Grants Funded
ASPS/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.
Research Abstracts
Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area or PSF funding mechanism.
Insurance as a Barrier to Hand Surgery Subspecialty Care
Principal Investigator
Alexander Khouri MD
Alexander Khouri MD
Year
2025
2025
Institution
The Regents of the University of Michigan
The Regents of the University of Michigan
Funding Mechanism
AAHS/PSF Research Grant
AAHS/PSF Research Grant
Focus Area
Economic Analysis/Quality/Outcome, Hand or Upper Extremity
Economic Analysis/Quality/Outcome, Hand or Upper Extremity
Abstract
Project Summary
Medicaid expansion, through the Patient Protection and Affordable Care Act, extended healthcare insurance for low-income earners. Preliminary studies have shown that state-participation in Medicaid expansion increases access to healthcare for
underserved populations. However, the impact of Medicaid expansion on hand surgery remains unknown. Secondarily, with declining reimbursement rates and increasing nationwide healthcare expenditures, it is unclear if increasing access to care
translates to timely, cost-effective, and affordable healthcare. The purpose of this research is to examine the impact of insurance status on access to elective hand surgery subspecialty care. Using state ambulatory and national insurance claims databases, we will employ quasi-experimental healthcare policy methodologies to evaluate the impact of state-specific Medicaid expansion on elective hand surgery procedural volumes. We will then compare time to surgery and cost variables for both Medicaid and private insurance patients. Lastly, as office-based procedures are a growing, safe, and cost-effective preference for elective hand surgery, we will
examine the trends in office-based procedures over time for patients of varying insurance coverages. Through the above aims, we will improve our understanding of healthcare disparities within the field of hand surgery and target interventions for equitable healthcare reform.
Impact Statement
Providing underinsured patients with timely access to cost-effective hand surgery care will contribute to equitable healthcare reform. Despite the success of the Affordable Care Act (ACA), ten states have not yet implemented Medicaid expansion. As patients,
providers, and state legislators continue to vote on expansion, it is critical to understand how Medicaid has impacted access to subspecialty care, such as hand surgery. Through this proposal, we will improve our understanding of healthcare disparities within
hand surgery and identify points of intervention to enhance health access and equity.
* Biography
Project Summary
Medicaid expansion, through the Patient Protection and Affordable Care Act, extended healthcare insurance for low-income earners. Preliminary studies have shown that state-participation in Medicaid expansion increases access to healthcare for
underserved populations. However, the impact of Medicaid expansion on hand surgery remains unknown. Secondarily, with declining reimbursement rates and increasing nationwide healthcare expenditures, it is unclear if increasing access to care
translates to timely, cost-effective, and affordable healthcare. The purpose of this research is to examine the impact of insurance status on access to elective hand surgery subspecialty care. Using state ambulatory and national insurance claims databases, we will employ quasi-experimental healthcare policy methodologies to evaluate the impact of state-specific Medicaid expansion on elective hand surgery procedural volumes. We will then compare time to surgery and cost variables for both Medicaid and private insurance patients. Lastly, as office-based procedures are a growing, safe, and cost-effective preference for elective hand surgery, we will
examine the trends in office-based procedures over time for patients of varying insurance coverages. Through the above aims, we will improve our understanding of healthcare disparities within the field of hand surgery and target interventions for equitable healthcare reform.
Impact Statement
Providing underinsured patients with timely access to cost-effective hand surgery care will contribute to equitable healthcare reform. Despite the success of the Affordable Care Act (ACA), ten states have not yet implemented Medicaid expansion. As patients,
providers, and state legislators continue to vote on expansion, it is critical to understand how Medicaid has impacted access to subspecialty care, such as hand surgery. Through this proposal, we will improve our understanding of healthcare disparities within
hand surgery and identify points of intervention to enhance health access and equity.
* Biography