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The article focuses on state program, Medicaid. Topics include Patient Protection and Affordable Care Act (ACA's) action against Medicaid programs; supporters views including high health care access, improvement in the finances of low-income families and mental health outcomes; and reductions in early mortality rates.

We conducted a literature review of best practice in peer review. Following this research, we identified five principles for better peer review: Content Integrity, Content Ethics, Fairness, Usefulness, and Timeliness. For each of these principles, we have developed a set of recommendations to improve peer review standards. In this article, we describe the role of peer review and how our five principles support that goal. This article is intended to continue the conversation about improving peer review standards and provide guidance to journal teams looking to improve their standards. It is accompanied by a detailed checklist, which could be used by journal teams to assess their current peer review standards. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of Medicaid coverage on dental care outcomes, a major health concern for low-income populations.Data Sources: Primary and secondary data on health care use and outcomes for participants in Oregon's 2008 Medicaid lottery.Study Design: We used the lottery's random selection to gauge the causal effects of Medicaid on dental care needs, medication, and emergency department visits for dental care.Data Collection: Data were collected for lottery participants over 2 years, including mail surveys (N = 23,777) and in-person questionnaires (N = 12,229). Emergency department (ED) records were matched to lottery participants in Portland (N = 24,646).Principal Findings: Medicaid coverage significantly reduced the share of respondents who reported needing dental care (-9.8 percentage points, p < .001) or having unmet dental care needs (-13.5 percentage points, p < 0.001). Medicaid doubled the share visiting the ED for dental care (+2.6 percentage points, p = .003) and the use of anti-infective medications often prescribed for dental care, but it had no detectable effect on uncovered dental care or out-of-pocket spending.Conclusions: Expansion of Medicaid covering emergency dental care substantially reduced unmet need for dental care, increasing ED dental visits and medication use, while not changing patient use of uncovered dental services. [ABSTRACT FROM AUTHOR]

Context The Affordable Care Act provides new Medicaid coverage to an estimated 12 million low-income adults. Barriers to access or quality could hamper the program's success. One of these barriers might be the stigma associated with Medicaid or poverty. Methods Our mixed-methods study involved 574 low-income adults and included data from an in-person survey and follow-up interviews. Our analysis of the interviews showed that many participants who were on Medicaid or uninsured described a perception or fear of being treated poorly in the health care setting. We defined this experience as stigma and merged our qualitative interviews coded for stigma with our quantitative survey data to see whether stigma was related to other sociodemographic characteristics. We also examined whether stigma was associated with access to care, quality of care, and self-reported health. Findings We were unable to identify other sociodemographic characteristics associated with stigma in this low-income sample. The qualitative interviews suggested that stigma was most often the result of a provider-patient interaction that felt demeaning, rather than an internalized sense of shame related to receiving public insurance or charity care. An experience of stigma was associated with unmet health needs, poorer perceptions of quality of care, and worse health across several self-reported measures. Conclusions Because a stigmatizing experience in the health system might interfere with the delivery of high-quality care to new Medicaid enrollees, further research and policy interventions that target stigma are warranted. [ABSTRACT FROM AUTHOR]