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Assess insurance Coverage Expansion on Diabetes complications


The ACA substantially increased access to health insurance and insurance coverage rates through Medicaid eligibility expansions (in states the expanded) and nationwide individual health insurance marketplaces. Analyses of the short-term impact of Medicaid expansion demonstrated increased access to preventative care and improved control of type 2 diabetes. However, there is limited information on the longer-term effects of Medicaid expansion of the health outcomes for patients who gain and lose Medicaid coverage due to changes in Medicaid eligibility. This study will analyze data from over 280,000 patients within the national ADVANCE clinical research network for community health centers, comparing outcomes for patients from states that expanded Medicaid with outcomes for patients from states that did not expand Medicaid, as well as examining patients with continuous insurance coverage, unstable insurance, and no insurance coverage. Outcomes will include acute and chronic diabetes-related complications as well as mortality. The analyses will also assess whether individual-level and/or community-level social determinants of health moderate the relationship between Medicaid expansion and health outcomes. 

Dr. Nathalie Huguet

What I really enjoy about NEXT-D is the collaborative nature of this network. The NEXT-D network evaluates whether and how national or local policies successfully (or not) impact the health of patients living with diabetes. By having this collaborative we are able to share learnings and brainstorm and solve challenges in evaluating these policies and provide robust evidence to stakeholders on whether a policy needs to be adapted, de-implemented, or implemented widely to equitably assist patient with diabetes live well with their conditions.

- Dr. Nathalie Huguet, PhD, Principal Investigator of OHSU team, Co-Chair of NEXT-D3