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Article ; Online: Policy Recommendations to Address High Risk of COVID-19 Among Immigrants.

Langellier, Brent A

2020 Volume 110, Issue 8, Page(s) 1137–1139

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Emigrants and Immigrants/legislation & jurisprudence ; Emigrants and Immigrants/statistics & numerical data ; Ethnicity/statistics & numerical data ; Humans ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Public Assistance/legislation & jurisprudence ; Public Policy ; SARS-CoV-2 ; Undocumented Immigrants/legislation & jurisprudence ; Undocumented Immigrants/statistics & numerical data ; United States
Keywords	covid19
Language	English
Publishing date	2020-06-25
Publishing country	United States
Document type	Editorial
ZDB-ID	121100-6
ISSN	1541-0048 ; 0090-0036 ; 0002-9572
ISSN (online)	1541-0048
ISSN	0090-0036 ; 0002-9572
DOI	10.2105/AJPH.2020.305792
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Article ; Online: Impact of county and state immigration policies on immigrant household enrollment in the supplemental nutrition assistance program.

Argibay, Sofia / Auchincloss, Amy H / Chaparro, M Pia / Kravitz, Caroline / Eastus, Alexandra / Langellier, Brent A

Journal of migration and health

2024 Volume 9, Page(s) 100224

Abstract: Introduction: Low-income immigrants who are eligible to participate in the Supplemental Nutrition Assistance Program (SNAP) participate at lower rates compared to non-immigrants. Immigrant households may be more likely to participate in SNAP if they ... ...

Abstract	Introduction: Low-income immigrants who are eligible to participate in the Supplemental Nutrition Assistance Program (SNAP) participate at lower rates compared to non-immigrants. Immigrant households may be more likely to participate in SNAP if they live in areas with policies that integrate them into society and protect them from deportation. Methods: Data on low-income immigrant households came from the 2019 American Community Survey ( Results: Living in a jurisdiction with a SP was associated with 21% higher odds of enrolling in SNAP compared to living in a jurisdiction without a SP (adjusted odds ratio [aOR] 1.21, 95% CI=1.11,1.31). Relative to the least immigrant friendly states, living in the most immigrant-friendly states was associated with 16% higher odds of SNAP enrollment (aOR=1.16, 95%CI=1.06-1.28). When SP and state-level immigrant friendly policy environment were cross-classified, SNAP participation was 23% and 26% higher for those living in jurisdictions with one- and both- exposures, respectively, relative to those with neither (aOR 1.23; CI 1.12,1.36; aOR 1.26; CI 1.15,1.37). Conclusions: Many at high risk of food insecurity - including immigrants and citizens in households with immigrants - are eligible for SNAP but under-enroll. Policies that welcome and safeguard immigrants could reduce under enrollment.
Language	English
Publishing date	2024-02-29
Publishing country	England
Document type	Journal Article
ISSN	2666-6235
ISSN (online)	2666-6235
DOI	10.1016/j.jmh.2024.100224
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Article ; Online: Care for food-insecure enrollees in Medicare Advantage vs traditional Medicare.

Park, Sunchul / Langellier, Brent A

The American journal of managed care

2021 Volume 27, Issue 7, Page(s) e234–e241

Abstract: Objectives: To examine whether enrollment in Medicare Advantage (MA) and fee-for-service traditional Medicare (TM) is differential by food insecurity and then examine differences in health care utilization, financial burden, care satisfaction, and ... ...

