Noelle K. Kurth

Bio: Noelle K. Kurth is an academic researcher from University of Kansas. The author has contributed to research in topics: Medicaid & Health care. The author has an hindex of 10, co-authored 29 publications receiving 259 citations. Previous affiliations of Noelle K. Kurth include University of North Carolina at Chapel Hill.

Effect of Medicaid Expansion on Workforce Participation for People With Disabilities

Abstract: Objectives. To use data from the Health Reform Monitoring Survey (HRMS) to examine differences in employment among community-living, working-age adults (aged 18–64 years) with disabilities who live in Medicaid expansion states and nonexpansion states.Methods. Analyses used difference-in-differences to compare trends in pooled, cross-sectional estimates of employment by state expansion status for 2740 HRMS respondents reporting a disability, adjusting for individual and state characteristics.Results. After the Affordable Care Act (ACA), respondents in expansion states were significantly more likely to be employed compared with those in nonexpansion states (38.0% vs 31.9%; P = .011).Conclusions. Prior to the ACA, many people with disabilities were required to live in poverty to maintain their Medicaid eligibility. With Medicaid expansion, they can now enter the workforce, increase earnings, and maintain coverage.Public Health Implications. Medicaid expansion may improve employment for people with disabilities.

Health Disparities Among Sexual and Gender Minorities with Autism Spectrum Disorder.

Abstract: We explored the health and health care experiences of people with autism spectrum disorder (ASD) who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ+) using data from a national, internet-based survey of adults with disabilities supplemented by focused interviews. LGBTQ+ respondents had significantly higher rates of mental illness, poor physical health days per month, and smoking compared to straight, cisgender respondents with ASD. LGBTQ+ respondents also reported much higher rates of unmet health care need, inadequate insurance provider networks, and rates of being refused services by a medical provider. Examining the intersection of LGBTQ+ identity and ASD reveals compounded health disparities that insurers and medical providers are not adequately addressing, particularly as individuals transition to the adult medical system.

Impact of ACA Health Reforms for People With Mental Health Conditions

Abstract: Objective:This brief report explores the impact of health reform for people with mental illness.Methods:The Health Reform Monitoring Survey was used to examine health insurance, access to care, and employment for 1,550 people with mental health conditions pre- and postimplementation of the Affordable Care Act (ACA) and by state Medicaid expansion status. Multivariate logistic regressions with predictive margins were used.Results:Post-ACA reforms, people with mental health conditions were less likely to be uninsured (5% versus 13%; t=−6.89, df=50, p<.001) and to report unmet need due to cost of mental health care (17% versus 21%; t=−3.16, df=50, p=.002) and any health services (46% versus 51%; t=−3.71, df=50, p<.001), and they were more likely to report a usual source of care (82% versus 76%; t=3.11, df=50, p=.002). These effects were experienced in both Medicaid expansion and nonexpansion states.Conclusions:Findings underscore the importance of ACA improvements in the quality of health insurance coverage.

Transition to Medicare Part D: an early snapshot of barriers experienced by younger dual eligibles with disabilities.

Abstract: Objective This study assessed the impact of transition from Medicaid drug coverage to Medicare Part D on a sample of dually eligible adults younger than age 65 years with disabilities. Study design Telephone survey of employed adults participating in the Kansas Medicaid Buy-In program, Working Healthy, about their experiences in accessing medications after their transition to Part D. Methods A total of 328 (55%) individuals from a random sample of 600 agreed to participate in a survey administered by a university-based research unit during February and March 2006, which included 18 questions with yes/no, multiple choice, and open-ended responses. Participants resembled other Kansas dual eligibles demographically and medically, other than having slightly higher rates of mental illness and lower rates of mental retardation and some physical conditions. Participants' 2004 Medicare and Medicaid claims data were analyzed to obtain an overview of their comorbidities and previous prescription use. Results Twenty percent of participants reported difficulty obtaining medications, including drugs in Part D-protected classes; 13% were required to switch medications; and 8% stopped taking at least 1 medication. More than half did not know they could change plans monthly, potentially improving their access to medications. Conclusion The high incidence of access problems despite Centers for Medicare & Medicaid Services (CMS) safeguards points to the need for ongoing monitoring of Part D. If the problems persist, CMS must be willing to modify the program and/or better enforce the rules already in place to avoid adverse outcomes for beneficiaries with disabilities.

Racial and Ethnic Disparities in U.S. Health Care: A Chartbook

Abstract: H Ho ol ll ly y M Me ea ad d, , L La ar ra a C Ca ar rt tw wr ri ig gh ht t-S Sm mi it th h, , K Ka ar re en n J Jo on ne es s, , C Ch hr ri is st ta al l R Ra am mo os s, , K Kr ri is st ty y W Wo oo od ds s, , a an nd d B Br ru uc ce e S Si ie eg ge el l The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. This and other Fund publications are available online at www.commonwealthfund.org. To learn more about new publications when they become available, visit the Fund's Web site and register to receive e-mail alerts. Mead has conducted research around disparities in chronically ill patients' self-management skills, as well as access barriers for vulnerable populations, including minorities, the uninsured, and the underserved. She practiced law for six years before coming to GWU and now works on projects to improve health care quality and reduce disparities. School of Public Health and Health Services. There she provides the primary statistical analysis and data management support for a variety of public health research projects. School of Public Health and Health Services. There he leads work on quality improvement with a focus on vulnerable populations and the safety net. He has served previously as a hospital chief executive and New Jersey State Health Commissioner.