About

Eric T Roberts, PhD, is an Associate Professor of Medicine in the Department of Medicine (General Internal Medicine) at the Perelman School of Medicine at the University of Pennsylvania. His educational background includes a BA and MA from Johns Hopkins University, both obtained in 2008, and a PhD in Health Economics & Policy from Johns Hopkins University Bloomberg School of Public Health in 2015. His research focuses on health economics, policy, and healthcare delivery, with key contributions to understanding Medicaid and Medicare policies, dual-eligible beneficiaries, and healthcare disparities. Dr. Roberts has authored numerous publications on these topics, contributing to the field's understanding of healthcare systems and policy impacts.

Research topics

• Virology
• Intensive care medicine
• Internal medicine
• Medical emergency
• Medicine

Selected publications

• Racial and Ethnic Disparities in Preventive and Chronic Disease Care in Medicare Advantage vs. Traditional Medicare

  Journal of General Internal Medicine · 2025-08-11 · 1 citations

  articleOpen accessSenior author

  BACKGROUND: Over half of Medicare beneficiaries are enrolled in Medicare Advantage (MA), with Black and Hispanic beneficiaries disproportionately in MA versus traditional Medicare (TM). OBJECTIVE: To examine Black-White and Hispanic-White disparities in preventive and chronic disease care by MA vs. TM. DESIGN: Cross-sectional propensity-score-weighted difference-in-disparities analyses compared Black-White and Hispanic-White disparities in MA and TM using the Medicare Current Beneficiary Survey (2015-2020). PARTICIPANTS: Medicare beneficiaries with cardiovascular disease or risk factors (N = 68,788 person-years). MAIN MEASURES: Influenza vaccine, pneumococcal vaccine, blood pressure check, cholesterol test, colorectal cancer screening, preventive care index (count of above; 0-5), mammogram, annual wellness visit; hemoglobin A1C and eye exam. KEY RESULTS: Black and Hispanic, compared to white, beneficiaries were less likely to receive annual wellness visits, influenza vaccines, pneumococcal vaccines, and colorectal cancer screening. Black beneficiaries in MA vs. TM had higher overall preventive care use (preventive care index, 3.67 vs. 3.44) and higher rates of all preventive services examined. Hispanic beneficiaries in MA vs. TM had higher preventive care use (index, 3.67 vs. 3.56), including annual wellness visit, blood pressure check, colorectal cancer screening, and breast cancer screening. Preventive care use was higher among White beneficiaries in MA than TM (index, 3.88 and 3.79). Black-White disparities were smaller in MA than TM for preventive care use (difference-in-disparities: + 0.13 index points, 95% CI 0.04-0.22), blood pressure check (+ 2.2 percentage points [p.p.], 95% CI 0.1-4.4), cholesterol check (+ 2.2 p.p., 95% CI 0.2-4.2), and eye exam (+ 5.0 p.p., 95% CI 1.4-8.7). Hispanic-White disparities were not statistically different in MA vs. TM. CONCLUSIONS: Although MA was associated with smaller Black-White disparities in preventive care compared to TM, these differences were modest, and MA was not associated with smaller Hispanic-White disparities.

  PublisherOA PDFDOI

• Effects of Dual-Eligible Integrated Care Plans on Medicaid Enrollment and Retention: Evidence From the Implementation of Medicare-Medicaid Plans

  Medical Care Research and Review · 2025-10-02 · 1 citations

  articleOpen access1st authorCorresponding

  Medicare and Medicaid are separate programs that together cover 13 million low-income older adults and people with disabilities, known as dual-eligible individuals. Concern about a lack of coordination across Medicare and Medicaid has prompted the development of Integrated Care Programs (ICPs). Although the primary goal of ICPs is to coordinate financing and care across Medicare and Medicaid, ICPs may also influence whether low-income individuals obtain or keep Medicaid. We evaluated whether the rollout of Medicare-Medicaid Plans (MMPs)-one of the largest ICPs-was associated with changes in Medicaid take-up and retention among Medicare beneficiaries residing in high-poverty zip codes. Using a stacked difference-in-differences design and variation in MMP rollouts across nine states, we found no evidence that MMPs increased monthly or continuous Medicaid enrollment in this population. These findings highlight the need for focused policies to address Medicaid enrollment gaps among low-income Medicare beneficiaries, which could complement broader integration efforts.

