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  1. Article ; Online: Inequities in Telehealth Use Associated with Payer Type During the COVID-19 Pandemic.

    Lewis, Kanna N / Goudie, Anthony / Wilson, Jonathan C / Tawiah, Edward / Li, Jialiang / Thompson, Joseph W

    Telemedicine journal and e-health : the official journal of the American Telemedicine Association

    2022  

    Abstract: Introduction: ...

    Abstract Introduction:
    Language English
    Publishing date 2022-03-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2035659-6
    ISSN 1556-3669 ; 1530-5627
    ISSN (online) 1556-3669
    ISSN 1530-5627
    DOI 10.1089/tmj.2021.0618
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    Zs.A 4576: Show issues Location:
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  2. Article ; Online: Enrollee Experience with Providers in the Arkansas Medicaid Expansion Program.

    Bollinger, Mary / Pyne, Jeff / Goudie, Anthony / Han, Xiaotong / Hudson, Teresa J / Thompson, Joseph W

    Journal of general internal medicine

    2021  Volume 36, Issue 6, Page(s) 1673–1681

    Abstract: Background: Patient ratings of their healthcare experience as a quality measure have become critically important since the implementation of the Affordable Care Act (ACA). The ACA enabled states to expand Medicaid eligibility to reduce uninsurance ... ...

    Abstract Background: Patient ratings of their healthcare experience as a quality measure have become critically important since the implementation of the Affordable Care Act (ACA). The ACA enabled states to expand Medicaid eligibility to reduce uninsurance nationally. Arkansas gained approval to use Medicaid funds to purchase a qualified health plan (QHP) through the ACA marketplace for newly eligible beneficiaries.
    Objective: We compare patient-reported satisfaction between fee-for-service Medicaid and QHP participants.
    Design: The Consumer Assessment of Healthcare Providers and Systems (CAHPS) was used to identify differences in Medicaid and QHP enrollee healthcare experiences. Data were analyzed using a regression discontinuity design.
    Participants: Newly eligible Medicaid expansion participants enrolled in Medicaid during 2013 completed the Consumer Assessment of Health Providers and Systems (CAHPS) survey in 2014. Survey data was analyzed for 3156 participants (n = 1759 QHP/1397 Medicaid).
    Measures: Measures included rating of personal and specialist provider, rating of all healthcare received, and whether the provider offered to communicate electronically. Demographic and clinical characteristics of the enrollees were controlled for in the analyses.
    Methods: Regression-discontinuity analysis was used to evaluate differential program effects on positive ratings as measured by the CAHPS survey while controlling for demographic and health characteristics of participants.
    Key results: Adjusted logistic regression models for overall healthcare (OR = 0.71, 95%CI = 0.56-0.90, p = 0.004) and personal doctor (OR = 0.68, 95%CI = 0.53-0.87, p = 0.002) predicted greater satisfaction among QHP versus Medicaid participants. Results were not significant for specialists or for use of electronic communication with provider.
    Conclusions: Using a quasi-experimental statistical approach, we were able to control for observed and unobserved heterogeneity showing that among participants with similar characteristics, including income, QHP participants rated their personal providers and healthcare higher than those enrolled in Medicaid. Access to care, utilization of care, and healthcare and health insurance literacy may be contributing factors to these results.
    MeSH term(s) Arkansas ; Humans ; Insurance, Health ; Medicaid ; Patient Protection and Affordable Care Act ; Patient Satisfaction ; United States
    Language English
    Publishing date 2021-02-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 639008-0
    ISSN 1525-1497 ; 0884-8734
    ISSN (online) 1525-1497
    ISSN 0884-8734
    DOI 10.1007/s11606-020-06552-0
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  3. Article ; Online: "It's been like a miracle": Low-income Arkansans and access to health care services following Medicaid reform.

