NCT02657499

Brief Summary

This innovative study will measure the impact of Affordable Care Act-sponsored Medicaid expansions on access to and utilization of community health center (CHC) services. Building on the investigators prior work that developed a robust community-based research infrastructure within the OCHIN community health information network, the investigator will utilize linked electronic health record data from the OCHIN network of \>400 CHC clinics in 8 states that expanded Medicaid coverage and 8 states that did not expand.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,939,848

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Jan 2012

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

January 1, 2012

Completed
4 years until next milestone

First Submitted

Initial submission to the registry

January 13, 2016

Completed
2 days until next milestone

First Posted

Study publicly available on registry

January 15, 2016

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 24, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 24, 2018

Completed
Last Updated

March 19, 2019

Status Verified

March 1, 2019

Enrollment Period

6.8 years

First QC Date

January 13, 2016

Last Update Submit

March 14, 2019

Conditions

Chronic Disease

Keywords

healthcare accessutilizationexpenditurespreventive services

Outcome Measures

Primary Outcomes (1)

  • Health Insurance Status

    Health insurance status derived from EHR data and is primarily based on information collected at each visit

    24 months prior to Medicaid expansion vs 24 months post

Secondary Outcomes (3)

  • Healthcare service utilization

    24 months prior to Medicaid expansion vs 24 months post

  • Preventive Service utilization

    24 months prior to Medicaid expansion vs 24 months post

  • Medicaid Expenditures

    24 months prior to Medicaid expansion vs 24 months post

Study Arms (2)

Medicaid Expansion States

Patients receiving care in community health centers in states that expanded Medicaid (intervention group)

Other: Medicaid Expansion

Non Medicaid Expansion States

Patients receiving care in community health centers in states that did not expand Medicaid (control group)

Other: Medicaid Expansion

Interventions

Medicaid ExpansionOTHER

There will be no direct intervention, but rather an observation of change based on whether a state expanded Medicaid or not

Medicaid Expansion StatesNon Medicaid Expansion States

Eligibility Criteria

Age20 Years - 64 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)
Sampling MethodNon-Probability Sample
Study Population

Study eligible patients within electronic health record data from the OCHIN community health information network

You may qualify if:

  • Patients in intervention and control states aged 20-64

You may not qualify if:

  • Patients outside of age range 20-64

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Oregon Health and Science University

Portland, Oregon, 97239, United States

Location

Related Publications (9)

  • Marino M, Angier H, Valenzuela S, Hoopes M, Killerby M, Blackburn B, Huguet N, Heintzman J, Hatch B, O'Malley JP, DeVoe JE. Medicaid coverage accuracy in electronic health records. Prev Med Rep. 2018 Jul 27;11:297-304. doi: 10.1016/j.pmedr.2018.07.009. eCollection 2018 Sep.

    PMID: 30116701BACKGROUND

  • Hoopes MJ, Angier H, Gold R, Bailey SR, Huguet N, Marino M, DeVoe JE. Utilization of Community Health Centers in Medicaid Expansion and Nonexpansion States, 2013-2014. J Ambul Care Manage. 2016 Oct-Dec;39(4):290-8. doi: 10.1097/JAC.0000000000000123.

    PMID: 26765808RESULT

  • Springer R, Marino M, O'Malley JP, Lindner S, Huguet N, DeVoe JE. Oregon Medicaid Expenditures After the 2014 Affordable Care Act Medicaid Expansion: Over-time Differences Among New, Returning, and Continuously Insured Enrollees. Med Care. 2018 May;56(5):394-402. doi: 10.1097/MLR.0000000000000907.

    PMID: 29578955RESULT

  • Angier, H., C. J. Tillotson, L. S. Wallace, M. Marino, J. P. O' Malley, A. Sumic, L. Baker, C. Nelson, N. Huguet, A. Suchocki, H. Holderness and J. E. DeVoe (2018).

    RESULT

  • Angier H, Hoopes M, Marino M, Huguet N, Jacobs EA, Heintzman J, Holderness H, Hood CM, DeVoe JE. Uninsured Primary Care Visit Disparities Under the Affordable Care Act. Ann Fam Med. 2017 Sep;15(5):434-442. doi: 10.1370/afm.2125.

    PMID: 28893813RESULT

  • Huguet N, Hoopes MJ, Angier H, Marino M, Holderness H, DeVoe JE. Medicaid Expansion Produces Long-Term Impact on Insurance Coverage Rates in Community Health Centers. J Prim Care Community Health. 2017 Oct;8(4):206-212. doi: 10.1177/2150131917709403. Epub 2017 May 17.

    PMID: 28513249RESULT

  • Heintzman J, Bailey SR, DeVoe J, Cowburn S, Kapka T, Duong TV, Marino M. In Low-Income Latino Patients, Post-Affordable Care Act Insurance Disparities May Be Reduced Even More than Broader National Estimates: Evidence from Oregon. J Racial Ethn Health Disparities. 2017 Jun;4(3):329-336. doi: 10.1007/s40615-016-0232-1. Epub 2016 Apr 22.

    PMID: 27105630RESULT

  • Hatch B, Marino M, Killerby M, Angier H, Hoopes M, Bailey SR, Heintzman J, O'Malley JP, DeVoe JE. Medicaid's Impact on Chronic Disease Biomarkers: A Cohort Study of Community Health Center Patients. J Gen Intern Med. 2017 Aug;32(8):940-947. doi: 10.1007/s11606-017-4051-9. Epub 2017 Apr 3.

    PMID: 28374214RESULT

  • Bailey SR, Hoopes MJ, Marino M, Heintzman J, O'Malley JP, Hatch B, Angier H, Fortmann SP, DeVoe JE. Effect of Gaining Insurance Coverage on Smoking Cessation in Community Health Centers: A Cohort Study. J Gen Intern Med. 2016 Oct;31(10):1198-205. doi: 10.1007/s11606-016-3781-4. Epub 2016 Jun 21.

    PMID: 27329121RESULT

MeSH Terms

Conditions

Chronic DiseasePatient Acceptance of Health Care

Condition Hierarchy (Ancestors)

Disease AttributesPathologic ProcessesPathological Conditions, Signs and SymptomsTreatment Adherence and ComplianceHealth BehaviorBehavior

Study Officials

  • Jennifer E DeVoe, MD

    Oregon Health and Science University

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principle Investigator

Study Record Dates

First Submitted

January 13, 2016

First Posted

January 15, 2016

Study Start

January 1, 2012

Primary Completion

October 24, 2018

Study Completion

October 24, 2018

Last Updated

March 19, 2019

Record last verified: 2019-03

Locations

US(1)