  PublisherDOI

• <scp>VA</scp> ‐Purchased Community Care and Risk of Potentially Unsafe Concurrent Medication Use Among Veterans Receiving Opioids: A Regression Discontinuity Analysis

  Health Services Research · 2025-07-05

  article1st authorCorresponding

  OBJECTIVE: To examine whether eligibility for Veterans Health Administration (VA) community care, which expanded Veterans' access to VA-funded care outside VA, increased the likelihood of Veterans concurrently filling prescriptions for opioids and central nervous system (CNS)-active medications. STUDY SETTING AND DESIGN: We used a regression discontinuity design to analyze Veterans across a distance threshold for community care eligibility in the Veterans Choice Program, under which Veterans residing > 40 miles from the closest VA medical facility staffed by ≥ 1 full-time primary care physician qualified for community care. We used local linear regression to test whether exceeding this 40-mile threshold was associated with discontinuities in the probability of receiving overlapping supplies of opioids and another CNS medication (benzodiazepine, muscle relaxant, antiepileptic, or sleep aid) for ≥ 30 days per year. DATA SOURCES AND ANALYTIC SAMPLE: We used VA pharmacy data for prescriptions filled at VA facilities, VA Program Integrity Tool files for prescriptions paid by VA and filled in community pharmacies, and Medicare and Medicaid data for prescriptions covered by those programs. Our analysis included annual cross-sectional samples of Veterans who filled ≥ 1 opioid prescription through VA, community care, Medicare, or Medicaid and lived 36-39 or 41-44 miles from the nearest VA facility during federal FYs 2016-2019 (n = 180,903 Veteran-year observations). PRINCIPAL FINDINGS: Among Veterans who filled an opioid prescription, 34.1% concurrently received another CNS medication for ≥ 30 days. Exceeding the threshold for community care eligibility was associated with a 1.14 percentage point (pp) increase (95% CI: 0.08, 2.20) in the probability of concurrently receiving an opioid and another CNS drug during 2016-2019. Discontinuities in overlap were larger among Veterans with a serious mental illness (2.7 pp.; 95% CI: 0.6, 4.9) during 2016-2019. During 2018-2019, discontinuities were larger in the overall sample (1.6 pp.; 0.0, 3.1) and among non-Hispanic Black Veterans (5.4 pp.; 95% CI: 0.5, 10.4). CONCLUSIONS: Overall, VA community care eligibility was associated with a small increase in medication overlap involving opioids and other CNS-active medications. Increases in overlap were larger in certain Veteran subgroups and later study years, underscoring a need for continued monitoring of higher-risk co-prescribing in VA community care.

  PublisherDOI

• Association of a State‐Wide Alternative Payment Model for Rural Hospitals With Bypass for Elective Surgeries