    Abraham, Traci H / McBain, Sacha A / Goudie, Anthony / Hudson, Teresa / Thompson, Joseph W

    Inquiry : a journal of medical care organization, provision and financing

    2020  Volume 57, Page(s) 46958020981169

    Abstract: This article reports qualitative results from a mixed-methods evaluation of the Arkansas Health Care Independence Program. Qualitative data was collected using telephone interviews with 24 low-income Arkansans newly enrolled in Medicaid or a Qualified ... ...

    Abstract This article reports qualitative results from a mixed-methods evaluation of the Arkansas Health Care Independence Program. Qualitative data was collected using telephone interviews with 24 low-income Arkansans newly enrolled in Medicaid or a Qualified Health Plan in 2014. We used methods developed for rapid qualitative assessment to explore a range of general barriers and facilitators to accessing health care services. Secondary analysis guided by the most significant change technique aided in the construction of case summaries that permitted insights into participants' experiences of managing their health over time. Barriers to accessing health care services included treatment costs, beliefs and values related to health, limited health literacy, poor quality health care, provider stigma, and difficulties that made travel challenging. For 1 participant who was no longer eligible for Medicaid or a QHP, lacking health care coverage was also problematic. Facilitators included having health care coverage, life experiences that re-enforced the value of prevention, health literacy, and enhanced health care services. Low-income Arkansans experiences accessing health care elucidate access as multi-dimensional, involving not only the availability of affordable services, but treatment effectiveness and patient experiences interacting with providers and clinic staff. We use these findings to formulate recommendations for programs and policies aimed at further increasing access to high-quality health care as a strategy for reducing health disparities.
    MeSH term(s) Health Services ; Health Services Accessibility ; Humans ; Medicaid ; Poverty ; Quality of Health Care ; United States
    Language English
    Publishing date 2020-12-17
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 42153-4
    ISSN 1945-7243 ; 0046-9580
    ISSN (online) 1945-7243
    ISSN 0046-9580
    DOI 10.1177/0046958020981169
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  4. Article ; Online: Impact of an Episode-Based Payment Initiative by Commercial Payers in Arkansas on Procedure Volume: an Observational Study.

    Chen, Julius L / Chernew, Michael E / Fendrick, A Mark / Thompson, Joseph W / Rose, Sherri

    Journal of general internal medicine

    2019  Volume 35, Issue 2, Page(s) 578–585

    Abstract: Background: Episode-based payment (EBP) is gaining traction among payers as an alternative to fee-for-service reimbursement. However, there is concern that EBP could influence the number of episodes.: Objective: To examine how procedure volume ... ...

    Abstract Background: Episode-based payment (EBP) is gaining traction among payers as an alternative to fee-for-service reimbursement. However, there is concern that EBP could influence the number of episodes.
    Objective: To examine how procedure volume changed after the introduction of EBP in 2013 and 2014 under the Arkansas Health Care Payment Improvement Initiative.
    Design: Using 2011-2016 commercial claims data, we estimate a difference-in-differences model to assess the impact of EBP on the probability of a beneficiary having an episode for four procedures that were reimbursed under EBP in Arkansas: total joint replacement, cholecystectomy, colonoscopy, and tonsillectomy.
    Participants: Commercially insured beneficiaries in Arkansas serve as our treatment group, while commercially insured beneficiaries in neighboring states serve as our comparison group.
    Interventions: Statewide implementation of EBP for various clinical conditions by two of Arkansas' largest commercial insurers.
    Main measures: For a given procedure type, the primary outcomes are the annual rate of procedures (number of procedures per 1000 beneficiaries) and the probability of a beneficiary undergoing that procedure in a given quarter.
    Key results: The relationship between EBP and procedure volume varies across procedures. After EBP was implemented, the probability of undergoing colonoscopy increased by 17.2% (point estimate, 2.63; 95% CI, 1.18 to 4.08; p < 0.001; Arkansas pre-period mean, 15.29). The probability of undergoing total joint replacement increased by 9.9% (point estimate, 0.091; 95% CI, - 0.011 to 0.19; p = 0.08; Arkansas pre-period mean, 0.91), though this effect is not significant. There is no discernable impact on cholecystectomy or tonsillectomy volume.
    Conclusions: We do not find clear evidence of deleterious volume expansion. However, because the impact of EBP on procedure volume may vary by procedure, payers planning to implement EBP models should be aware of this possibility.
    MeSH term(s) Arkansas ; Fee-for-Service Plans ; Humans ; Reimbursement Mechanisms ; United States
    Language English
    Publishing date 2019-09-16
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 639008-0
    ISSN 1525-1497 ; 0884-8734
    ISSN (online) 1525-1497
    ISSN 0884-8734
    DOI 10.1007/s11606-019-05318-7
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    Zs.A 2205: Show issues Location:
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  5. Article ; Online: SARS-CoV-2 Incidence in K-12 School Districts with Mask-Required Versus Mask-Optional Policies - Arkansas, August-October 2021.

