Answering health questions
Social work researcher Christina Andrews looks at impact of Affordable Care Act
By Page Ivey, email@example.com, 803-777-3085
Christina Andrews’s research on how the Affordable Care Act has affected substance abuse treatment could provide the first national scale data on the ACA’s impact on an area of treatment that has been neglected.
“One of the things that has always interested and intrigued me about this field is that you see society trying to reconcile this underlying question of what is addiction: Is it deviance or is it disease?” the social work professor says. “The way you define the problem really dictates the set of solutions you go to.
“If it’s deviance, then law enforcement is the solution. If it’s disease, then medicine is the solution. You see society pursuing both of these in tandem.”
The Affordable Care Act put addiction treatment on par with other medical services, and Andrews’ research seeks to find the impact of that change. It’s just one of her projects that looks at disparities in health care, including racial disparities in access to health care that have been a major issue in South Carolina.
“In addition to building a strong research program, Dr. Andrews has also played a leading role in our profession’s capacity to participate in innovative service delivery models created by the ACA,” says social work professor Teri Browne. “She was selected to present her research during a congressional briefing in Washington, D.C., in which she discussed how social workers can participate in models of integrated care to treat mental health and addiction.”
Andrews’ National Institutes of Health study began in 2014, collecting information before many of the provisions of the ACA were implemented. The project is now in the second wave of that research, looking at 2016-17 to see what changed: “How many people are getting treatment, who’s getting treatment, do we see a decline in the uninsured, do we see people getting treatment for longer because they have insurance to cover it?”
One of the things that has always interested and intrigued me about this field is that you see society trying to reconcile this underlying question of what is addiction: Is it deviance or is it disease?
The change in presidential administrations and legislative emphasis on eliminating the ACA could have a significant impact on the work.
“It changes the questions that drive my research,” Andrews says. “It also changes the way we need to frame the research so it can continue to be relevant.”
Andrews also has received a Mentored Research Scientist Career Development Award from the National Institute on Drug Abuse to analyze national Medicaid claims data to look at the impact of Medicaid health homes, a coordinated care model that was established by the ACA.
“Regardless of what happens with the ACA, there is value in understanding how coordinating care influences outcomes for people with addiction issues,” Andrews says. “The study will really look at the different ways these providers/states are organizing their treatment services: Are they screening for addiction? Do they include addiction treatment providers on their interdisciplinary team of health care providers?
“Then we will see how those different strategies influence how many people actually access treatment [and] does it help keep them out of the emergency room, out of the hospital and what is the cost impact of that.”
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