Medicaid Policy Lab.
Our mission is to inform policymaking with evidence to improve access, quality, and equity for low-income populations and marginalized groups.
The Boston University Medicaid Policy Lab engages in scholarship focused on Medicaid, the state-federal partnership program that provides access to health care for over 70 million low-income people. Medicaid is a primary payer for births, children, mental health care, and long-term care in the United States. We are an interdisciplinary group of faculty and students across Boston University, comprised of health services researchers, health economists, legal scholars, physicians, and political scientists. Our work evaluates the impacts of policy changes and innovative care delivery models on health insurance coverage, access to care, quality of care, health outcomes, and equity in low-income and Medicaid-enrolled populations. Medicaid Policy Lab researchers receive grants from public and private funding organizations, including the National Institutes of Health, the Health Resources and Services Administration, the Donaghue Foundation, Kate B. Reynolds Charitable Trust, the Robert Wood Johnson Fund, the Milbank Memorial Fund, and the Commonwealth Fund.
What We Do
Our multidisciplinary research, translation, and dissemination activities promote effective solutions to strengthen Medicaid programs nationwide through:
- Generating rigorous quantitative and qualitative evidence to assess the intended and unintended effects of Medicaid policies
- Fostering multidisciplinary collaboration to generate innovative, policy-relevant scholarship
- Analyzing how the intersection between Medicaid law, politics, and policy can shape access to care and population health
- Engaging in legal scholarship to analyze policy changes and preserve equity, quality, and access for Medicaid populations
- Promoting the application of evidence in health care policy-making
- Partnerships with states and safety-net health systems
Co-Directors
SPH Affiliated Faculty
External Affiliated Faculty
- Heather Hsu, MD, MPH
- Anna L. Goldman, MD, MPA, MPH
- Elena Byhoff, MD, MSc
- Paul Christine, MD, PhD
- Astha Singhal, PhD
- Alison Galbraith, MD, PhD
Research Projects
Medicaid Data
Title: Medicaid Data Learning Network
Funder: The Commonwealth Fund/Robert Wood Johnson Foundation
Description: This project convenes users of the Transformed Medicaid Statistical Information System Analytic Files (T-MSIS TAF) to discuss their experiences using this new source of national Medicaid claims. The goal of the learning network is to share best practices, develop standardized approaches to using TAF data, and disseminate learnings.
MPL faculty contact: Sarah Gordon
Payment and Delivery Models
Title: Improving Quality of Care for Low-Income Pregnant People through Medicaid Accountable Care Organizations (R01MD017703)
Funder: National Institute on Minority Health Disparities (NIMHD), NIH
Description: This project evaluates how Medicaid accountable care organizations (ACOs), and different Medicaid ACO model designs, can improve quality and equity of care for pregnant people across the prenatal, delivery, and postpartum periods. It does so by leveraging a novel natural experiment using both claims data and qualitative interview data.
MPL faculty contact: Megan Cole Brahim
Title: Improving Quality of Care by Addressing Social Needs in Medicaid ACOs
Funder: National Center for Advancing Translational Sciences, NIH
Description: This project investigates the intersections of quality of care and social service integration within the statewide Massachusetts Medicaid ACO by using Medicaid claims data, electronic health record data, and qualitative data.
MPL faculty contact: Megan Cole Brahim
Title: Evaluating an Equity-Focused Telehealth Delivery Model for Medicaid-Enrolled Populations at Federally Qualified Health Centers
Funder: The Donaghue Foundation; the Robert Wood Johnson Foundation
Description: This project investigates how implementation of an equity- focused telehealth delivery model in FQHCs across Massachusetts affects quality, cost, and equity of care for Medicaid enrollees.
MPL faculty contact: Megan Cole Brahim
Title: Transforming and Expanding Access to Mental Health Care in Urban Pediatrics
Funder: The Smith Family Foundation & The Klarman Family Foundation
Description: This project evaluates how integrating behavioral health into primary care affects cost of care, utilization of services, and quality of care for Medicaid-enrolled children at community health centers.
MPL faculty contact: Megan Cole Brahim
Title: Improving Value-Based Care for Opioid Use Disorder
Funder: National Institute on Drug Abuse (NIDA) K01, NIH
Description: Dr. Hsu’s career development award from NIDA leverages Massachusetts’ experience with Medicaid accountable care organization implementation as a natural experiment to understand the effect of value-based care reform on quality of care and adequacy of reimbursement for opioid use disorder.
MPL faculty contact: Heather Hsu
Eligibility and Enrollment
Title: Randomized Communication Nudges to Increase Primary Care Engagement among Medicaid Enrollees in Maine
Funder: Boston University Clinical and Translational Science Institute Integrated Pilot Program
Description: This randomized intervention tests strategies to streamline outreach for new Medicaid enrollees in Maine on engagement with primary care services.
MPL faculty contact: Anna Goldman, Sarah Gordon
Title: National estimates of the impact of the Affordable Care Act on healthcare utilization, outcomes, and quality among Hispanic patients
Funder: National Institute on Minority Health Disparities (NIMHD), NIH
Description: This work is examining how Medicaid expansion has affected racial/ethnic disparities in ED use over time and differentially in areas with high versus low primary care capacity.
MPL faculty contact: Megan Cole Brahim
Title: A Data-Driven Approach to Ending Racial Inequity Through Health Policy Evaluation and Innovation
Funder: The Commonwealth Fund
Description: The Racial Policy Tracker will support antiracist policymaking by documenting current health and social policies, especially key state and federal policies (e.g., Medicaid, voting rights, housing), and evaluating them. They will gather information on health policy implementation to be able to: 1) measure the racially disparate impact of policy choices across key health metrics; 2) proactively support effective antiracist policymaking; and 3) assess challenges that interested policymakers face in implementing antiracist policies.
