This project will use data from the 1993, 1997, and 2001 Robert Wood Johnson Foundation Employer Health Insurance Surveys to study how changes in health care markets have affected access to insurance coverage for two vulnerable populations: workers in low wage businesses and workers employed in rural areas. Specifically, the project will use the three employer surveys to assess the effects of health care market structure on employer decisions to offer insurance the benefits and types of plans offered, and the out-of-pocket cost burden for these populations. The project also will examine whether the structure of the local health care safety net affects employers' offers of insurance of insurance, providing a unique test of the """"""""crowd out"""""""" hypothesis from the perspective of employers. Lastly, the project will develop a simulation model to predict the effect of varying market structure on the distribution of employment-based coverage and on out-of-pocket costs for workers in low wage businesses and rural workers.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Program Projects (P01)
Project #
5P01HS010770-02
Application #
6459583
Study Section
Special Emphasis Panel (ZHS1)
Project Start
2001-07-01
Project End
2002-06-30
Budget Start
Budget End
Support Year
2
Fiscal Year
2001
Total Cost
Indirect Cost
Name
Rand Corporation
Department
Type
DUNS #
City
Santa Monica
State
CA
Country
United States
Zip Code
90401
Escarce, Jose J; Kapur, Kanika (2009) Do patients bypass rural hospitals? Determinants of inpatient hospital choice in rural California. J Health Care Poor Underserved 20:625-44
Gresenz, Carole Roan; Rogowski, Jeannette; Escarce, Jose J (2009) Community demographics and access to health care among U.S. Hispanics. Health Serv Res 44:1542-62
Gresenz, Carole Roan; Rogowski, Jeannette; Escarce, Jose J (2008) Individuals'use of care while uninsured: effects of time since episode inception and episode length. J Natl Med Assoc 100:1394-404
Bao, Yuhua; Fox, Sarah A; Escarce, Jose J (2007) Socioeconomic and racial/ethnic differences in the discussion of cancer screening: ""between-"" versus ""within-"" physician differences. Health Serv Res 42:950-70
Kapur, Kanika; Rogowski, Jeannette A; Freedman, Vicki A et al. (2006) Socioeconomic status and medical care expenditures in Medicare managed care. J Health Care Poor Underserved 17:876-98