2022
Does Primary Care Fill the Gap in Access to Specialty Mental Health Care? A Mixed Methods Study
Kyanko KA, A. Curry L, E. Keene D, Sutherland R, Naik K, Busch SH. Does Primary Care Fill the Gap in Access to Specialty Mental Health Care? A Mixed Methods Study. Journal Of General Internal Medicine 2022, 37: 1641-1647. PMID: 34993864, PMCID: PMC8734538, DOI: 10.1007/s11606-021-07260-z.Peer-Reviewed Original ResearchConceptsSpecialty mental health carePrimary care providersMental health carePrimary careMental health treatmentMental health providersHealth careHealth treatmentHealth providersOutpatient mental health providersPatient-reported barriersSerious psychological distressAddress unmet needsAdults ages 18PCP rolePCP careSpecialty careKey ResultsOfPCP engagementCare providersClinician trainingSpecialty consultantsSpecialty servicesPatient experienceUnmet need
2021
Assessment of Perceptions of Mental Health vs Medical Health Plan Networks Among US Adults With Private Insurance
Busch SH, Kyanko K. Assessment of Perceptions of Mental Health vs Medical Health Plan Networks Among US Adults With Private Insurance. JAMA Network Open 2021, 4: e2130770. PMID: 34677592, PMCID: PMC8536951, DOI: 10.1001/jamanetworkopen.2021.30770.Peer-Reviewed Original ResearchConceptsMental health treatmentPrimary care practitionersMental health careHealth treatmentMental healthMental health practitionersUS adultsCare practitionersHealth provider networksPrivate insuranceHealth practitionersSpecialty mental healthNon-Hispanic white individualsHealth carePrimary care practicesAddiction Equity ActInsurance-related barriersMental Health ParitySerious psychological distressMental health networkHealth plan's networkOnline research panelStudy criteriaPatients' perceptionsHealth ParityUS Smoking Trends Among Young Adults with Serious Psychological Distress: 1997–2018
Friedman AS, Tam J, Busch SH. US Smoking Trends Among Young Adults with Serious Psychological Distress: 1997–2018. Journal Of General Internal Medicine 2021, 37: 2110-2112. PMID: 34378116, PMCID: PMC9198120, DOI: 10.1007/s11606-021-07013-y.Peer-Reviewed Original ResearchInsurance Status and Continuity for Young Adults With First-Episode Psychosis
Golberstein E, Busch SH, Sint K, Rosenheck RA. Insurance Status and Continuity for Young Adults With First-Episode Psychosis. Psychiatric Services 2021, 72: 1160-1167. PMID: 33971726, PMCID: PMC8488003, DOI: 10.1176/appi.ps.201900571.Peer-Reviewed Original ResearchConceptsFirst-episode psychosisInsurance statusPeriods of uninsurancePublic insuranceMedical Expenditure Panel StudyCoordinated care interventionQuality of careSimilar age groupLevels of uninsuranceRAISE-ETPMedication adherenceTreatment continuityCare interventionsEpisode psychosisGeneral populationAge groupsStudy participantsBivariate comparisonsYoung adultsExperimental interventionSimilar ageUninsuranceLongitudinal dataAdultsInsurance changes
2019
Effects of ACA Expansion of Dependent Coverage on Hospital-Based Care of Young Adults With Early Psychosis
Busch SH, Golberstein E, Goldman HH, Loveridge C, Drake RE, Meara E. Effects of ACA Expansion of Dependent Coverage on Hospital-Based Care of Young Adults With Early Psychosis. Psychiatric Services 2019, 70: 1027-1033. PMID: 31480928, PMCID: PMC7605277, DOI: 10.1176/appi.ps.201800492.Peer-Reviewed Original ResearchConceptsDependent coverage expansionYoung adultsPrivate insuranceInsurance coverageACA dependent coverage expansionAge groupsCoverage expansionEarly psychosis treatmentEmergency department visitsHospital-based treatmentCapita admissionsHospital-based service useTargeted age groupOlder age groupsDependent coveragePrivate insurance benefitsDifferences study designDepartment visitsPsychosis treatmentAffordable Care ActPrivate health plansEarly psychosisService useOverall insurance coverageRehabilitation services
2017
Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention
D’Onofrio G, Chawarski MC, O’Connor P, Pantalon MV, Busch SH, Owens PH, Hawk K, Bernstein SL, Fiellin DA. Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention. Journal Of General Internal Medicine 2017, 32: 660-666. PMID: 28194688, PMCID: PMC5442013, DOI: 10.1007/s11606-017-3993-2.Peer-Reviewed Original ResearchConceptsIllicit opioid useOpioid usePrimary careHIV riskBrief interventionAddiction treatmentBuprenorphine groupEmergency Department-Initiated BuprenorphineCohort of patientsLong-term followLong-term outcomesFormal addiction treatmentSignificant differencesMain MeasuresSelfStudy entryUrine toxicologyBuprenorphine/Opioid dependenceED interventionsUrine resultsBuprenorphineTreatment engagementDrug useReferralPatients
2016
Evidence Suggests That The ACA’s Tobacco Surcharges Reduced Insurance Take-Up And Did Not Increase Smoking Cessation
