Health Care Financing & Access

RISE: Examining Race, gender Identity, and Sexual orientation for health Equity

Compared to heterosexual people, those who identify as LGBTQ experience worse health outcomes, including higher rates of depression, anxiety, and cardiovascular problems. Black Americans, straight and queer, face profound health inequity across nearly all measures. Yet few studies look at the intersection of these groups to assess health outcomes for Black sexual minorities.

Led by Center for HOPES Research Scholar, Dr. Wilson Figueroa, the RISE Study examines the effects of daily minority stressors in queer persons of color. This pilot study will collect survey and biometric data to examine daily minority stress among a sample of racially diverse queer adults residing in the Franklin County, Ohio area. This work will build on previous findings that demonstrated minority stress was uniquely related to cortisol in a sample of mostly White queer young adults.

Contact the RISE Study coordinator


Coordinated Care for First-Episode Psychosis

Absent coordinated specialty care (CSC) programs, patients experiencing their first episode of psychosis incur excess costs; they often present at emergency rooms and receive referrals for secondary health conditions until they finally secure appropriate care for their psychosis. The Center for HOPES is part of a collaborative team of researchers led by Dr. Nicholas Breitborde of the Ohio State Wexner Medical Center’s Harding Hospital that will develop validated estimates of the cost of care for individuals with first-episode psychosis in Ohio.

This work is funded by a mental health block grant from Ohio Mental Health and Addiction Services, which is concerned with both the behavioral health and physical health care costs associated with uncoordinated care.  The team will estimate costs separately for individuals with first-episode psychosis served by three different payers over 6- and 12-month windows. Data from Ohio Medicaid, MarketScan (a private payer), and OSU EPICENTER (a CSC program developed by Dr. Breitborde) will allow the team to develop  benchmark estimates essential to evaluating the cost savings of the CSC approach.


LINK: Improving Diabetes Care through Cross-Sector Social Partnerships

The Linking Education, Produce Provision, and Community Referrals to Improve Diabetes Care (LINK) program aims to address evidence gaps on the effectiveness of cross-sector partnerships to support social needs for type-II diabetes (T2D) patients experiencing food insecurity. Using a prospective and pragmatic randomized controlled trial (pRCT) study design, the team is assessing the impact of health care organizations making coordinated and targeted referrals to community based organizations for their T2D patients. Gathering empirical evidence on the effectiveness and cost of this strategy is critical as health care payers expand their role in population health and health equity in the communities they serve.

The Center for HOPES leads the micro-costing and cost effectiveness analysis for this project. Working with the research team and those in the programmatic settings, Center evaluators are creating an itemized list of direct and indirect costs for addressing the study outcomes, guiding the development of a cost data collection protocol and template and retrospectively collecting data related to start-up costs through semi-structured interviews with key staff involved in intervention development. Our cost effectiveness analysis involves comparing total costs, costs per participant, and incremental cost-effectiveness ratios (to compare costs with respect to study outcomes) for each study arm.

The Center for HOPES is partnering with Mid-Ohio Food Collective, Health Impact Ohio, Cooking Matters, and CATALYST on this National Institutes of Health (NIH)-funded project.


Ohio Medicaid Assessment Survey Series

The Ohio Medicaid Assessment Survey (OMAS) is an Ohio-specific assessment that provides health care access, utilization, and health status information about residential Ohioans at the state, regional and county levels, with a concentration on Ohio’s Medicaid, Medicaid-eligible, and non-Medicaid populations. The OMAS mission is to assist the efficient and effective administration of Ohio’s Medicaid program.

OMAS is a mail, web, and random digit dial telephone survey first fielded in 1997. In its eighth iteration, OMAS enables tracking of the state’s health system and health status over time. In 2020, OMAS is fielding a supplemental survey on the effects of the COVID-19 pandemic on Ohio households.

The main topics for OMAS are health care access, health care utilization, insurance status, chronic and acute health conditions, mental health, health risk behaviors, and health demographics such as employment, income, and socioeconomic indicators. These topics assist the Ohio Department of Medicaid and other health-associated state and local agencies in identifying health services and system gaps and assist in developing strategies for improving health services to Ohio’s population.

OMAS is widely used for health system research and program development by Ohio’s colleges and universities, state and local governments, private sector organizations, and policy makers. OMAS data have been used for grant applications, community health initiatives, academic publications and presentations, health system planning activities, and philanthropic activities. These uses comply with the OMAS project’s purpose to serve Ohio’s Medicaid population and the state’s health-vulnerable populations.