Medicaid State Hepatitis C Treatment Restrictions: Spillover Effects on the Care Cascade

Rachel Epstein accessed the MarketScan commercial claims dataset and linked these data with a novel dataset of Medicaid HCV treatment policies maintained by the National Viral Hepatitis Roundtable and the Center for Health Law and Policy Innovation of Harvard Law School. This enabled her to analyze HCV screening, linkage, and treatment rates by state and compare the trends in outcomes among states maintaining more restrictive HCV treatment Medicaid policies to those that decreased restrictions over the study period. Her pilot grant provides important information regarding unintended (or “spillover”) effects from Medicaid policies to commercial payers that could have future implications for the treatment policy landscape.

Rachel Epstein is an assistant professor of medicine and pediatrics in the Sections of Infectious Diseases and Pediatric Infectious Diseases at Boston University School of Medicine/Boston Medical Center. She sees adult and pediatric patients living with or at risk for hepatitis C virus (HCV), human immunodeficiency virus (HIV), and other infectious diseases. Her research focuses on analyzing large data sets and utliitizing decision modelling to identify ways to improve care delivery along the HCV, HIV, and opioid use disorder care continuums, with particular expertise on pregnant and post-partum women with substance use, their exposed infants, and adolescents. Her current and recent work includes projects analyzing the effects of Medicaid HCV treatment restrictions on care cascade outcome achievement, HIV prevention and medication adherence, and comparing the cost-effectiveness of various HCV screening, evaluation, and treatment interventions.