    Donovan, Catherine V / Rose, Charles / Lewis, Kanna N / Vang, Kristyn / Stanley, Nichole / Motley, Michael / Brown, Clare C / Gray, Franklin John / Thompson, Joseph W / Amick, Benjamin C / Williams, Mark L / Thomas, Ebony / Neatherlin, John / Zohoori, Namvar / Porter, Austin / Cima, Mike

    MMWR. Morbidity and mortality weekly report

    2022  Volume 71, Issue 10, Page(s) 384–389

    Abstract: Masks are effective at limiting transmission of SARS-CoV-2, the virus that causes COVID-19 (1), but the impact of policies requiring masks in school settings has not been widely evaluated (2-4). During fall 2021, some school districts in Arkansas ... ...

    Abstract Masks are effective at limiting transmission of SARS-CoV-2, the virus that causes COVID-19 (1), but the impact of policies requiring masks in school settings has not been widely evaluated (2-4). During fall 2021, some school districts in Arkansas implemented policies requiring masks for students in kindergarten through grade 12 (K-12). To identify any association between mask policies and COVID-19 incidence, weekly school-associated COVID-19 incidence in school districts with full or partial mask requirements was compared with incidence in districts without mask requirements during August 23-October 16, 2021. Three analyses were performed: 1) incidence rate ratios (IRRs) were calculated comparing districts with full mask requirements (universal mask requirement for all students and staff members) or partial mask requirements (e.g., masks required in certain settings, among certain populations, or if specific criteria could not be met) with school districts with no mask requirement; 2) ratios of observed-to-expected numbers of cases, by district were calculated; and 3) incidence in districts that switched from no mask requirement to any mask requirement were compared before and after implementation of the mask policy. Mean weekly district-level attack rates were 92-359 per 100,000 persons in the community* and 137-745 per 100,000 among students and staff members; mean student and staff member vaccination coverage ranged from 13.5% to 18.6%. Multivariable adjusted IRRs, which included adjustment for vaccination coverage, indicated that districts with full mask requirements had 23% lower COVID-19 incidence among students and staff members compared with school districts with no mask requirements. Observed-to-expected ratios for full and partial mask policies were lower than ratios for districts with no mask policy but were slightly higher for districts with partial policies than for those with full mask policies. Among districts that switched from no mask requirement to any mask requirement (full or partial), incidence among students and staff members decreased by 479.7 per 100,000 (p<0.01) upon implementation of the mask policy. In areas with high COVID-19 community levels, masks are an important part of a multicomponent prevention strategy in K-12 settings (5).
    MeSH term(s) Arkansas/epidemiology ; COVID-19/epidemiology ; COVID-19/prevention & control ; Health Policy ; Humans ; Incidence ; Masks ; SARS-CoV-2 ; Schools
    Language English
    Publishing date 2022-03-11
    Publishing country United States
    Document type Technical Report
    ZDB-ID 412775-4
    ISSN 1545-861X ; 0149-2195
    ISSN (online) 1545-861X
    ISSN 0149-2195
    DOI 10.15585/mmwr.mm7110e1
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    Zs.B 1827: Show issues Location:
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  6. Article ; Online: Multicomponent Informed Consent with Marshallese Participants.

