Maria Alva
Georgetown University, DC·Public Health & Epidemiology
Type 2 diabetes is one of the costliest chronic conditions in the United States, and the quality of care people receive for it varies sharply from state to state — in whether recommended tests and treatments happen at all, and in how often patients end up in the emergency department or hospital. Medicaid, the public insurance program for low-income Americans, covers a quarter of all adults with the disease, and more than 80 percent of its beneficiaries get at least some care through Medicaid managed care organizations (MMCOs): private non-profit or for-profit companies that states pay to deliver care, with the aim of controlling costs and quality while shifting financial risk off the state.
- Fields
Public Health & Epidemiology
Social Science
Medicine & Clinical Research
- Topics
type 2 diabetes
Medicaid
health disparities
- Grants
- 1 known grant, through May 2027
What they work on
- Compile a database of Medicaid managed care organization and state program features over 2016-2025, organized by a healthcare conceptual framework, that could plausibly influence the quality of type 2 diabetes care.
- Measure variation in receipt of recommended diabetes care and in emergency and hospital use among non-disabled, non-pregnant adults aged 18-64 with type 2 diabetes, using national Medicaid encounter data from the Transformed Medicaid Statistical Information System.
- Test whether managed care plan and state program features moderate diabetes care and outcomes over time, using panel data models to follow 2016-2019 enrollment cohorts in 12 states and the District of Columbia that mandate comprehensive managed care enrollment.
- Interview state Medicaid officials, managed care representatives and clinicians in Kentucky and Florida — states identified as having the smallest and largest differences in diabetes care — to explain which aspects of program design and implementation drive those contrasts.
More about the research
Whether these arrangements help or hurt diabetes care, and whether they widen or narrow racial and ethnic gaps, is largely unknown.
Why it matters
Diabetes imposes heavy health and financial costs on families, communities and state budgets, and low-income people covered by Medicaid are hit hardest. Evidence on which managed care contract and state program features correspond to better diabetes care, and smaller racial and ethnic gaps in that care, would give state policymakers concrete design choices — what to require of plans and how to structure their markets — to reduce geographic variation in diabetes burden.
Known grants
From NIH and NSF research grants. Labs often have other funding we can't see.
Closest labs
Cameron Kaplan
University of Southern California, CA·Public Health & Epidemiology
Quantify how the COVID-19 pandemic changed racial and ethnic disparities in receipt of appropriate primary care, chronic disease management and downstream health outcomes, using longitudinal individual-level claims and billing data.
Kara Zivin
University of Michigan, MI·Public Health & Epidemiology
Identify patient-level clinical characteristics linked to mental health care use, overall perinatal care and delivery outcomes among women with diagnosed PMAD, and estimate national and state disparities, using Medicaid and Optum insurance data.
Monica O'Reilly-Jacob
Columbia University, NY·Public Health & Epidemiology
Identify people living with dementia who receive care from nurse practitioners serving as main or ancillary primary care providers, by correcting Medicare claims for incident-to billing and applying the Primary Care Provider Identification Algorithm (PCP-IA).
The school
Georgetown University: 14 labs on PI Pages, $377M a year on research, 206 research doctorates a year.
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