  Health Services Research · 2025-01-30 · 1 citations

  articleOpen access

  OBJECTIVE: This study aimed to measure the changes in rural hospital bypass for 11 common elective surgeries following the implementation of the Pennsylvania Rural Health Model (PARHM), a global budget payment model. STUDY SETTING AND DESIGN: We leveraged a natural experiment arising from the phase-in of PHARM in Pennsylvania. We conducted a comparative interrupted time series analysis to assess changes in rural hospital bypass, comparing trends in rural hospital bypass among patients in hospital service areas (HSAs) with PARHM-participating hospitals to patients in control HSAs with hospitals eligible for but not participating in PARHM. Analyses accounted for staggered entry into PARHM and examined outcomes up to 4 years post-entry. DATA SOURCES AND ANALYTIC SAMPLE: We used Pennsylvania all-payer visit-level inpatient discharge data (2016-2022) to measure rural hospital bypass, encompassing 175,138 surgeries. PRINCIPAL FINDINGS: The average bypass rate for elective surgeries was 59.9%, with an increasing trend observed during the study period. Overall, differential changes in bypass rates between PARHM-participating and control HSAs were not statistically significant, from a low of 0.53 percentage points (-8.17-9.22) among Cohort 2 HSAs and a high of 5.96 percentage points (-4.63-16.55) among Cohort 1 HSAs. However, among critical access hospitals, PARHM participation was associated with a significant relative increase in levels and trends in bypass rates compared to controls, from a low of 9.12 percentage points (2.45-15.79) among Cohort 1 HSAs and a high of 29.70 percentage points (12.54-46.86) among Cohort 2 HSAs. These relative increases were largely due to a stable rate in PARHM-participating HSAs and a marked decrease in control HSAs. CONCLUSIONS: This study fills a gap in the relationship between global budgets and hospital bypass. Although PARHM did not broadly alter rural bypass rates overall, the differential increase in bypass among HSAs with CAHs participating in PARHM suggests meaningful effect heterogeneity, warranting further research and analysis of impacts on patient outcomes.

  PublisherOA PDFDOI

• Hospital Mergers, Hospital Choice, and Care Quality for Pregnant Enrollees in Medicaid

  JAMA Health Forum · 2025-12-05

  articleOpen accessSenior author

  Importance: Despite increasing consolidation in the US hospital market, little is known about how these mergers influence labor and delivery admissions and obstetric outcomes for patients with Medicaid. Objective: To assess whether hospital mergers are associated with changes in patient flows to hospitals and care quality for pregnant Medicaid enrollees. Design, Setting, and Participants: This cross-sectional study used a stacked difference-in-differences design to examine mergers occurring between 2004 and 2011. Changes in outcomes were examined in the 3 years before vs 3 years after a merger. Estimates were compared by urban vs rural settings and for Medicaid patients relative to privately insured patients. Labor and delivery admissions in 9 US states accounted for approximately 25% of all Medicaid-covered births nationwide during the study period. Medicaid-enrolled patients admitted for labor and delivery residing in counties that experienced a single hospital merger (intervention) or matched comparison counties without a merger during the same period were included. The analysis took place between December 2023 and April 2025. Exposure: Residing in a county that experienced a hospital merger. Outcomes: Outcomes included patient travel distance for delivery, admissions to safety net hospitals, and admissions to hospitals with a neonatal intensive care unit (NICU), indicating advanced obstetric capabilities. Obstetric quality outcomes included obstetric trauma for instrument-assisted and non-instrument-assisted admissions and in-hospital mortality. Results: The analysis included 527 499 Medicaid labor and delivery admissions across 30 merger and 28 nonmerger counties. The mean (SD) age across Medicaid labor and delivery admissions was 25.8 (5.9) years, and all were female individuals. In addition, 15.4% were Black, 19.9% were Hispanic, and 20.5% were White individuals. County-level exposure to a merger was associated with an adjusted 0.5-mile (95% CI, 0.1-1.0) increase in travel distance (an 8% increase from the 6.3-mile premerger baseline), a 9.2-percentage point (95% CI, 2.3-16.1) increase in admissions to safety net hospitals, and a 7.9-percentage point (95% CI, -11.2 to -4.6) decrease in admissions to NICU-equipped hospitals. One obstetric trauma measure (among non-instrument-assisted deliveries) increased slightly (0.4 percentage points; 95% CI, 0.2-0.6), whereas in-hospital mortality was unchanged. Urban counties experienced a decrease in admissions to NICU-equipped hospitals, whereas rural counties experienced increases. Compared with privately insured patients, Medicaid enrollees had larger increases in travel distance (0.6; 95% CI, 0.0-1.1) and safety net admissions (6.8; 95% CI, 1-12.6), but similar changes in NICU-equipped hospital admissions (-0.1; 95% CI, -2.4 to 2.3). Conclusions and Relevance: This cross-sectional study of labor and delivery admissions among patients with Medicaid found that hospital mergers were associated with an increased probability of admission to safety-net hospitals, lower probability of NICU-equipped hospitals, and worsening in 1 obstetric quality metric. These changes differed for Medicaid vs commercially insured patients and varied among Medicaid patients in urban vs rural markets. The findings underscore the importance of considering local market structure and potential adverse impacts on low-income populations when evaluating proposed hospital mergers.

