# Improving the Health of Low-SES Americans Approaching Retirement Under the Affordable Care Act

> **NIH NIH K08** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2021 · $167,400

## Abstract

PROJECT SUMMARY / ABSTRACT
Candidate: Renuka Tipirneni, MD, MSc is a general internist and junior health services researcher focused on
improving the health care system for prematurely aging low socioeconomic status (SES) adults approaching
retirement age. Dr. Tipirneni's long-term career objective is to become an independent mixed methods
investigator integrating large-scale clinical and economic data with in-depth qualitative data to inform the
design and evaluation of policies and programs to improve the health of low-SES aging adults.
Research Context: Low-SES Americans approaching retirement face a crisis of poor health and markedly
increasing mortality. Between 2001 and 2014, disparities in life expectancy between low- and high-SES adults
near retirement have widened and this may have accounted for 500,000 excess deaths. Yet the drivers of this
crisis are poorly understood. The Affordable Care Act (ACA) should improve access to care through insurance
expansions and care delivery innovations and help this group manage chronic conditions and improve their
health. However, it is not clear how low-SES aging adults are specifically benefitting from ACA policies, which
groups should be principally targeted for new care delivery programs encouraged under the ACA, and what
factors are associated with successful health improvement and decreased costs for at-risk aging Americans.
Specific Aims: 1) Determine changes in coverage, access, utilization, health and financial stress for low-SES
55-64-year-olds before and after the ACA Medicaid expansion; 2) Classify sub-groups of low-SES 55-64-year-
olds at highest risk of poor health and characterize heterogeneity of changes in access, utilization, health and
costs in identified high-risk sub-groups; 3) Identify facilitators of and barriers to improvements in health
outcomes and health care utilization among high-risk low-SES aging adults in an ACA care delivery program.
Research Plan: To accomplish these aims, Dr. Tipirneni will perform quasi-experimental analyses with the
Health and Retirement Study to assess health and health care changes before and after the ACA. She will
then identify sub-groups of low-SES near retirement adults at high risk of poor health trajectories. Lastly, she
will conduct qualitiatve interviews with low-SES near retirement adults in an ACA care delivery program to
identify facilitators of and barriers to health improvement and decreased high-cost utilization.
Career Development Plan: Dr. Tipirneni will develop expertise in 1) analysis of large-scale longitudinal survey
and administrative data; 2) application of quasi-experimental approaches to evaluate programs; 3) mixed
methods research; and 4) programmatic research focused on aging adults. Dr. Tipirneni's career development
goals will be supported by close mentorship from an interdisciplinary team; advanced didactic coursework;
participation in research and career development meetings/seminars; and ongoing guidance in her rese...

## Key facts

- **NIH application ID:** 10176324
- **Project number:** 5K08AG056591-05
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Renuka Tipirneni
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $167,400
- **Award type:** 5
- **Project period:** 2017-09-15 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10176324

## Citation

> US National Institutes of Health, RePORTER application 10176324, Improving the Health of Low-SES Americans Approaching Retirement Under the Affordable Care Act (5K08AG056591-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10176324. Licensed CC0.

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