Abstract	Objectives: To examine whether enrollment in Medicare Advantage (MA) and fee-for-service traditional Medicare (TM) is differential by food insecurity and then examine differences in health care utilization, financial burden, care satisfaction, and health status between food-insecure enrollees in MA and TM and between food-secure enrollees in MA and TM. Study design: We employed a retrospective cohort study design. Using the 2015-2016 Medicare Current Beneficiary Survey, we identified the following 4 mutually exclusive groups: food-insecure enrollees in MA, food-insecure enrollees in TM, food-secure enrollees in MA, and food-secure enrollees in TM. Methods: We used an instrumental variable approach to address endogenous choice between MA and TM. Using a 2-stage least squares regression model, we estimated the adjusted outcomes for each group and differences in the adjusted outcomes between food-insecure enrollees in MA and TM and between food-secure enrollees in MA and TM. Results: There were no significant differences in enrollment between MA and TM by food insecurity status. Compared with food-insecure enrollees in TM, food-insecure enrollees in MA had significantly lower health care utilization and financial burden. A similar pattern was observed among food-secure enrollees, but the difference in health care utilization was greater between food-insecure enrollees in MA and TM than between food-secure enrollees in MA and TM. There were no significant differences in care satisfaction and health status between MA and TM. However, food insecurity status did not improve in MA and TM enrollees over time. Conclusions: MA may deliver care more efficiently to food-insecure beneficiaries than TM, but it is not better at reducing food insecurity.
MeSH term(s)	Aged ; Fee-for-Service Plans ; Health Status ; Humans ; Medicare Part C ; Patient Acceptance of Health Care ; Retrospective Studies ; United States
Language	English
Publishing date	2021-07-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2035781-3
ISSN	1936-2692 ; 1088-0224 ; 1096-1860
ISSN (online)	1936-2692
ISSN	1088-0224 ; 1096-1860
DOI	10.37765/ajmc.2021.88707
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Article ; Online: Methods and measures to evaluate the impact of participatory model building on public policymakers: a scoping review protocol.

Henson, Rosie Mae / Purtle, Jonathan / Headen, Irene / Stankov, Ivana / Langellier, Brent A

BMJ open

2024 Volume 14, Issue 1, Page(s) e074891

Abstract: Introduction: Public policymakers are increasingly engaged in participatory model building processes, such as group model building. Understanding the impacts of policymaker participation in these processes on policymakers is important given that their ... ...

Abstract	Introduction: Public policymakers are increasingly engaged in participatory model building processes, such as group model building. Understanding the impacts of policymaker participation in these processes on policymakers is important given that their decisions often have significant influence on the dynamics of complex systems that affect health. Little is known about the extent to which the impacts of participatory model building on public policymakers have been evaluated or the methods and measures used to evaluate these impacts. Methods and analysis: A scoping review protocol was developed with the objectives of: (1) scoping studies that have evaluated the impacts of facilitated participatory model building processes on public policymakers who participated in these processes; and (2) describing methods and measures used to evaluate impacts and the main findings of these evaluations. The Joanna Briggs Institute's Population, Concept, Context framework was used to formulate the article identification process. Seven electronic databases-MEDLINE (Ovid), ProQuest Health and Medical, Scopus, Web of Science, Embase (Ovid), CINAHL Complete and PsycInfo-will be searched. Identified articles will be screened according to inclusion and exclusion criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist for scoping reviews will be used and reported. A data extraction tool will collect information across three domains: study characteristics, methods and measures, and findings. The review will be conducted using Covidence, a systematic review data management platform. Ethics and dissemination: The scoping review produced will generate an overview of how public policymaker engagement in participatory model building processes has been evaluated. Findings will be disseminated through peer-reviewed publications and to communities of practice that convene policymakers in participatory model building processes. This review will not require ethics approval because it is not human subject research.
MeSH term(s)	Humans ; Administrative Personnel ; Checklist ; Data Management ; Databases, Factual ; MEDLINE ; Review Literature as Topic ; Research Design
Language	English
Publishing date	2024-01-06
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-074891
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Article: Policy Recommendations to Address High Risk of COVID-19 Among Immigrants

Langellier, Brent A

Am J Public Health

Abstract: The health and economic consequences of COVID-19 will be devastatingly widespread, but the populations that will suffer most are those who have experienced longstanding health disparities. For example, emerging evidence strongly suggests that incidence ... ...