MPL faculty contact: Paul Shafer
Title: DS-TO-THE-MAX
Funder: National Institute on Aging (NIA), NIH
Description: We are using nine years of longitudinal Medicaid and Medicare data to understand the epidemiology and disparities in common conditions that co-occur with Down syndrome.
MPL faculty contact: Eric Rubenstein
Title: Role of State Medicaid Policies on Access to Dental Care among Low-Income Adults
Funder: National Institute of Dental and Craniofacial Research (NIDCR), NIH
Description: Low-income adults face significant barriers to access to dental care, evident in declining rates of dental care utilization, high unmet dental need, and the increasing rate of emergency department visits for dental problems. The goals of this project are to develop synthetic indices of state Medicaid dental benefit generosity, and examine how state Medicaid policies regarding eligibility, coverage and dentist reimbursement impact access to dental care among low-income adults.
MPL faculty contact: Astha Singhal
Title: The Effects of Postpartum Medicaid Policies on Postpartum Depression Care Among Low-Income Women
Funder: National Institute of Mental Health (NIMH), NIH
Description: This mixed-methods research examines the effects of postpartum Medicaid eligibility and benefit policies on PPD care among low-income women by evaluating the effects of retaining Medicaid eligibility beyond the pregnancy-related eligibility limit of 60 days postpartum and Medicaid reimbursement for PPD screening during well-child visits on PPD screening, diagnosis, and treatment rates in the postpartum year.
MPL faculty contact: Sarah Gordon
Title: Improving Pregnancy Outcomes For Women With Intellectual And Developmental Disabilities In Medicaid
Funder: National Institute of Child Health and Human Development (NICHD), NIH
Description: This project uses national data and qualitative interviews to identify optimal practices and policies that reduce maternal morbidity in Medicaid-enrolled pregnant women with intellectual and developmental disabilities.
MPL faculty contact: Eric Rubenstein
Recently Completed Medicaid Policy Lab Projects
Title: Doula Care Saves Lives, Improves Equity, And Empowers Mothers. State Medicaid Programs Should Pay For It
Description: Doula care is an effective, evidence-based practice that improves health outcomes and patient satisfaction. However, traditional maternity care teams do not often include doulas, and private and public insurance carriers rarely cover their services. In this blog post, the authors lay out policy recommendations to expand Medicaid coverage of doula services.
MPL contact: Cara Safon
Title: Informing North Carolina’s COVID-19 Pandemic Response: Projected Service Needs of Medicaid Beneficiaries
Funder: Kate B. Reynolds Charitable Trust
Description: This project examines Medicaid participation during COVID-19, including: 1) the relationship between county-level changes in unemployment and Medicaid enrollment, testing social vulnerability as a moderator and 2) how new Medicaid enrollees during COVID-19 are using health care relative to existing and prior cohorts of new enrollees.
MPL faculty contact: Paul Shafer
Title: Does a transition to accountable care in Medicaid shift the modality of colorectal cancer testing?
Description: This study explored trajectories in colorectal cancer (CRC) testing over a 5-year period that included implementation of 16 Medicaid Accountable Care Organizations and Medicaid expansion in Oregon.
MPL faculty contact: Paul Shafer
Title: The Association between the Veterans’ Health Administration Choice Program and Access to Care among Medicaid Enrollees
Funder: Veterans’ Health Administration (VHA) Office of Health Equity
Description: This project examines the association between county-level penetration of the Veterans’ Health Administration Community Care program and self-reported access to care among Medicaid enrollees.
MPL faculty contact: Sarah Gordon
Title: The Impact of Medicaid Expansion on Continuity of Coverage and Health Care Utilization
Funder: Agency for Healthcare Research and Quality (AHRQ)
Description: This project examined the effect of Medicaid expansion under the Affordable Care Act on continuity of Medicaid enrollment and the association between cost-sharing reductions in ACA Marketplaces and duration of enrollment.
MPL faculty contact: Sarah Gordon
Title: The Impact of Medicaid Expansion on Federally Qualified Health Centers: Effects on Quality Performance and Capacity to Provide Care
Funder: Agency for Healthcare Research and Quality (AHRQ)
Description: This project examined the effect of Medicaid expansion under the Affordable Care Act (ACA) on quality of care, equity in quality of care, and service volume at all Federally Qualified Health Centers across the US, where 40% of patients were uninsured prior to the ACA.
MPL faculty contact: Megan Cole Brahim
Title: Rhode Island Health Care Cost Analysis and Cost Growth Target-Setting
Funder: The Peterson Foundation
Description: This work collaborates with stakeholders throughout the RI and uses all payer claims data to examine health care cost drivers across the state, including drivers of cost within Medicaid and across Medicaid ACOs.
MPL faculty contact: Megan Cole Brahim
Title: Racial and Ethnic Disparities in Postpartum Maternal Health: Implications of Postpartum Medicaid Eligibility Extensions
Funder: The Commonwealth Fund
Description: This project evaluates the causal effect of postpartum Medicaid coverage on enrollment, health care utilization, health outcomes, and racial and ethnic disparities in the postpartum year.
MPL faculty contact: Sarah Gordon
Title: Racial and Ethnic Differences in Severe Maternal Morbidity among Pregnant Women in Medicaid
Funder: National Center for Advancing Translational Sciences (NCATS), NIH
Description: This project examines racial and ethnic disparities in the timing of enrollment in Medicaid during the prenatal period.
MPL faculty contact: Sarah Gordon
If you are interested in an affiliation with the Medicaid Policy Lab, please reach out to mplab@bu.edu to be added to our listserv or join our monthly meetings.
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