{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:31:14Z","timestamp":1747150274809,"version":"3.40.5"},"reference-count":41,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare patient access to urgent care centers (UCCs) with a diagnosis of sudden hearing loss based on insurance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred twenty\u2010five random UCCs in states with Medicaid expansion and 125 random UCCs in states without Medicaid expansion were contacted by a research assistant posing as a family member seeking care on behalf of a patient with a one\u2010week history of sudden, unilateral hearing loss. Each clinic was called once as a Medicaid patient and once as a private insurance (PI) patient for 500 total calls. Each phone encounter was evaluated for insurance acceptance and self\u2010pay price. Secondary outcomes included other measures of timely\/accessible care. Chi\u2010square\/McNemar's tests and independent\/paired sample t\u2010tests were performed to determine whether there were statistically significant differences between expansion status and insurance type. Calls ended before answering questions were not included in the analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Medicaid acceptance rate was significantly lower than PI (68.1% vs. 98.4%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). UCCs in Medicaid expansion states were significantly more likely to accept Medicaid (76.8% vs. 59.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). The mean wage\u2010adjusted self\u2010pay price was significantly greater in states with Medicaid expansion at $169.84 than in states without at $145.34 when called as a Medicaid patient (mean difference: $24.50, 95% Confidence Interval: $0.45\u2013$48.54, <jats:italic>p<\/jats:italic>\u2009=\u20090.046). The rates of referral to an emergency department and self\u2010pay price nondisclosure rates were greater for Medicaid calls than for private insurance calls (8.2% vs. 0.4% and 17.4% vs. 5.8%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 for both).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Medicaid patients with otologic emergencies face reduced access to care at UCCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 134:5066\u20135072, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31596","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T12:34:38Z","timestamp":1719923678000},"page":"5066-5072","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Access to Sudden Hearing Loss Care at Urgent Care Centers"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7268-6142","authenticated-orcid":false,"given":"Afash","family":"Haleem","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear, Harvard Medical School  Boston Massachusetts U.S.A."},{"name":"Rutgers New Jersey Medical School  Newark New Jersey U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear, Harvard Medical School  Boston Massachusetts 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