Abstract	The health and economic consequences of COVID-19 will be devastatingly widespread, but the populations that will suffer most are those who have experienced longstanding health disparities. For example, emerging evidence strongly suggests that incidence and case fatality rates are higher among Blacks than Whites.1 Immigrants are among the groups most likely to experience disproportionate effects from COVID-19. Unlike race/ethnicity, however, nativity and citizenship status are not included on the Centers for Disease Control and Prevention's (CDC's) coronavirus case report form,2 so data regarding testing and spread across immigrant groups are likely to remain scarce. Information from other health and social surveys-including data that I present in Table 1-suggest that noncitizens experience barriers to physical distancing that will place them at high risk of contracting COVID-19 and have high levels of disadvantage that leave them vulnerable to its economic effects. I recommend three policy changes to address the high health and economic risk among noncitizens, goals that are in the best interest of public health and the broader economy. (Am J Public Health. Published online ahead of print June 25, 2020: e1-e3. doi:10.2105/AJPH.2020.305792).
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32584591
Database	COVID19

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Article ; Online: Differences between integrated and non-integrated plans in Medicare Advantage.

Park, Sungchul / Langellier, Brent A / Meyers, David J

Health services research

2022 Volume 58, Issue 3, Page(s) 560–568

Abstract: Objective: To understand differences in financial performance, quality performance, supplemental benefits provision, and enrollee composition between integrated and non-integrated plans in the Medicare Advantage (MA) program.: Data sources: We used ... ...

Abstract	Objective: To understand differences in financial performance, quality performance, supplemental benefits provision, and enrollee composition between integrated and non-integrated plans in the Medicare Advantage (MA) program. Data sources: We used data from the Center for Medicare and Medicaid Services for 2015-2017. We included 156 integrated MA plans (31 unique contracts) and 2096 non-integrated MA plans (392 unique contracts). Study design: We estimated linear probably models for financial performance, quality performance, supplemental benefits provision, and enrollee composition with state fixed effects and contract random effects. We adjusted for county-level market structure-related factors, cost-related factors, and demand-related factors. Our primary independent variable was an indicator of plan-provider integration. Principal findings: Integrated MA plans were associated with $19.4 (95% CI: 9.2, 29.7) and $16.6 (95% CI: 10.3, 22.9) higher Part C and Part D monthly premiums, but were associated with higher star quality ratings. There were no significant differences in revenues and plan payments per enrollee between integrated and non-integrated MA plans. Integrated MA plans were associated with $40.5 (95% CI: -54.0, -26.9) lower non-claims costs than non-integrated MA plans. There was limited evidence that integrated MA plans provided more generous supplemental benefits than non-integrated MA plans. Enrollment rates in integrated MA plans were particularly low among socially marginalized groups (3.4 [95% CI: -5.9, -1.0], 4.7 [95% CI: -8.5, -0.9], and 4.4 [95% CI: -6.4, -2.4] percentage points lower among non-Hispanic Black, Medicare-Medicaid dual eligible, and the disabled). Conclusions: Our findings suggest that integrated MA plans may achieve higher efficiency and quality, but these benefits may not be experienced by all beneficiaries due to disparities in enrollment. As these models continue to spread, it is critical to develop policies to ensure that MA enrollees have equal access to integrated plans.
MeSH term(s)	Aged ; Humans ; United States ; Medicare Part C ; Contracts ; Policy
Language	English
Publishing date	2022-11-21
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	410435-3
ISSN	1475-6773 ; 0017-9124
ISSN (online)	1475-6773
ISSN	0017-9124
DOI	10.1111/1475-6773.14101
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Article ; Online: Association of Health Insurance Literacy With Enrollment in Traditional Medicare, Medicare Advantage, and Plan Characteristics Within Medicare Advantage.

Park, Sungchul / Langellier, Brent A / Meyers, David J

JAMA network open

2022 Volume 5, Issue 2, Page(s) e2146792

Abstract: Importance: Health insurance literacy helps individuals make informed choices. However, evidence suggests that Medicare beneficiaries experience low health insurance literacy, leading to high-cost or poor-quality coverage choices.: Objective: To ... ...

