the ACA provisions on Coverage, access to cancer care, and disparities throughout the cancer control continuum. Finally, we identify research gaps to inform evaluation of current and emerging Health policies related to cancer outcomes.
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cancer history Health Insurance Coverage and cost related medication nonadherence and medication cost coping strategies in the united states
Value in Health, 2019Co-Authors: Jingxuan Zhao, Zhiyuan Zheng, Xuesong Han, Amy J Davidoff, Matthew P Banegas, Ashish Rai, Ahmedin Jemal, Robin K YabroffAbstract:Abstract Objectives To evaluate the relationship between cancer history and cost-related medication nonadherence (CRN) as well as cost-coping strategies, by Health Insurance Coverage. Methods We used the 2013 to 2016 National Health Interview Survey to identify adults aged 18 to 64 years with (n = 3599) and without (n = 56 909) a cancer history. Cost-related changes in medication use included (1) CRN, measured as skipping, taking less, or delaying medication because of cost, and (2) cost-coping strategies, measured as requesting lower cost medication or using alternative therapies to save money. Separate multivariable logistic regressions were used to calculate the adjusted odds ratios (AORs) of CRN and cost-coping strategies associated with cancer history, stratified by Insurance. Results Cancer survivors were more likely than adults without a cancer history to report CRN (AOR 1.26; 95% confidence interval [CI] 1.10-1.43) and cost-coping strategies (AOR 1.10; 95% CI 0.99-1.19). Among the privately insured, the difference in CRN by cancer history was the greatest among those enrolled in high-deductible Health plans (HDHPs) without Health savings accounts (HSAs) (AOR 1.78; 95% CI 1.30-2.44). Among adults with HDHP and HSA, cancer survivors were less likely to report cost-coping strategies (AOR 0.62; 95% CI 0.42-0.90). Regardless of cancer history, CRN and cost-coping strategies were the highest for those uninsured, enrolled in HDHP without HSA, and without prescription drug Coverage under their Health plan (all P Conclusions Cancer survivors are prone to CRN and more likely to use cost-coping strategies. Expanding options for Health Insurance Coverage, use of HSAs for those with HDHP, and enhanced prescription drug Coverage may effectively address CRN.
Henry S Farber - One of the best experts on this subject based on the ideXlab platform.
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recent trends in employer sponsored Health Insurance Coverage are bad jobs getting worse
Social Science Research Network, 1998Co-Authors: Henry S Farber, Helen LevyAbstract:We examine whether the decline in the availability of employer-provided Health Insurance is a phenomenon common to all jobs or is concentrated only on certain jobs. In particular, we investigate the extent to which employers have continued to provide Health Insurance on what we term reducing the availability of Health Insurance on jobs. We consider two dimensions on which jobs may be considered peripheral: if they are new (tenure less than one year) or part-time. We consider three outcomes whose product is the Health Insurance Coverage rate: 1) the fraction of workers who are in firms that offer Health Insurance to at least some workers (the offer rate); 2) the fraction of workers who are eligible for Health Insurance, conditional on being in a firm where it is offered (the eligibility rate); and 3) the fraction of workers who enroll in Health Insurance when they are eligible for it (the takeup rate). We find that declines in own-employer Insurance Coverage over the 1988-1997 period are driven primarily by declines in takeup for core workers and declines in eligibility for peripheral workers. We also look at trends by workers' education level and see how much of the decline is offset by an increase in Coverage through a spouse's policy. Our findings are consistent with the view that employers are continuing to make Health Insurance available to their core long-term employees but are restricting access to Health Insurance by their peripheral short-term and pa
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recent trends in employer sponsored Health Insurance Coverage are bad jobs getting worse
Research Papers in Economics, 1998Co-Authors: Henry S Farber, Helen LevyAbstract:We examine whether the decline in the availability of employer-provided Health Insurance is a phenomenon common to all jobs or is concentrated only on certain jobs. In particular, we investigate the extent to which employers have continued to provide Health Insurance on what we term core jobs while reducing the availability of Health Insurance on peripheral jobs. We consider two dimensions on which jobs may be considered peripheral: if they are new (tenure less than one year) or part-time. We consider three outcomes whose product is the Health Insurance Coverage rate: 1) the fraction of worker who are in firms that offer Health Insurance to at least some workers (the offer rate); 2) the fraction of workers who are eligible for Health Insurance, conditional on being in a firm where it is offered (the eligibility rate); and 3) the fraction of workers who enroll in Health Insurance when they are eligible for it (the take up rate). We find that declines in own-employer Insurance Coverage over the 1988-1997 period are driven primarily by declines in take up for core workers and declines in eligibility for peripheral workers. We also look at trends by workers' education level, and see how much of the decline in is offset by an increase in Coverage through a spouse's policy. Our findings are consistent with the view that employers are continuing to make Health Insurance available to their core long-term, full-time employees but are restricting access to Health Insurance by their peripheral short-term and part-time employees.
