The Affordable Care Act's Preventive Services Mandate: Breaking down the Barriers to Nationwide Access to Preventive Services

Cogan, Jr. John Aloysius

doi:10.1111/j.1748-720x.2011.00605.x

Cited by 29 publications

(17 citation statements)

References 18 publications

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“…In the future, there is a need to ensure that young adults with insurance coverage use appropriate routine health care services and to more clearly define high-quality care and comprehensive preventive health care goals for this population. 23,24 Opportunities for improved primary care access are linked to USCs because people with a USC are more likely to use appropriate care services and to have continuity of care, especially when they also have insurance coverage.…”

Section: Discussionmentioning

confidence: 99%

Changes in Young Adult Primary Care Under the Affordable Care Act

et al. 2015

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Objectives. We sought to describe changes in young adults’ routine care and usual sources of care (USCs), according to provider specialty, after implementation of extended dependent coverage under the Affordable Care Act (ACA) in 2010. Methods. We used Medical Expenditure Panel Survey data from 2006 to 2012 to examine young adults’ receipt of routine care in the preceding year, identification of a USC, and USC provider specialties (pediatrics, family medicine, internal medicine, and obstetrics and gynecology). Results. The percentage of young adults who sought routine care increased from 42.4% in 2006 to 49.5% in 2012 (P < .001). The percentage identifying a USC remained stable at approximately 60%. Among young adults with a USC, there was a trend between 2006 and 2012 toward increasing percentages with pediatric (7.6% vs 9.1%) and family medicine (75.9% vs 80.9%) providers and declining percentages with internal medicine (11.5% vs 7.6%) and obstetrics and gynecology (5.0% vs 2.5%) providers. Conclusions. Efforts under the ACA to increase health insurance coverage had favorable effects on young adults’ use of routine care. Monitoring routine care use and USC choices in this group can inform primary care workforce needs and graduate medical education priorities across specialties.

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Section: Discussionmentioning

confidence: 99%

Changes in Young Adult Primary Care Under the Affordable Care Act

et al. 2015

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“…This cost-sharing will decrease the use of any screening protocol aimed at PC prevention. 22,23 Since a major goal of the ACA is to increase the use of preventive services, the USPSTF must update its PC screening guidelines to reflect recent knowledge and advances in risk stratification and PC screening.…”

Section: Discussionmentioning

confidence: 99%

A cost analysis of a pancreatic cancer screening protocol in high-risk populations

Bruenderman

Martin

2015

The American Journal of Surgery

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Background Pancreatic cancer is the 4th leading cause of cancer death in the U.S. A screening protocol is needed to catch early stage, resectable disease. This study suggests a protocol for high-risk individuals and assesses the cost in the context of the Affordable Care Act. Methods Medicare and national average pricing were used for cost analysis of a protocol using MRI/MRCP biannually in high-risk groups. Results: ‘ Costs per year of life added’ based on Medicare and national average costs, respectively, are: $638.62 and $2542.37 for Peutz-Jehgers Syndrome, $945.33 and $3763.44 for Hereditary Pancreatitis, $1141.77 and $4545.45 for Familial Pancreatic Cancer and p16-Leiden mutations, and $356.42 and $1418.92 for new-onset diabetes over age 50 with weight loss or smoking. Conclusion A screening program using MRI/MRCP is affordable in high-risk populations. The U.S. Preventive Services Task Force must reevaluate its pancreatic cancer screening guidelines to make screening more cost-effective for the individual.

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“…The inclusion of self-neglect as a category of abuse brings England in line with Scotland and the USA (United States of America), although there are still significant differences in jurisdiction between England, Scotland and the USA (Daniel et al, 2014;Day and Leahy-Warren, 2008). However, similar to UK laws, in the USA the Patient Protection and Affordable Care Act 2010 makes preventative work and wellness one of its key policy and legislative priorities (Cogan, 2011). The Elder Justice Act (EJA), passed as part of the Patient Protection and Affordable Care Act 2010, strengthened federal laws to prevent, protect and intervene in adult abuse and neglect cases.…”

Section: Background: the Legal Contextmentioning

confidence: 99%

Social work intervention with adults who self-neglect in England: responding to the Care Act 2014

Anka¹,

Sorensen²,

Brandon³

et al. 2017

JAP

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Purpose The purpose of this paper is to report on findings from an evaluative research study which looked at a timed intervention model of practice comprising of up to 24 weeks of intensive meetings with adult service users set up by one local authority in England, to prevent and delay the need for care and support. A particular focus of this paper is on adults who hoard. Design/methodology/approach The study employed a mixed-methods design, consisting of interviews with service users (n=13), social workers (n=3), social work managers (n=2) and stakeholders from external services and agencies (n=6). It included a costing analysis of staff time and an analysis of goals of service users and “satisfaction with life” self-report questionnaires (n=20), completed at pre- and post-intervention stages. Findings There was evidence that social workers used strengths, relationship-based and outcome-based focused approaches in their work. The techniques used by social workers to engage, achieve change and assess effectiveness with service users varied. These techniques included the use of photographs to enable the service user to map and assess their own progress over time, encouraging hoarders to declutter and reclaim their living space. The service users valued the time the social workers spent with them and the way that they were treated with sensitivity and respect. Research limitations/implications The study focused on one local authority in England; there was no comparison group. This, and the small sample size, means that statistical generalisations cannot be made and only limited conclusions can be drawn from the quantitative data. Originality/value The paper provides insights into the work undertaken by social workers with adults who hoard. It contributes to the body of knowledge on effective social work interventions with adults who hoard.

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The Affordable Care Act's Preventive Services Mandate: Breaking down the Barriers to Nationwide Access to Preventive Services

Cited by 29 publications

References 18 publications

Changes in Young Adult Primary Care Under the Affordable Care Act

Changes in Young Adult Primary Care Under the Affordable Care Act

A cost analysis of a pancreatic cancer screening protocol in high-risk populations

Social work intervention with adults who self-neglect in England: responding to the Care Act 2014

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