{"id":170430,"date":"2020-08-01T09:00:15","date_gmt":"2020-08-01T13:00:15","guid":{"rendered":"https:\/\/www.bu.edu\/sph\/?p=170430"},"modified":"2020-09-17T10:18:25","modified_gmt":"2020-09-17T14:18:25","slug":"professor-wins-outstanding-dissertation-award","status":"publish","type":"bu-article","link":"https:\/\/www.bu.edu\/sph\/news\/articles\/2020\/professor-wins-outstanding-dissertation-award\/","title":{"rendered":"Professor Wins Outstanding Dissertation Award"},"content":{"rendered":"\n
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August 1, 2020<\/div>\n\t\t\n\t\t\t\t
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\"\"Sarah Gordon<\/a>, assistant professor of health law, policy & management, has received the 2020 Outstanding Dissertation Award<\/a> by AcademyHealth<\/a>. She accepted the award during a session at the organization\u2019s virtual Annual Research Meeting (ARM) on July 30.<\/p>\n

Titled \u201cContinuity of Health Insurance under the Affordable Care Act: Evidence from Public and Private Markets in Colorado and Utah,\u201d Gordon\u2019s dissertation evaluates the stability of health insurance coverage under the ACA\u2019s two major insurance expansions\u2014Medicaid and the individual Marketplaces\u2014and it is the first body of research that assesses multiple all-payer claims databases (APCDs) to measure transition rates between public and private insurance markets. Gordon completed her dissertation in 2019 at Brown University School of Public Health, where she earned a PhD in health services research, before becoming a faculty member at the School of Public Health in August 2019.<\/p>\n

In addition to the Dissertation Award, the third chapter of Gordon\u2019s dissertation, titled \u201cEffects of Medicaid Expansion on Postpartum Coverage and Outpatient Utilization: Evidence from Colorado and Utah\u201d was named Best of the Annual Research Meeting by AcademyHealth in the Coverage and Access theme, and Gordon will present her findings on postpartum coverage during an ARM plenary session on August 5.<\/p>\n

Gordon\u2019s full dissertation highlights the importance of evaluating continuity of insurance coverage, rather than insurance rates, to determine whether people have adequate access to the care they need to live long and healthy lives.<\/p>\n

Although the ACA coverage expansions drastically reduced the number of Americans who are uninsured, \u201cinsurance rates depict only a snapshot in time and do not capture the dynamic nature of health insurance,\u201d says Gordon. \u201cAmericans move in and out of different types of health insurance many times throughout their lifetimes, and the full benefits of health insurance can only be realized when coverage is continuous\u201d to account for emergencies and ongoing access to care, she says.<\/p>\n

Furthermore, research has shown that gaps in insurance do occur, particularly for low-income Americans who have unstable employment or whose income and eligibility for public insurance programs varies.<\/p>\n

To date, APCDs are the only administrative data source that tracks individuals through insurance switches\u2014but they are only available at the state level, and not all states utilize them, Gordon says. \u201cMy study achieved a novel data innovation because I\u00a0combined two APCDs from neighboring states, Colorado and Utah, which enabled the assessment of enrollment and utilization outcomes across multiple payers,\u201d she says. Colorado opted to expand Medicaid under the ACA in 2014, while Utah only recently expanded the program.<\/p>\n

In her research, Gordon found that from 2014 to 2016, 25 percent of Colorado enrollees dropped out of the individual Marketplace, and that cost-sharing reduction payments were associated with lower disenrollment. She also found that Medicaid expansion was associated with greater stability of Medicaid coverage for people who were eligible for Medicaid prior to the expansion.<\/p>\n

\u201cAfter the expansion, Medicaid enrollees in Colorado were 16 percentage points less likely to experience a coverage disruption in a given year relative to enrollees in Utah,\u201d she says.<\/p>\n

Her findings also show that Medicaid expansion in Colorado was associated with improved postpartum Medicaid retention and increased use of postpartum utilization of outpatient care.<\/p>\n

\u201cUse of postpartum outpatient care increased nearly 50 percent among women who experienced severe maternal morbidity at the time of delivery, demonstrating that there are important access benefits of expansion for women at the highest risk of postpartum morbidity and mortality,\u201d she says.<\/p>\n

Gordon says her research suggests that states that did not expand Medicaid should do so to increase stability of coverage and access to postpartum care. In the individual Marketplaces, policy approaches such as reinstating the individual mandate, reinstating cost-sharing reduction payments to insurers, and increasing premium subsidies would also be effective, she says.<\/p>\n

Coincidently, Gordon began the work for her dissertation on Brown\u2019s campus in Providence, RI, but her family made an unexpected move to Utah for the final year of her program in 2018\u2014the same year that the state voted to expand Medicaid.<\/p>\n

\u201cIt could not have been a more serendipitous or timely move,\u201d says Gordon, who was able to provide policy and economic analysis support to health policy organizations, and was invited to testify at a legislative hearing about the ballot initiative on Medicaid expansion. \u201cConnecting in a real-world way with the policies and communities I was studying was the highlight of my doctoral experience.\u201d<\/p>\n

\u2014Jillian McKoy<\/a><\/span><\/em><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Sarah Gordon received the award from AcademyHealth for her research that utilized all-payer claims databases in Colorado and Utah to examine continuity of health insurance coverage under the ACA.<\/p>\n","protected":false},"author":15205,"featured_media":170402,"comment_status":"closed","ping_status":"open","template":"","meta":{"bu_prepress_billboard":"","_bu_prepress_primary_term":"","_bu_prepress_primary_term_manual":""},"tags":[511,2094,1986,2178,1976,1616,3380,1996],"bu-publication":[3516],"sphnews-article-category":[3519,3531,3535,3540,3541],"sphnews-topic":[],"bu_edition":[],"media_type":[],"profile_tax":[3292],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/170430"}],"collection":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article"}],"about":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/types\/bu-article"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/users\/15205"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/comments?post=170430"}],"version-history":[{"count":5,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/170430\/revisions"}],"predecessor-version":[{"id":188029,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/170430\/revisions\/188029"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media\/170402"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media?parent=170430"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/tags?post=170430"},{"taxonomy":"bu-publication","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-publication?post=170430"},{"taxonomy":"sphnews-article-category","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-article-category?post=170430"},{"taxonomy":"sphnews-topic","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-topic?post=170430"},{"taxonomy":"bu_edition","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu_edition?post=170430"},{"taxonomy":"media_type","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media_type?post=170430"},{"taxonomy":"profile_tax","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/profile_tax?post=170430"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}