17 results on '"Taubman, Sarah"'
Search Results
2. The Effect of Medicaid on Dental Care of Poor Adults: Evidence from the Oregon Health Insurance Experiment
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Baicker, Katherine, Allen, Heidi L., Wright, Bill J., Taubman, Sarah L., and Finkelstein, Amy N.
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United States. National Center for Health Statistics ,United States. Centers for Medicare and Medicaid Services ,Medicaid ,Emergency medicine ,Health insurance -- Usage ,Adults -- Surveys ,Business ,Health care industry - Abstract
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. Key Words. Medicaid, dental health, Dental care is an important component of health spending and of overall health and well-being. The United States spent an estimated $117.5 billion on dental services in 2015, with a [...]
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- 2018
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3. The Effect of Medicaid on Management of Depression: Evidence From the Oregon Health Insurance Experiment
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BAICKER, KATHERINE, ALLEN, HEIDI L., WRIGHT, BILL J., TAUBMAN, SARAH L., and FINKELSTEIN, AMY N.
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- 2018
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4. The Impact of Medicaid on Labor Market Activity and Program Participation: Evidence from the Oregon Health Insurance Experiment
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Baicker, Katherine, Finkelstein, Amy, Song, Jae, and Taubman, Sarah
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- 2014
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5. THE OREGON HEALTH INSURANCE EXPERIMENT: EVIDENCE FROM THE FIRST YEAR
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Oregon Health Study Group, Finkelstein, Amy, Taubman, Sarah, Wright, Bill, Bernstein, Mira, Gruber, Jonathan, Newhouse, Joseph P., Allen, Heidi, and Baicker, Katherine
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- 2012
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6. Health Care Hotspotting — A Randomized, Controlled Trial
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Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Zhou, Annetta, Taubman, Sarah, Doyle, Joseph, Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Zhou, Annetta, Taubman, Sarah, and Doyle, Joseph
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Copyright © 2020 Massachusetts Medical Society. BACKGROUND: There is widespread interest in programs aiming to reduce spending and improve health care quality among “superutilizers,” patients with very high use of health care services. The “hotspotting” program created by the Camden Coalition of Healthcare Providers (hereafter, the Coalition) has received national attention as a promising superutilizer intervention and has been expanded to cities around the country. In the months after hospital discharge, a team of nurses, social workers, and community health workers visits enrolled patients to coordinate outpatient care and link them with social services. METHODS: We randomly assigned 800 hospitalized patients with medically and socially complex conditions, all with at least one additional hospitalization in the preceding 6 months, to the Coalition's care-transition program or to usual care. The primary outcome was hospital readmission within 180 days after discharge. RESULTS: The 180-day readmission rate was 62.3% in the intervention group and 61.7% in the control group. The adjusted between-group difference was not significant (0.82 percentage points; 95% confidence interval, -5.97 to 7.61). In contrast, a comparison of the intervention-group admissions during the 6 months before and after enrollment misleadingly suggested a 38-percentage-point decline in admissions related to the intervention because the comparison did not account for the similar decline in the control group. CONCLUSIONS: In this randomized, controlled trial involving patients with very high use of health care services, readmission rates were not lower among patients randomly assigned to the Coalition's program than among those who received usual care.
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- 2021
7. The Effect of Medicaid on Management of Depression: Evidence From the Oregon Health Insurance Experiment
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Baicker, Katherine, Allen, Heidi L., Wright, Bill J., Taubman, Sarah L., Finkelstein, Amy, Baicker, Katherine, Allen, Heidi L., Wright, Bill J., Taubman, Sarah L., and Finkelstein, Amy
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Context Expanding Medicaid to previously uninsured adults has been shown to increase detection and reduce the prevalence of depression, but the ways that Medicaid affects mental health care, how effectively it addresses unmet needs, and how those effects differ for those with and without a history of depression remain unclear. Methods We take advantage of Oregon's Medicaid lottery to gauge the causal effects of Medicaid coverage using a randomized‐controlled design, drawing on both primary and administrative data sources. Findings Medicaid coverage reduced the prevalence of undiagnosed depression by almost 50% and untreated depression by more than 60%. It increased use of medications frequently prescribed to treat depression and related mental health conditions and reduced the share of respondents reporting unmet mental health care needs by almost 40%. The share of respondents screening positive for depression dropped by 9.2 percentage points overall, and by 13.1 for those with preexisting depression diagnoses, with greatest relief in symptoms seen primarily in feeling down or hopeless, feeling tired, and trouble sleeping—consistent with the increase observed not just in medications targeting depression but also in those targeting sleep. Conclusions Medicaid coverage had significant effects on the diagnosis, treatment, and outcomes of a population with substantial unmet mental health needs. Coverage increased access to care, reduced the prevalence of untreated and undiagnosed depression, and substantially improved the symptoms of depression. There are likely to be substantial mental health consequences of policy decisions about Medicaid coverage for vulnerable populations. Keywords: Medicaid; insurance; depression; mental health, National Institute on Aging (Grant P30AG012810), National Institute on Aging (Grant RC2AGO36631), National Institute on Aging (Grant R01AG0345151), National Bureau of Economic Research (Grant 5 RRC 08098400‐03‐00)
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- 2020
8. Intervening on risk factors for coronary heart disease: an application of the parametric g-formula
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Taubman, Sarah L, Robins, James M, Mittleman, Murray A, and Hernán, Miguel A
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- 2009
9. Effect of Medicaid Coverage on ED Use — Further Evidence from Oregon’s Experiment
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Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Allen, Heidi L., Wright, Bill J., Baicker, Katherine, Taubman, Sarah L., Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Allen, Heidi L., Wright, Bill J., Baicker, Katherine, and Taubman, Sarah L.