Abstract	Importance: Health insurance literacy helps individuals make informed choices. However, evidence suggests that Medicare beneficiaries experience low health insurance literacy, leading to high-cost or poor-quality coverage choices. Objective: To examine how health insurance literacy was associated with coverage choices between traditional Medicare (TM) and Medicare Advantage (MA), as well as within MA. Design, setting, and participants: This cross-sectional study included 6627 TM and MA enrollees, using data from the 2015-2016 Medicare Current Beneficiary Survey. Data analyses were conducted between May 1 and June 30, 2021. Exposures: Three self-reported measures of health insurance literacy (presence of information to make an informed comparison, ease in reviewing and comparing coverage options, and annual review and comparison of coverage options). Main outcomes and measures: Enrollment in TM vs MA and enrollment in an MA plan with different characteristics (star rating, monthly plan premium, in-network maximum out-of-pocket limit, plan type, and provision of supplemental benefits). Results: We included 6627 Medicare beneficiaries (3578 women [54.0%]; mean [SD] age, 75.13 [7.12] years). A total of 77 individuals were Asian (1.2%), 696 were Black (10.5%), 488 were Hispanic (7.4%), 5277 were non-Hispanic White (79.6%), and 225 (3.4%) were single races not of Hispanic origin (including American Indian or Alaska Native and Native Hawaiian) or were 2 or more races. Medicare Advantage enrollment was higher among individuals with higher health insurance literacy than those with lower health insurance literacy, especially for those who reviewed or compared coverage options annually than among those who did not (38.0%; 95% CI, 36.0%-40.1% vs 27.8%; 95% CI, 25.8%-29.7%). Among MA beneficiaries, those who reviewed or compared coverage options annually were more likely to enroll in plans with 4 to 4.5 stars and plans with monthly premiums of $1 to $50 by 4.6 percentage points (95% CI, 0.1-9.2 percentage points) and 4.8 percentage points (95% CI, 0.6-9.0 percentage points), respectively. However, enrollment in plans with 5 stars was 3.8 percentage points lower (95% CI, -5.8 to -1.9 percentage points) among individuals who reviewed or compared coverage options annually than among those who did not. Among individuals with low socioeconomic status, the likelihood of reviewing or comparing coverage options annually was lower for those with Medicare and Medicaid dual eligibility than for those without it (odds ratio, 0.79; 95% CI, 0.63-0.99). Conclusions and relevance: Results of this study suggest that higher health insurance literacy-particularly, annual review and comparison of coverage choices-is associated with higher MA enrollment and choice of a particular MA plan. Policy makers should develop programs to encourage frequent review and comparison of coverage options for informed decision making.
MeSH term(s)	Aged ; Choice Behavior ; Cross-Sectional Studies ; Female ; Health Literacy ; Humans ; Insurance, Health ; Male ; Medicare ; Medicare Part C ; United States
Language	English
Publishing date	2022-02-01
Publishing country	United States
Document type	Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2021.46792
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Article ; Online: Methods and measures to evaluate the impact of participatory model building on public policymakers

Brent A Langellier / Ivana Stankov / Jonathan Purtle / Rosie Mae Henson / Irene Headen

BMJ Open, Vol 14, Iss

a scoping review protocol

2024 Volume 1

Abstract: Introduction Public policymakers are increasingly engaged in participatory model building processes, such as group model building. Understanding the impacts of policymaker participation in these processes on policymakers is important given that their ... ...

