Assessing the effect of virtual navigation interventions to improve health insurance literacy and decrease financial burden in cancer survivors: The HINT II study protocol.

Background: Childhood cancer survivors often face high healthcare costs to monitor and manage new or lasting effects of their treatment. Enhancing survivors' health insurance literacy (HIL) - the knowledge, ability, and confidence in enrolling in and navigating health plans - is vital for minimizing financial burden. Few studies have assessed the effect of a health insurance navigation program on improving HIL among survivors.

Examining selection in Affordable Care Act (ACA) Marketplaces: special enrollment periods.

Introduction: Affordable Care Act (ACA) Marketplace members who enroll through a special enrollment period (SEP) have significantly higher average monthly spending than members who enroll through the annual open enrollment period (OEP), driven primarily by higher inpatient spending.

Methods: Using data from a large national insurer that participated in the federal ACA Marketplace from 2015 to 2016 in 24 US states, we examined differences between SEP and OEP Marketplace enrollees in time from enrollment to inpatient use of predictable and discretionary care (ie, hip and knee replacement), predictable and nondiscretionary care (ie, childbirth), and nonpredictable and nondiscretionary care (ie, acute myocardial infarction and stroke). We examined whether a 2016 policy that increased SEP eligibility verification requirements was associated with changes in utilization.

Sociodemographic Disparities in Uncorrectable Visual Impairment Among US Adolescents.

Purpose: To estimate the prevalence of uncorrectable visual impairment and to identify sociodemographic factors associated with such impairment among US adolescents.

Design: Cross-sectional study.

Setting: 1999 to 2008 National Health and Nutrition Examination Survey.

Diagnostic disparities in inborn errors of immunity: From clinical suspicion to diagnosis.

Background: Emerging evidence suggests that inborn errors of immunity (IEI) are underdiagnosed among underserved populations. However, there remains a lack of national studies evaluating diagnostic disparities in IEI.

Objective: We examined disparities in the timely IEI diagnosis and related health outcomes.

Factors Associated With Repeat Pediatric Influenza Vaccination Among Inconsistent Vaccinators.

Promoting consistent vaccination practices may help improve suboptimal influenza vaccination rates. This study evaluated the prevalence and correlates of repeat influenza (flu) vaccination among children who had previously received the vaccine inconsistently. An online survey study was conducted in 2022 among parents of commercially insured children ages 3 to 19 years who were previously inconsistently vaccinated.

"No room for error": a qualitative interview study of experiences with health insurance coverage loss and COVID-19 pandemic relief policies among people with asthma.

Objectives: The COVID-19 pandemic led to unemployment and associated health insurance loss, prompting an unprecedented adoption of emergency policies, including economic relief efforts and health insurance coverage expansion. We sought to understand pandemic-related challenges for people with asthma and how emergency policies served families facing both chronic disease management and health insurance loss.

Study Design: Qualitative interview study.

Health Insurance Navigation Tools Intervention: A Pilot Trial Within the Childhood Cancer Survivor Study.

Purpose: Childhood cancer survivors are at increased risk for underinsurance and health insurance-related financial burden. Interventions targeting health insurance literacy (HIL) to improve the ability to understand and use health insurance are needed.

Methods: We codeveloped a four-session health insurance navigation tools (HINT) intervention, delivered synchronously by a patient navigator, and a corresponding booklet.

"Pick a Plan and Roll the Dice": A qualitative study of consumer experiences selecting a health plan in the non-group market.

Background: For consumers without access to employer-sponsored or public insurance, health plan choices in the non-group (individual) insurance market that do not meet consumer needs have the potential for negative downstream implications for health and financial well-being.

Objective: This qualitative interview study sought to understand consumers' experiences and challenges with choosing a non-group health plan, among those who later had negative experiences with the plan they chose.

Methods: We conducted semi-structured telephone interviews with a purposive sample of 36 participants from a large regional health insurance carrier in three states who enrolled in non-group plans in 2017 (21 in Affordable Care Act (ACA) Marketplace plans and 15 enrolled off-Marketplace).

Using Cost Conversations to Address Financial Toxicity in Pediatric Asthma Care: Findings From a Survey of Caregivers.

Introduction: Asthma care teams are well-positioned to help caregivers address financial toxicity in pediatric asthma care, although discussing cost can be challenging. We sought to characterize cost conversations in pediatric asthma specialty care.

Method: We surveyed 45 caregivers of children aged 4-17 with asthma.

"You Have to Rob Peter to Pay Paul So Your Kid Can Breathe": Using Qualitative Methods to Characterize Trade-Offs and Economic Impact of Asthma Care Costs.

Background: Economic analyses often focus narrowly on individual patients' health care use, while overlooking the growing economic burden of out-of-pocket costs for health care on other family medical and household needs.

Objective: The aim of this study was to explore intrafamilial trade-offs families make when paying for asthma care.

Research Design: In 2018, we conducted telephone interviews with 59 commercially insured adults who had asthma and/or had a child with asthma.

Vaccine Mandates and Influenza Vaccination During the Pandemic.

Objectives: To determine whether a state influenza vaccine mandate and elevated community coronavirus disease 2019 (COVID-19) severity affected a child's probability of receiving an influenza vaccine during the 2020-2021 influenza season, given the child's previous vaccination history.

Methods: Longitudinal cohort study using enrollment and claims data of 71 333 children aged 6 months to 18 years living in Massachusetts, New Hampshire, and Maine, from a regional insurer. Schoolchildren in Massachusetts were exposed to a new influenza vaccine mandate in the 2020-2021 season.

Utilization and Spending With Preventive Drug Lists for Asthma Medications in High-Deductible Health Plans.

Importance: High-deductible health plans with health savings accounts (HDHP-HSAs) incentivize patients to use less health care, including necessary care. Preventive drug lists (PDLs) exempt high-value medications from the deductible, reducing out-of-pocket cost sharing; the associations of PDLs with health outcomes among patients with asthma is unknown.

Objective: To evaluate the associations of a PDL for asthma medications on utilization, adverse outcomes, and patient spending for HDHP-HSA enrollees with asthma.

Principles of Child Health Care Financing.

The American Academy of Pediatrics believes that the United States can and should ensure that all children, adolescents, and young adults from birth through the age of 26 years who reside within its borders have affordable access to high-quality comprehensive health care. Comprehensive, high-quality care addresses issues, challenges, and opportunities unique to children and young adults and addresses the effects of historic and present inequities. All families should have equitable access to professionals and facilities with expertise in the care of children within a reasonable distance of their residence.

Vision Screening Among Children With Private Insurance: 2010-2019.

Objectives: To describe trends in vision screening based on insurance claims for young children in the United States.

Methods: This cross-sectional study used administrative claims data from the 2010-2019 IBM MarketScan Commercial Claims and Encounters Database. We included children aged 1 to <5 years at the beginning of each calendar year.