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The effect of Medicaid coverage on health and the use of health care services is of first-order policy importance, particularly as policymakers consider expansions of public health insurance. Estimating the effects of expanding Medicaid is challenging, however, because Medicaid enrollees and the uninsured differ in many ways that may also affect outcomes of interest. Oregon’s 2008 expansion of Medicaid through random-lottery selection of potential enrollees from a waiting list offers the opportunity to assess Medicaid’s effects with a randomized evaluation that is not contaminated by such confounding factors. In a previous examination of the Oregon Health Insurance Experiment, we found that Medicaid coverage increased health care use across a range of settings, improved financial security, and reduced rates of depression among enrollees, but it produced no detectable changes in several measures of physical health, employment rates, or earnings.
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- 2018
10. The Effect of Medicaid on Dental Care of Poor Adults: Evidence from the Oregon Health Insurance Experiment
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Baicker, Katherine, primary, Allen, Heidi L., additional, Wright, Bill J., additional, Taubman, Sarah L., additional, and Finkelstein, Amy N., additional
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- 2017
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11. The Impact of Medicaid on Labor Market Activity and Program Participation: Evidence from the Oregon Health Insurance Experiment
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Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Baicker, Katherine, Song, Jae, Taubman, Sarah, Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Baicker, Katherine, Song, Jae, and Taubman, Sarah
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In 2008, a group of uninsured low-income adults in Oregon was selected by lottery for the chance to apply for Medicaid. Using this randomized design and 2009 administrative data, we find no significant effect of Medicaid on employment or earnings. Our 95 percent confidence intervals allow us to reject that Medicaid causes a decline in employment of more than 4.4 percentage points, or an increase of more than 1.2 percentage points. Medicaid increases food stamps receipt, but has little, if any, impact on receipt of other measured government benefits, including SSDI., United States. Dept. of Health and Human Services (Assistant Secretary for Planning and Evaluation), California HealthCare Foundation, John D. and Catherine T. MacArthur Foundation, National Institute on Aging (P30AG012810), National Institute on Aging (RC2AGO36631), National Institute on Aging (R01AG0345151), Robert Wood Johnson Foundation, Alfred P. Sloan Foundation, Smith Richardson Foundation, United States. Social Security Administration (National Bureau of Economic Research. Grant 5 RRC 08098400-03-00), Centers for Medicare & Medicaid Services (U.S.)
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- 2015
12. Medicaid Increases Emergency-Department Use: Evidence from Oregon's Health Insurance Experiment
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Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Taubman, Sarah L., Allen, Heidi L., Wright, Bill J., Baicker, Katherine, Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Taubman, Sarah L., Allen, Heidi L., Wright, Bill J., and Baicker, Katherine
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In 2008, Oregon initiated a limited expansion of a Medicaid program for uninsured, low-income adults, drawing names from a waiting list by lottery. This lottery created a rare opportunity to study the effects of Medicaid coverage by using a randomized controlled design. By using the randomization provided by the lottery and emergency-department records from Portland-area hospitals, we studied the emergency department use of about 25,000 lottery participants over about 18 months after the lottery. We found that Medicaid coverage significantly increases overall emergency use by 0.41 visits per person, or 40% relative to an average of 1.02 visits per person in the control group. We found increases in emergency-department visits across a broad range of types of visits, conditions, and subgroups, including increases in visits for conditions that may be most readily treatable in primary care settings., United States. Dept. of Health and Human Services (Assistant Secretary for Planning and Evaluation), California HealthCare Foundation, John D. and Catherine T. MacArthur Foundation, National Institute on Aging (Grant P30AG012810), National Institute on Aging (Grant RC2AG036631), National Institute on Aging (Grant R01AG0345151), Robert Wood Johnson Foundation, Alfred P. Sloan Foundation, Smith Richardson Foundation
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- 2014
13. The Oregon Experiment — Effects of Medicaid on Clinical Outcomes
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Massachusetts Institute of Technology. Department of Economics, Gruber, Jonathan, Finkelstein, Amy, Baicker, Katherine, Taubman, Sarah L., Allen, Heidi L., Bernstein, Mira, Newhouse, Joseph P., Schneider, Eric C., Wright, Bill J., Zaslavsky, Alan M., Massachusetts Institute of Technology. Department of Economics, Gruber, Jonathan, Finkelstein, Amy, Baicker, Katherine, Taubman, Sarah L., Allen, Heidi L., Bernstein, Mira, Newhouse, Joseph P., Schneider, Eric C., Wright, Bill J., and Zaslavsky, Alan M.
