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The relationship between social needs and primary care use after enrollment in Virginia’s Medicaid expansion: The influence of sociocultural and built environments

Award Number: F30MD018324
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 11/10/2022
PERIOD OF PERFORMANCE END DATE: 05/25/2026

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The relationship between social needs and primary care use after enrollment in Virginia’s Medicaid expansion: The influence of sociocultural and built environments - Medicaid expansion is a tool that improves health outcomes. Medicaid expansion increases access to primary care, a known determinant that can improve population health. However, many variables influence an individual’s ability to access primary care, including food and housing insecurity. This study applies the NIMHD’s Research Framework to understand these relationships. This work will leverage a well-established state-university partnership and unique data set consisting of the experiences of newly enrolled Medicaid expansion members in Virginia. The following existing data will be linked for this study by Medicaid member identification number: 1) pre-enrollment surveys asking members about their experiences in the year prior to Medicaid expansion enrollment (n=1,255), 2) a follow-up survey asking members about experiences in the year after enrollment (n=580), 3) all encounter and pharmacy claims data for these same Virginia Medicaid members, 4) Medicaid Managed Care Organization (MCO) Health Screening completed by the MCO for each member around the time of enrollment and 4) publicly-available measures of rurality and neighborhood economic status linked to members’ census tracts or counties. This proposed work aims to: 1) Assess primary care utilization to understand if food and housing insecurity reduce primary care utilization during the first year of Medicaid enrollment 2) Explore whether primary care utilization reduces food insecurity after the year after enrollment in Medicaid expansion. Ultimately this work will provide much needed information about the use of primary care and provide insight into how Medicaid expansion is related to changes in food and housing insecurity, known causes of poor health. This application describes an excellent research and training environment for the proposed work, supported by a collaborative mentorship team that includes both faculty members and Virginia Medicaid’s Chief Medical Officer. This proposal will provide integrated, robust clinical and research training in health services research and geospatial statistics to a physician-scientist dedicated to practicing family medicine and pursuing a faculty position focused on advancing health systems.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $16,665 )
2026	2026	VIRGINIA COMMONWEALTH UNIVERSITY	910 WEST FRANKLIN ST	RICHMOND	VA	23284	RICHMOND CITY	USA	Minority Health and Health Disparities Research	000	4	8/24/2026	NON-COMPETING CONTINUATION	$16,665
														Subtotal = $16,665

Issue Date FY: 2025 ( Subtotal = $43,475 )
2025	2025	VIRGINIA COMMONWEALTH UNIVERSITY	910 WEST FRANKLIN ST	RICHMOND	VA	23284	RICHMOND CITY	USA	Minority Health and Health Disparities Research	001	3	7/21/2025	NON-COMPETING CONTINUATION	$564
2025	2025	VIRGINIA COMMONWEALTH UNIVERSITY	910 WEST FRANKLIN ST	RICHMOND	VA	23284	RICHMOND CITY	USA	Minority Health and Health Disparities Research	000	3	10/29/2024	NON-COMPETING CONTINUATION	$42,911
														Subtotal = $43,475

Issue Date FY: 2024 ( Subtotal = $42,911 )
2024	2024	VIRGINIA COMMONWEALTH UNIVERSITY	910 WEST FRANKLIN ST	RICHMOND	VA	23284	RICHMOND CITY	USA	Minority Health and Health Disparities Research	002	2	11/6/2023	NON-COMPETING CONTINUATION	$40,689
2024	2024	VIRGINIA COMMONWEALTH UNIVERSITY	910 WEST FRANKLIN ST	RICHMOND	VA	23284	RICHMOND CITY	USA	Minority Health and Health Disparities Research	003	2	6/20/2024	NON-COMPETING CONTINUATION	$2,222
2024	2022	VIRGINIA COMMONWEALTH UNIVERSITY	910 WEST FRANKLIN ST	RICHMOND	VA	23284	RICHMOND CITY	USA	Minority Health and Health Disparities Research	001	1	11/6/2023	NEW	$0
2024	2022	VIRGINIA COMMONWEALTH UNIVERSITY	910 WEST FRANKLIN ST	RICHMOND	VA	23284	RICHMOND CITY	USA	Minority Health and Health Disparities Research	000	1	10/10/2023	NEW	$0
														Subtotal = $42,911

Issue Date FY: 2022 ( Subtotal = $40,689 )
2022	2022	VIRGINIA COMMONWEALTH UNIVERSITY	912 W FRANKLIN ST	RICHMOND	VA	23284	RICHMOND CITY	USA	Minority Health and Health Disparities Research	000	1	9/25/2022	NEW	$40,689
														Subtotal = $40,689

Grand Total All Awards = $143,740

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The relationship between social needs and primary care use after enrollment in Virginia’s Medicaid expansion: The influence of sociocultural and built environments

Award Number: F30MD018324

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 11/10/2022

PERIOD OF PERFORMANCE END DATE: 05/25/2026

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