The department of health systems and policy at the Rutgers School of Public Health has been awarded a three-year, nearly $600,000 grant by the Agency for Healthcare Research and Quality (AHRQ) (R01HS024053) to examine how the financial insecurity of families due to actual and anticipated losses in income, employment, and health insurance affect family health care decision making and its out-of-pocket health care spending burden. The study will also consider how public policy, such as expanded Medicaid coverage and provisions of the Affordable Care Act, can reduce the impact of such economic losses on the family’s health care decisions.

[Photo: Dr. Alan Monheit]

Health economist Dr. Alan Monheit, professor and chair of health systems and policy and director of the Center for Health Economics and Health Policy at the Rutgers School of Public Health, is the principal investigator for the project. Dr. Irina Grafova, assistant professor of health systems and policy is a co-principal investigator and Ms. Rizie Kumar, instructor of health systems and policy is an investigator.

Financial insecurity resulting from negative economic shocks – losses of income, employment, and health insurance – can result in difficult spending choices by families on critical necessities. As families strive to preserve their living standards, decisions regarding health care use may become far more discretionary and complex. In particular, families experiencing an economic shock may be required to prioritize their health care spending among family members and specific health care services. The analysis will apply panel data from the Medical Expenditure Panel Survey for the years 2004 – 2012 to measure the impact of these economic shocks on changes in family health care decision making over two-year observation periods.

“This project will allow us to consider how family health care decision making – decisions to allocate health care spending across specific family members and among specific health care services – responds to actual and anticipated economic shocks,” said Dr. Monheit.  “This project will contribute to public health policy by enhancing our understanding of how family health care use responds to changes in economic circumstances and whether existing public policy provisions are effective in protecting the health security of families.”