    Purvis, Rachel S / Ayers, Britni L / Bogulski, Cari A / Kaminicki, Kyle F / Haggard-Duff, Lauren K / Riklon, Lynda A / Iban, Anita / Mejbon-Samuel, Rotha / Lakmis, Rumina / Riklon, Sheldon / Thompson, Joseph W / McElfish, Pearl A

    Journal of empirical research on human research ethics : JERHRE

    2021  Volume 16, Issue 3, Page(s) 144–153

    Abstract: Pacific Islanders are the second fastest-growing population in the United States; however, Pacific Islanders, and Marshallese specifically, are underrepresented in health research. A community-based participatory research (CBPR) approach was used to ... ...

    Abstract Pacific Islanders are the second fastest-growing population in the United States; however, Pacific Islanders, and Marshallese specifically, are underrepresented in health research. A community-based participatory research (CBPR) approach was used to engage Marshallese stakeholders and build an academic-community research collaborative to conduct health disparities research. Our CBPR partnership pilot tested a multicomponent consent process that provides participants the option to control the use of their data. Consent forms used concise plain language to describe study information, including participant requirements, risks, and personal health information protections, and were available in both English and Marshallese. This study demonstrates that when provided a multicomponent consent, the vast majority of consenting study participants (89.6%) agreed to all additional options, and only five (10.4%) provided consent for some but not all options. Our description of the development and implementation of a multicomponent consent using a CBPR approach adds a specific example of community engagement and may be informative for other indigenous populations.
    MeSH term(s) Humans ; Community-Based Participatory Research/statistics & numerical data ; Informed Consent/statistics & numerical data ; Language ; Native Hawaiian or Other Pacific Islander/statistics & numerical data ; United States
    Language English
    Publishing date 2021-03-29
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2263068-5
    ISSN 1556-2654 ; 1556-2646
    ISSN (online) 1556-2654
    ISSN 1556-2646
    DOI 10.1177/15562646211005651
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  7. Article ; Online: Arkansas's novel approach to expanding health care coverage.

    Thompson, Joseph W / Wilson, J Craig / Allison, Andrew / Beebe, Mike

    Journal of health politics, policy and law

    2014  Volume 39, Issue 6, Page(s) 1277–1288

    Abstract: The state of Arkansas is implementing a novel approach to expanding health care coverage for individuals newly eligible for Medicaid under the Patient Protection and Affordable Care Act (ACA). Through a section 1115 demonstration waiver, the state will ... ...

    Abstract The state of Arkansas is implementing a novel approach to expanding health care coverage for individuals newly eligible for Medicaid under the Patient Protection and Affordable Care Act (ACA). Through a section 1115 demonstration waiver, the state will use federal funding via a premium assistance model to secure private health insurance offered through the newly formed health insurance marketplace to those individuals aged nineteen to sixty-four who have incomes at or below 138 percent of the federal poverty level. As of April 2014, the Health Care Independence Program (HCIP), as it is formally known, had over 155,000 individuals who had been determined eligible. The HCIP premium assistance approach is commonly referred to as the "private option" and was designed to achieve comparable access, network availability, quality of care, and opportunities for improved outcomes for HCIP enrollees (i.e., those who would be eligible for traditional, fee-for-service Medicaid through ACA expansion) when compared with their privately insured counterparts. This article provides the background, political discourse, policy development, evaluation strategy, and progress report for this innovative new program.
    MeSH term(s) Adult ; Arkansas ; Eligibility Determination ; Female ; Health Insurance Exchanges/economics ; Health Insurance Exchanges/organization & administration ; Health Services Accessibility/organization & administration ; Humans ; Male ; Medicaid/economics ; Medicaid/organization & administration ; Middle Aged ; Patient Protection and Affordable Care Act/legislation & jurisprudence ; Policy ; Policy Making ; Politics ; Poverty ; United States ; Young Adult
    Language English
    Publishing date 2014-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 752966-1
    ISSN 1527-1927 ; 0361-6878
    ISSN (online) 1527-1927
    ISSN 0361-6878
    DOI 10.1215/03616878-2829483
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    Zs.B 1972: Show issues Location:
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  8. Article: Arkansas health care payment improvement initiative: overview and the role of quality measures.