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• Factors Influencing Rural Hospitals’ Decisions To Join An Alternative Payment Model: A Mixed-Methods Study

  Health Affairs · 2025-07-01

  article

  Hospitals' participation in voluntary Alternative Payment Models has implications for model evaluation and performance. This mixed-methods study examined factors underlying hospitals' decision to participate in the Pennsylvania Rural Health Model (PARHM), a voluntary model under the Center for Medicare and Medicaid Innovation that combined hospital global budgets and care transformation plans. Quantitative analyses tested for pre-PARHM differences in characteristics, and qualitative analyses examined contextual factors identified in interviews with hospital administrators across participating and eligible nonparticipating hospitals. At baseline, hospitals that joined PARHM had smaller total margins, fewer inpatient discharges, and greater likelihood of being independent compared with nonparticipating hospitals. Qualitative findings suggested that the desire to improve financial stability and maintain independence influenced decisions to participate, whereas the desire to preserve operational autonomy and flexibility for future growth influenced the choice not to participate. These findings can inform the development and targeting of future Alternative Payment Models, with specific considerations for rural hospitals.

  PublisherDOI

• Changes in blood pressure, medication adherence, and cardiovascular-related health care use associated with the 2018 angiotensin receptor blocker recalls and drug shortages among patients with hypertension

  Journal of Managed Care & Specialty Pharmacy · 2025-04-29 · 3 citations

  articleOpen access

  BACKGROUND: One of the largest-ever retail drug shortages began in 2018 when several angiotensin II receptor blockers (ARBs) for treating hypertension, heart failure, and chronic kidney disease-valsartan, losartan, and irbesartan-were recalled for carcinogenic impurities. The long-term consequences of the ARB shortages and whether certain groups experienced more adverse outcomes is unknown. OBJECTIVE: To evaluate changes in adherence and health outcomes after ARB recalls and to identify patients who experienced greater changes in access and adverse clinical outcomes. METHODS: Using an integrated claims and electronic health record dataset and a difference-in-differences design, we evaluated changes in the proportion of days covered (PDC) for ARBs and similar drugs (angiotensin-converting enzyme inhibitors [ACE-Is]), uncontrolled blood pressure, major cardiovascular event (MACE)-related acute care visits, and all-cause ambulatory care visits in the 12 months before vs 18 months after recalls for valsartan, losartan, and irbesartan users vs patients taking similar, nonrecalled drugs (ACE-Is, nonrecalled ARBs). Triple-difference models characterized heterogeneous associations by pre-recall patient demographic (race, ethnicity, age), clinical (baseline indication, mental health conditions), and adherence variables. RESULTS: Adjusting for pre-recall patient characteristics, we observed no significant changes in PDC for ARBs and ACE-Is (combined), uncontrolled blood pressure, or ambulatory care visits among 86,507 recalled ARB users vs 123,583 comparison drug users in the 18 months after the recalls. Following the recalls, medication switches increased on average by an additional 2.08 percentage points (p.p.) per quarter (95% CI = 2.01-2.15) for recalled ARB vs comparison drug users, a 195.9% relative increase. We observed the most switches in the 90-day period immediately after valsartan's recall (difference-in-difference: 9.48 p.p.; 95% CI = 9.36-9.59; relative change = 892%). Cumulatively, 55.2% of valsartan, 7.6% of losartan, and 18.9% of irbesartan users switched medications after 18 months. We observed an increase in the proportion of recalled ARB vs comparison patients who experienced medication gaps exceeding 30 days (1.13 p.p. per quarter on average; 95% CI = 0.97-1.30), which was most apparent after approximately 15 months (5 quarters). Although MACE-related acute care visits did not change in the quarter (90 days) immediately after valsartan's recall, we observed an increase of 1.40 additional visits per 1,000 recalled ARB vs comparison drug patients in each subsequent quarter, a 9.3% relative increase. Results were similar across most subgroups. CONCLUSIONS: The 2018 ARB recalls were associated with immediate changes in antihypertension medication use. Many patients transitioned to alternative medications. Although overall impacts on clinical outcomes were minimal and not statistically significant, small increases in medication gaps and MACE-related acute care visits among some patients occurred after more than 1 year. The ARB recalls may have been associated with fewer adverse events than other recent shortages owing to the widespread availability of alternative treatments in the same or similar drug class.

