Aaron Schwartz
University of Pennsylvania, PA·Public Health & Epidemiology
Heart disease is the leading cause of death in the United States, and getting tests and treatments on time matters. Many insurers require prior authorization (PA): the insurer must approve certain services before they are given.
- Fields
Public Health & Epidemiology
Medicine & Clinical Research
Social Science
- Topics
prior authorization
health insurance
Medicare Advantage
- Grants
- 1 known grant, through Apr 2030
What they work on
- Measure how many Medicare Advantage patients faced prior authorization (insurer pre-approval) for heart-related services from 2016–2024, and which clinical, demographic and geographic groups were most affected, using UnitedHealth policy and claims data.
- Estimate whether UnitedHealth's 2017 removal of prior authorization in 71 plans increased use of heart tests and treatments, and whether effects differed for lower- versus higher-value services, using difference-in-differences analysis.
- Test whether removing prior authorization changed the timeliness of heart care and rates of major adverse cardiac events, hospitalization and death among Medicare Advantage enrollees.
More about the research
PA may prevent unnecessary care, but it may also delay or block needed care. Heart-related services, such as echocardiography (heart ultrasound), are among those most often subject to PA. Yet there is little evidence on how PA affects care or health, and no causal evidence for heart care.
Why it matters
Federal and state lawmakers are considering prior authorization reforms with little evidence to guide them. Causal estimates of how PA affects heart care use, delays and outcomes could help insurers and regulators target PA so it limits low-value care without blocking timely, effective care for people with cardiovascular disease, especially Medicare Advantage enrollees.
Known grants
From NIH and NSF research grants. Labs often have other funding we can't see.
Closest labs
Vinay Kini
Weill Medical College of Cornell University, NY·Medicine & Clinical Research
Test whether commonly used claims-based measures of low-value care for patients with coronary artery disease are accurate by comparing them against the gold standard of medical chart review.
Jean Guglielminotti
Columbia University, NY·Public Health & Epidemiology
Test whether the 2010 ACA Dependent Coverage Provision, which expanded private insurance to people under 26, is associated with lower severe maternal morbidity during childbirth, using Healthcare Cost and Utilization Project data.
Jennifer Waljee
Indiana University-Purdue University-Indianapolis, IN·Public Health & Epidemiology
Measure how state opioid prescribing limits affect opioid prescribing and adverse events after surgery, and how effects vary by policy feature, patient, procedure and prescriber, using commercial, Medicare and Medicaid claims with quasi-experimental methods.
The school
University of Pennsylvania: 90 labs on PI Pages, $2.2B a year on research, 750 research doctorates a year.
Reach out
A start for your email. Fill in the brackets.