    Golden, William / Griffin, Robert F / Thompson, Joseph W / Armstrong, Richard

    The Journal of the Arkansas Medical Society

    2012  Volume 109, Issue 1, Page(s) 16–17

    MeSH term(s) Arkansas ; Episode of Care ; Humans ; Outcome Assessment (Health Care)/methods ; Outcome Assessment (Health Care)/trends ; Quality Assurance, Health Care/methods ; Quality Assurance, Health Care/trends ; Reimbursement Mechanisms/trends
    Language English
    Publishing date 2012-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 437911-1
    ISSN 0004-1858
    ISSN 0004-1858
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  9. Article ; Online: Arkansas' experience: statewide surveillance and parental information on the child obesity epidemic.

    Thompson, Joseph W / Card-Higginson, Paula

    Pediatrics

    2009  Volume 124 Suppl 1, Page(s) S73–82

    Abstract: Parents, clinicians, public health officials, and policy makers need readily available information on the extent of the childhood obesity epidemic. As in any epidemic, the strategies and tools used to combat the imminent threat are frequently based on ... ...

    Abstract Parents, clinicians, public health officials, and policy makers need readily available information on the extent of the childhood obesity epidemic. As in any epidemic, the strategies and tools used to combat the imminent threat are frequently based on scientific rationale and experience but applied in areas in which we lack complete understanding. The urgent need for information requires execution of decisions that are not risk-free--such is the case of BMI screening obesity. Use of BMI percentiles to classify weight status among youth and quantify the epidemic can inform and engage parents and other key stakeholders. Arkansas has completed its sixth year of BMI screenings for public school students. Through a groundbreaking legislative mandate that requires BMI assessments in public schools, the state has achieved both enhanced awareness among parents and their children and increased engagement by school, clinical, public health, and community leaders in response to the epidemic. External evaluations conducted since institution of BMI assessments have revealed none of the initially feared negative consequences of BMI measurements such as teasing, use of diet pills, or excessive concerns about weight. In the face of this epidemic, the risks of using BMI assessments in clinical or school-based settings must be recognized but can be managed. Arkansas' Act 1220 and BMI-reporting efforts have not only afforded parents detailed information about their children's health but also provided longitudinal data needed to fully understand the scope of childhood and adolescent obesity in the state and to track progress made in combating this epidemic.
    MeSH term(s) Adolescent ; Arkansas ; Body Mass Index ; Child ; Communication ; Health Behavior ; Health Promotion ; Humans ; Legislation, Medical ; Life Style ; Medical Records ; Obesity/epidemiology ; Overweight/prevention & control ; Population Surveillance ; School Health Services
    Language English
    Publishing date 2009-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2008-3586J
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  10. Article: Am I my brother's keeper? A proposal to determine state governments' affirmative duty to advance public health.

    Ryan, Kevin W / Card-Higginson, Paula / Thompson, Joseph W

    Journal of health and human services administration

    2008  Volume 31, Issue 1, Page(s) 124–133

    MeSH term(s) Community Participation ; Humans ; Midwestern United States ; Poverty Areas ; Public Health ; Social Responsibility ; Southeastern United States ; State Government ; United States
    Language English
    Publishing date 2008
    Publishing country United States
    Document type Journal Article ; Legal Cases
    ZDB-ID 1223296-8
    ISSN 2168-5509 ; 1079-3739 ; 0160-4198
    ISSN (online) 2168-5509
    ISSN 1079-3739 ; 0160-4198
    Database MEDical Literature Analysis and Retrieval System OnLINE

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