Abstract	Introduction Public policymakers are increasingly engaged in participatory model building processes, such as group model building. Understanding the impacts of policymaker participation in these processes on policymakers is important given that their decisions often have significant influence on the dynamics of complex systems that affect health. Little is known about the extent to which the impacts of participatory model building on public policymakers have been evaluated or the methods and measures used to evaluate these impacts.Methods and analysis A scoping review protocol was developed with the objectives of: (1) scoping studies that have evaluated the impacts of facilitated participatory model building processes on public policymakers who participated in these processes; and (2) describing methods and measures used to evaluate impacts and the main findings of these evaluations. The Joanna Briggs Institute’s Population, Concept, Context framework was used to formulate the article identification process. Seven electronic databases—MEDLINE (Ovid), ProQuest Health and Medical, Scopus, Web of Science, Embase (Ovid), CINAHL Complete and PsycInfo—will be searched. Identified articles will be screened according to inclusion and exclusion criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist for scoping reviews will be used and reported. A data extraction tool will collect information across three domains: study characteristics, methods and measures, and findings. The review will be conducted using Covidence, a systematic review data management platform.Ethics and dissemination The scoping review produced will generate an overview of how public policymaker engagement in participatory model building processes has been evaluated. Findings will be disseminated through peer-reviewed publications and to communities of practice that convene policymakers in participatory model building processes. This review will not require ethics approval because it ...
Keywords	Medicine ; R
Subject code	306
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Financial Performance of Medicare Advantage Contracts in 2014 and Plan Renewal, Consolidation, and Termination Rates in the Subsequent Year.

Langellier, Brent A / Park, Sungchul

Medical care

2020 Volume 58, Issue 8, Page(s) 674–680

Abstract: Background: Starting in 2014, the Affordable Care Act mandated that Medicare Advantage (MA) contracts spend at least 85% of total revenue on claims and quality improvement [ie, the medical loss ratio (MLR)] and submit revenue and cost data annually in ... ...

Abstract	Background: Starting in 2014, the Affordable Care Act mandated that Medicare Advantage (MA) contracts spend at least 85% of total revenue on claims and quality improvement [ie, the medical loss ratio (MLR)] and submit revenue and cost data annually in MLR reports. These reports can improve transparency of the financial performance of MA contracts. However, little is known about revenues and costs of insurers that participate in MA and its impacts on status changes in the following year. Objective: To characterize revenues and costs of MA contracts in 2014, with a focus on MLRs and gross margins, and to assess heterogeneity in subsequent-year plan renewal and termination rates by gross margins. Research design: Cross-sectional data from MLR reports submitted in 2014 by MA contracts and from 2015 Part C & D Plan Crosswalk Files regarding plan renewal, termination, and other status changes from 2014 to 2015. Subjects: Three hundred eighty-nine MA contracts. Measures: Primary outcomes are MLRs and gross margins. Results: MLRs averaged 93% in 2014; 11% of contracts reported MLRs of at least 100%. Fifty-six percent reported negative margins, or costs that exceeded revenues. Seventeen percent of plans in contracts in the lowest quartile of gross margins were terminated in 2015, compared to under 5% of plans in the highest-margin contracts. Conclusions: In 2014, MA contracts reported MLRs greater than the mandatory minimum of 85%. Gross margins likely contribute to trends in plan and insurer availability. MLR reports from subsequent years can help explain fluctuations in insurers' participation in MA.
MeSH term(s)	Contracts/economics ; Contracts/standards ; Contracts/statistics & numerical data ; Cross-Sectional Studies ; Financial Management/statistics & numerical data ; Humans ; Medicare Part C/economics ; Medicare Part C/standards ; Medicare Part C/statistics & numerical data ; United States
Language	English
Publishing date	2020-02-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	411646-x
ISSN	1537-1948 ; 0025-7079
ISSN (online)	1537-1948
ISSN	0025-7079
DOI	10.1097/MLR.0000000000001314
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Article ; Online: Adoption of Telehealth Benefits by Medicare Advantage Plans in 2020 and 2021.

Park, Sungchul / Langellier, Brent A / Meyers, David J

Journal of general internal medicine

2021 Volume 37, Issue 3, Page(s) 686–688

MeSH term(s)	Aged ; Humans ; Insurance Benefits ; Medicare Part C ; Telemedicine ; United States
Language	English
Publishing date	2021-01-26
Publishing country	United States
Document type	Letter
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-020-06535-1
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