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• Reversibility and Enantioselectivity of Palladium-Catalyzed Allylic Aminations: Ligand, Base-Additive, and Solvent Effects

  The Journal of Organic Chemistry · 2025-05-20 · 1 citations

  article

  The enantioselective, palladium-catalyzed reaction of benzylamine with (E)-1,3-diphenylallyl ethyl carbonate was examined with 12 different chiral ligands across a range of scaffold types. In 8 out of 12 cases, the observed enantiomeric excess was 36–92% higher when DBU or Cs2CO3 was added. Nucleophile crossover experiments between the N-benzyl-1,3-diphenylallylamine product and 4-methoxybenzylamine mechanistically linked the changes in enantioselectivity to reformation of the η3-allylpalladium intermediate. In the crossover reactions with 9 out of 12 chiral ligands, 10–75% less elimination to 1-phenylbutadiene was observed with Cs2CO3 than with DBU. Analysis of percent crossover vs percent completion of the simultaneous reaction of 1-phenyl-3-methylallyl ethyl carbonate in the crossover experiment revealed that (1) the formation of the 1,3-diphenylallylpalladium intermediate frequently occurred before the reaction of 1-phenyl-3-methylallyl ethyl carbonate was complete, (2) the addition of DBU or Cs2CO3 suppressed formation of the 1,3-diphenylallylpalladium intermediate, and (3) the less polar toluene and THF solvents resulted in less or slower formation of the 1,3-diphenylallylpalladium intermediate than the more polar DCM and DMF solvents.

  PublisherDOI

• Health Care Utilization and Costs for Older Adults Aging Into Medicare After the Affordable Care Act

  JAMA Health Forum · 2025-01-17 · 3 citations

  articleOpen access

  Importance: The Affordable Care Act (ACA) expanded Medicaid and Marketplace insurance to nonelderly adults in 2014, but whether these policies improved outcomes later in life is unknown. Objective: To examine whether exposure to ACA expansions during middle age (50-64 years) was associated with changes in health, utilization, and spending after these adults entered Medicare at 65 years of age. Design, Setting, and Participants: This serial analysis of the Health and Retirement Study cohort linked to Medicare enrollment and claims data from January 1, 2010, to December 31, 2018. Adults aged 65 to 68 years entering Medicare after the ACA (exposed to ACA expansions during middle age) were compared with adults entering Medicare before the ACA (4452 person-years). Interrupted time series analyses were used to assess overall changes associated with exposure to ACA expansions and difference-in-differences analyses to isolate changes associated with Medicaid expansion among low-income adults (incomes ≤400% of the federal poverty level for any ACA coverage and ≤138% for Medicaid expansion coverage). Data were analyzed from March 1, 2023, to May 1, 2024. Exposures: ACA coverage expansion overall in 2014 and Medicaid expansion as of 2018. Main Outcomes and Measures: Health (self-reported overall, activities of daily living [ADL], instrumental ADL, and depressive symptoms), utilization (outpatient visits, emergency department visits, and hospital admission), and costs (self-reported out-of-pocket and Medicare costs). Results: Among the analytic sample of 2782 participants (mean age, 66.4 [95% CI, 66.3-66.5] years), a weighted 59.1% (95% CI, 55.3%-62.7%) were female. In interrupted time series analyses, reductions across cohorts were found in use of chronic disease medications (-5.0 [95% CI, -9.8 to -0.3] percentage points), hospitalizations per year (-0.2 [95% CI, -0.4 to -0.03]), and out-of-pocket costs (-$417 [95% CI, -$694 to -$139]) but no significant changes across cohorts in health status, outpatient or emergency visits, or Medicare costs. In difference-in-differences analyses relative to nonexpansion states, greater reductions were found in the number of ADL limitations (-0.4 [95% CI, -0.8 to -0.02]) and lesser reductions in out-of-pocket costs ($900 [95% CI, $275-$1526]) in Medicaid expansion states but otherwise similar changes in other outcomes. Conclusions and Relevance: This study found modest evidence of reductions in out-of-pocket costs and improvements in health among adults entering Medicare after the ACA. Insurance coverage and financial assistance should be preserved and enhanced to improve health and health care access among vulnerable older adults.