Friedman AS, Schpero WL, Busch SH. Evidence Suggests That The ACA’s Tobacco Surcharges Reduced Insurance Take-Up And Did Not Increase Smoking Cessation. Health Affairs 2016, 35: 1176-1183. PMID: 27385231, PMCID: PMC5589079, DOI: 10.1377/hlthaff.2015.1540.Peer-Reviewed Original ResearchConceptsExcess health care costsSmoking cessationAffordable Care ActBehavioral Risk Factor Surveillance SystemRisk Factor Surveillance SystemTobacco surchargesNon-tobacco usersHealth care costsInsurance statusTobacco usersCare costsMarketplace coverageCessationCare ActSmokersSignificant differencesFirst yearPocket premiumsSurveillance systemFinancial protectionHealth insurance exchangesPotential effectsInsurance exchangesEstimating demand for primary care‐based treatment for substance and alcohol use disorders
Barry CL, Epstein AJ, Fiellin DA, Fraenkel L, Busch SH. Estimating demand for primary care‐based treatment for substance and alcohol use disorders. Addiction 2016, 111: 1376-1384. PMID: 26899802, PMCID: PMC4940268, DOI: 10.1111/add.13364.Peer-Reviewed Original ResearchConceptsAlcohol use disorderSubstance use disordersPrimary care settingPrimary careUsual careUse disordersCollaborative careCare settingsAlcohol treatmentPrimary care-based treatmentTreatment ratesSpecialty care settingsPrior treatment historyDrug treatment centersHigh societal costsDrug treatmentSUD treatmentCommon reasonDiagnostic criteriaTreatment historyTreatment centersDisorder treatmentSocietal costsCareDisorders
2015
Emergency Department–Initiated Buprenorphine/Naloxone Treatment for Opioid Dependence: A Randomized Clinical Trial
D’Onofrio G, O’Connor P, Pantalon MV, Chawarski MC, Busch SH, Owens PH, Bernstein SL, Fiellin DA. Emergency Department–Initiated Buprenorphine/Naloxone Treatment for Opioid Dependence: A Randomized Clinical Trial. JAMA 2015, 313: 1636-1644. PMID: 25919527, PMCID: PMC4527523, DOI: 10.1001/jama.2015.3474.Peer-Reviewed Original ResearchConceptsBrief intervention groupOpioid-dependent patientsIllicit opioid useAddiction treatment servicesPercent of patientsBuprenorphine groupEmergency departmentIntervention groupReferral groupOpioid useTreatment servicesBrief interventionOpioid dependenceClinical trialsHIV riskUrban teaching hospital emergency departmentBuprenorphine/naloxone treatmentHuman immunodeficiency virus (HIV) riskTeaching hospital emergency departmentAddiction treatmentBuprenorphine treatment groupUrine samplesBuprenorphine/naloxoneRandomized clinical trialsCommunity-based treatment services
2014
ACA Dependent Coverage Provision Reduced High Out-Of-Pocket Health Care Spending For Young Adults
Busch SH, Golberstein E, Meara E. ACA Dependent Coverage Provision Reduced High Out-Of-Pocket Health Care Spending For Young Adults. Health Affairs 2014, 33: 1361-1366. PMID: 25092837, DOI: 10.1377/hlthaff.2014.0155.Peer-Reviewed Original ResearchConceptsDependent coverage provisionAffordable Care ActPrivate insurance plansYoung adultsACA dependent coverage provisionCoverage provisionPocket health care spendingHealth care spendingPocket expensesPocket expenditureCare spendingInsurance plansCare ActAdultsSignificant reductionFinancial protectionCoverage rateAge twentyNet differenceOlder peersUse of Hospital-Based Services Among Young Adults With Behavioral Health Diagnoses Before and After Health Insurance Expansions
Meara E, Golberstein E, Zaha R, Greenfield SF, Beardslee WR, Busch SH. Use of Hospital-Based Services Among Young Adults With Behavioral Health Diagnoses Before and After Health Insurance Expansions. JAMA Psychiatry 2014, 71: 404-411. PMID: 24554245, PMCID: PMC4140186, DOI: 10.1001/jamapsychiatry.2013.3972.Peer-Reviewed Original ResearchConceptsBehavioral health diagnosesHospital-based careInpatient admission ratesBehavioral health disordersEmergency departmentYoung adultsHealth diagnosisPrimary diagnosisAdmission ratesHealth disordersEmergency department visit ratesInsurance coverageEmergency department useHospital discharge dataUse of hospitalPopulation-based sampleMassachusetts' 2006 health reformSubstance use disordersInsurance coverage expansionBehavioral health needsHealth insurance coverageHealth reformHealth insurance expansionsHospital dischargeInpatient admissions
2013
Characteristics of Adults With Substance Use Disorders Expected to Be Eligible for Medicaid Under the ACA
Busch SH, Meara E, Huskamp HA, Barry CL. Characteristics of Adults With Substance Use Disorders Expected to Be Eligible for Medicaid Under the ACA. Psychiatric Services 2013, 64: 520-526. PMID: 23450343, PMCID: PMC3672321, DOI: 10.1176/appi.ps.201200011.Peer-Reviewed Original ResearchConceptsSubstance use disorder treatmentUse disorder treatmentAffordable Care ActSubstance use disordersDisorder treatmentMedicaid enrolleesUse disordersUnmet needTreatment ratesSignificant unmet needFederal poverty levelCharacteristics of adultsTreatment needsMedicaid coverageDrug useHealth statusUninsured individualsInsurance expansionDemographic characteristicsCare ActDisordersTreatmentNational surveyLow-income individualsInformal care