Grant #75026

Grantee: University of Pittsburgh

PI: David J. Wallace, M.D.

Grant Period: 12/01/2017 – 2/28/2019

Budget: $114,558

This project is funded as part of the Robert Wood Johnson Foundation’s solicitation, “Research in Transforming Health and Health Care Systems,” which seeks to build the evidence base on the potential effects of policies or policy changes intended to transform health. The goal of this project is to address potential impacts of eliminating the Medicaid expansion and reducing federal funding for Medicaid through a per capita cap. The researchers hypothesize that hospital closures occurred at a greater frequency in states that did not adopt Medicaid expansion compared to states that did. They will examine the effect of state decisions to expand Medicaid under the ACA on timely geographic access to safety net and acute care hospitals for safety net populations. Specifically, they will explore the following: (1) was geographic access to either safety net hospitals or acute care hospitals different between Medicaid expansion and non-expansion states prior to the policy enactment; (2) did states that expanded Medicaid experience fewer safety net or acute care hospital closures compared to states that did not expand Medicaid; (3) did non-adoption of Medicaid expansion result in a larger proportion of the population that did not have timely geographic access to a safety net or acute care hospital; and (4) did hospital closures in non-adoption states result in worsening geographic access to hospitals for at-risk patient populations. Deliverables will include a project work plan and final narrative and financial reports. The grantee will also produce paper(s) suitable for publication and present findings at national research meetings and to other stakeholder audiences as appropriate, including policymakers at the federal, state, and local levels, as part of the deliverables for this grant.


Association Between State Medicaid Expansion and Emergency Access to Acute Care Hospitals in the United States
JAMA Network Open | November 2020