This study examined how the 2016 Gobeille v. Liberty Mutual Insurance Co. decision affected the usefulness of state All-Payer Claims Databases (APCDs) for opioid overdose research. The researchers found that after the ruling exempted many self-funded employer health plans from submitting claims data, APCDs became less complete and may underestimate opioid-related healthcare utilization and overdose risks. The study concludes that while APCDs remain valuable research tools, gaps in data reporting can limit their ability to fully track population-level health outcomes and inform public health policy.

This study examined healthcare utilization among adults enrolled in Medicaid and found that people with both diabetes and chronic kidney disease used substantially more healthcare services and incurred higher costs than those with diabetes alone. The increased burden was driven by more frequent hospitalizations, emergency department visits, and outpatient care, highlighting the significant impact of chronic kidney disease on healthcare utilization and spending among Medicaid beneficiaries with diabetes.

This study analyzed 912 gender-affirming chest masculinization surgeries performed in Massachusetts between 2016 and 2020 and found that 70% included nipple–areolar complex (NAC) reconstruction. Researchers observed that the use of NAC reconstruction increased over time, but patients who received it were more likely to live in higher-income areas and the Greater Boston region, highlighting socioeconomic and geographic disparities in access. The study also found that publicly insured patients received lower insurer payments for NAC reconstruction, suggesting potential differences in coverage and reimbursement.

This study found that the Massachusetts All-Payer Claims Database can be used to identify new cases of chronic tic disorders, such as Tourette syndrome, among children and adolescents. Researchers identified 1,258 incident cases between 2012 and 2016, with diagnoses occurring at an average age of 9.7 years; most patients were male and covered by Medicaid. The findings support using claims data to better understand the incidence of tic disorders and to study future questions about access to care and treatment quality.

The article explains that health insurance claim denials are becoming increasingly common in the U.S., affecting everything from preventive care to major medical treatments. While some denials result from legitimate issues like coding errors or lack of coverage, the article argues that insurers are also using denials as a cost-control strategy, creating financial and administrative burdens for both providers and patients. It also highlights that most denied claims are never appealed, which can lead to delayed care, medical debt, and reduced access to healthcare.