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Reproductive care in the safety net: Women's health after Affordable Care Act implementation (EVERYWOMAN)

Award Number: R01HS025155
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2017
PERIOD OF PERFORMANCE END DATE: 09/30/2022

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Reproductive care in the safety net: Women's health after Affordable Care Act implementation (EVERYWOMAN) - PROJECT SUMMARY Evidence-based reproductive care decreases morbidity and mortality for women and their children, reduces disparities, and saves money; however, many women do not receive needed reproductive care. Cost and lack of health insurance are known barriers to receiving care, and women who are poor and representative of racial and/or ethnic minorities are least likely to receive needed reproductive care. The Affordable Care Act (ACA) prioritized reproductive health care as an essential component of women's clinical preventive services and called for every state to significantly expand Medicaid coverage by 2014. Little is yet known about how ACA Medicaid expansions are impacting the delivery of reproductive health care. The 2012 United States (US) Supreme Court ruling that made ACA Medicaid expansions optional for states created a natural experiment to answer this important question. As of January, 2016, 31 states and the District of Columbia had expanded Medicaid, while 19 states had not. We will use this unprecedented natural experiment to study the impact of the ACA and Medicaid expansion on the provision of women's reproductive health care in community health centers (CHCs). The proposed Reproductive care in the safety net: Women's health after Affordable Care Act implementation (EVERYWOMAN) project is a mixed-methods study that will leverage patient-level electronic health record (EHR) data from two CHC networks: the Community Health Applied Research Network (CHARN) and the ADVANCE clinical data research network (CDRN). Together, the CHARN and ADVANCE research data warehouses have patient-level data on over 3 million patients from CHCs across 26 states (14 expansion and 12 non-expansion states). These data will be augmented through qualitative data on patient and provider perceptions of the impact of the ACA on reproductive health care in low-income and vulnerable populations. The specific aims are as follows: Aim 1: Describe provision of women's reproductive health care before and after implementation of the ACA and between expansion and non-expansion states. Aim 2: Identify individual, clinic, and state-level factors associated with provision of women's reproductive health care. Aim 3: Understand provider and patient perceptions of the provision and utilization of reproductive health care in low-income and vulnerable populations. This project builds on our team's experience in insurance, primary care, women's health, and utilizing EHR clinical data for research. The ADVANCE and CHARN datasets position us uniquely to study national-level impacts of the ACA. Findings will be relevant to policy and practice, informing efforts to enhance the provision of timely, evidence-based reproductive care, improve health outcomes, and reduce disparities among low- income vulnerable populations of women.


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: 2023 ( Subtotal = $0 )
2023	2021	OCHIN, INC	1881 SW NAITO PKWY	PORTLAND	OR	97201	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	000	5	1/26/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $362,660 )
2021	2021	OCHIN, INC.	1881 SW NAITO PKWY	PORTLAND	OR	97205	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	000	5	4/15/2021	NON-COMPETING CONTINUATION	$362,660
														Subtotal = $362,660

Issue Date FY: 2020 ( Subtotal = $371,344 )
2020	2020	OCHIN, INC.	1881 SW NAITO PKWY	PORTLAND	OR	97205	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	4/22/2020	NON-COMPETING CONTINUATION	$371,344
														Subtotal = $371,344

Issue Date FY: 2019 ( Subtotal = $380,416 )
2019	2019	OCHIN, INC.	1881 SW NAITO PKWY	PORTLAND	OR	97205	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	5/9/2019	NON-COMPETING CONTINUATION	$380,416
														Subtotal = $380,416

Issue Date FY: 2018 ( Subtotal = $389,330 )
2018	2018	OCHIN, INC.	1881 SW NAITO PKWY	PORTLAND	OR	97205	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	5/10/2018	NON-COMPETING CONTINUATION	$389,330
														Subtotal = $389,330

Issue Date FY: 2017 ( Subtotal = $399,634 )
2017	2017	OCHIN, INC.	1881 SW NAITO PKWY	PORTLAND	OR	97205	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	7/28/2017	NEW	$399,634
2017	2017	OCHIN, INC.	1881 SW NAITO PKWY	PORTLAND	OR	97205	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	001	1	9/6/2017	NEW	$0
														Subtotal = $399,634

Grand Total All Awards = $1,903,384

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Reproductive care in the safety net: Women's health after Affordable Care Act implementation (EVERYWOMAN)

Award Number: R01HS025155

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2017

PERIOD OF PERFORMANCE END DATE: 09/30/2022

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