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Background: Despite the imminent expansion of Medicaid coverage for low-income adults, the effects of expanding coverage are unclear. The 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided an opportunity to evaluate these effects. Methods: Approximately 2 years after the lottery, we obtained data from 6387 adults who were randomly selected to be able to apply for Medicaid coverage and 5842 adults who were not selected. Measures included blood-pressure, cholesterol, and glycated hemoglobin levels; screening for depression; medication inventories; and self-reported diagnoses, health status, health care utilization, and out-of-pocket spending for such services. We used the random assignment in the lottery to calculate the effect of Medicaid coverage. Results: We found no significant effect of Medicaid coverage on the prevalence or diagnosis of hypertension or high cholesterol levels or on the use of medication for these conditions. Medicaid coverage significantly increased the probability of a diagnosis of diabetes and the use of diabetes medication, but we observed no significant effect on average glycated hemoglobin levels or on the percentage of participants with levels of 6.5% or higher. Medicaid coverage decreased the probability of a positive screening for depression (−9.15 percentage points; 95% confidence interval, −16.70 to −1.60; P=0.02), increased the use of many preventive services, and nearly eliminated catastrophic out-of-pocket medical expenditures. Conclusions: This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain., United States. Dept. of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation, California HealthCare Foundation, National Institute on Aging (P30AG012810), National Institute on Aging (RC2AGO36631), National Institute on Aging (R01AG0345151), John D. and Catherine T. MacArthur Foundation, Robert Wood Johnson Foundation, Alfred P. Sloan Foundation, Smith Richardson Foundation, United States. Social Security Administration (5 RRC 08098400-03-00, to the National Bureau of Economic Research as part of the Retirement Research Consortium of the Social Security Administration), Centers for Medicare & Medicaid Services (U.S.)
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- 2013
14. What The Oregon Health Study Can Tell Us About Expanding Medicaid
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Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Allen, Heidi L., Baicker, Katherine, Taubman, Sarah, Wright, Bill J., Oregon Health Study Group, Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Allen, Heidi L., Baicker, Katherine, Taubman, Sarah, Wright, Bill J., and Oregon Health Study Group
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The recently enacted Patient Protection and Affordable Care Act includes a major expansion of Medicaid to low-income adults in 2014. This paper describes the Oregon Health Study, a randomized controlled trial that will be able to shed some light on the likely effects of such expansions. In 2008, Oregon randomly drew names from a waiting list for its previously closed public insurance program. Our analysis of enrollment into this program found that people who signed up for the waiting list and enrolled in the Oregon Medicaid program were likely to have worse health than those who did not. However, actual enrollment was fairly low, partly because many applicants did not meet eligibility standards., United States. Dept. of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation, California HealthCare Foundation, John D. and Catherine T. MacArthur Foundation, National Institute on Aging, Robert Wood Johnson Foundation, Alfred P. Sloan Foundation, United States. Social Security Administration
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- 2013
15. The Oregon Health Insurance Experiment: Evidence from the First Year
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Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Gruber, Jonathan, Taubman, Sarah, Wright, Bill, Bernstein, Mira, Newhouse, Joseph P., Allen, Heidi L., Baicker, Katherine, Massachusetts Institute of Technology. Department of Economics, Finkelstein, Amy, Gruber, Jonathan, Taubman, Sarah, Wright, Bill, Bernstein, Mira, Newhouse, Joseph P., Allen, Heidi L., and Baicker, Katherine
- Abstract
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group., National Institutes of Health. Department of Health and Human Services, California HealthCare Foundation, John D. and Catherine T. MacArthur Foundation, National Institute on Aging (P30AG012810), National Institute on Aging (RC2AGO36631), National Institute on Aging (R01AG0345151), Robert Wood Johnson Foundation, Alfred P. Sloan Foundation, Smith Richardson Foundation, United States. Social Security Administration (grant 5 RRC 08098400-03-00 to the National Bureau of Economic Research as part of the SSA Retirement Research Consortium), Centers for Medicare & Medicaid Services (U.S.)
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- 2012
16. THE IMPACT OF MEDICAID ON LABOR FORCE ACTIVITY AND PROGRAM PARTICIPATION: EVIDENCE FROM THE OREGON HEALTH INSURANCE EXPERIMENT.
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Baicker, Katherine, Finkelstein, Amy, Jae Song, and Taubman, Sarah
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- 2013
17. THE OREGON HEALTH INSURANCE EXPERIMENT: EVIDENCE FROM THE FIRST YEAR.
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Finkelstein, Amy, Taubman, Sarah, Wright, Bill, Bernstein, Mira, Gruber, Jonathan, Newhouse, Joseph P., Allen, Heidi, and Baecker, Katherine
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HEALTH insurance ,MEDICALLY uninsured persons ,LOTTERIES ,MEDICAID ,MEDICAL care of poor people ,SERVICES for poor people ,HEALTH services administration - Abstract
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group. [ABSTRACT FROM AUTHOR]
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- 2012
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