  PublisherOA PDFDOI

• Prescriber-Level Responses to the 2018–2019 Valsartan, Irbesartan, and Losartan Recalls and Drug Shortages

  Medical Care · 2025-09-19

  article

  BACKGROUND: Global shortages for 3 angiotensin receptor-II blockers (ARBs)-valsartan, losartan, and irbesartan-occurred in 2018-2019 after recalls due to ingredient impurities. Provider-level responses to the ARB shortages in the United States and spillovers to other antihypertensive classes are unknown. OBJECTIVE: To estimate changes in provider-level prescribing for ARBs and non-ARB antihypertensives up to 18 months after the 2018-2019 recalls and shortages. RESEARCH DESIGN: National cohort study of prescribers using all-payer pharmacy claims. Mixed interrupted time series models quantified changes in prescribing postshortages and heterogeneous changes by specialty, region, medical school graduation cohort, sex, and level of prerecall prescribing. PATIENTS AND METHODS: Active providers exposed to the 2018-2019 valsartan, irbesartan, and losartan shortages (defined as top-25th percentile for these drugs in 2017). MEASURES: Within-class changes in prescribing for ARBs (recalled and nonrecalled). Between-class substitutions to non-ARB antihypertensives (ACE-Is, alpha- and beta-adrenergic blockers, calcium channel blockers, diuretics, and other agents). RESULTS: Among 138,032 prescribers who met the inclusion criteria, per-prescriber fills for valsartan decreased by 57%-59% after it was recalled in July 2018. We observed concurrent increases for losartan and irbesartan fills and no change in overall ARB prescribing. There were no significant changes in fills for ACE-Is or for other antihypertensives. Absolute decreases in valsartan fills were greatest among providers with higher levels of prescribing at baseline. However, relative changes did not differ by prescriber characteristics. CONCLUSIONS: In this prescriber level, national study, substitutions to other ARBs mitigated decreases in valsartan fills after it was recalled. There were no spillovers to non-ARB anti-hypertensives. The availability of close substitutes during drug shortages may mitigate gaps in access for prescribers and their patients.

  PublisherDOI

Recent grants

• Financial assistance for low-income Medicare beneficiaries: Using natural experiments to assess effects on care and health outcomes

  NIH · $545k · 2019–2023

Frequent coauthors

• Bernadette Boden‐Albala

  University of California, Irvine

  97 shared

• Michael Parides

  Albert Einstein College of Medicine

  30 shared

• Nina S. Parikh

  New York University

  30 shared

• Veronica Torrico

  New York University

  29 shared

• Leigh W. Quarles

  27 shared

• J. Michael McWilliams

  Harvard University

  27 shared

• Harmon Moats

  Columbia University Irving Medical Center

  27 shared

• Joshua Stillman

  Columbia University Irving Medical Center

  26 shared

Labs

• Eric T Roberts LabPI

Education

• Marshall J. Seidman Postdoctoral Fellow, Health Care Policy

  Harvard Medical School Department of Health Care Policy

  2017

• PhD, Health Policy & Management

  Johns Hopkins University

  2015