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Open research questions in Healthcare Policy and Management

480 gap statements mined from Healthcare Policy and Management papers in our 7.9M-paper local library, which holds 6,493 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

Choosing where to publish on Healthcare Policy and Management? See the ranked Economics journals.

What the literature leaves open

  • Little is known about how childbirth influences credit scores and debt. Plausibly causal differences by race, ethnicity, and geography are also less well documented.

    The Financial Impact of Pregnancy and Childbirth Among Louisiana Medicaid Beneficiaries · 2026 · DOI

  • Future research should consider analyzing data from multiple healthcare organizations to identify patterns and trends that can inform policy and practice. Future research should investigate the causal mechanisms, determinants, or correlations of the inequities in accessing healthcare services.

    Patterns of Service Utilization across the Full Continuum of Care: Using Patient Journeys to Assess Disparities in Access to Health Services · 2024 · DOI

  • Despite a wide adoption of observation status policy for Medicare beneficiaries with diverse conditions across United States, little is known about population-level changes in observation status use for children.

    Rising Use of Observation Status for Pediatric Populations in Six States, 2012–2019 · 2026 · DOI

  • Consequently, Medicaid HCBS programs vary significantly by state, yet little is known about how Medicaid HCBS program structures and generosity differ, which impedes rigorous evaluation of the effectiveness of different HCBS programs.

    State Design and Use of Medicaid 1915(c) Waivers and Related Benefits to Provide Home‐ and Community‐Based Services to Aging and Disabled Adults: The Medicaid HCBS Waiver Atlas · 2026 · DOI

  • Many plans have adopted predictive modeling and cost-based criteria; however, their equity implications remain unclear.

    Machine learning evaluation of racial and ethnic inclusion under alternative cost-based approaches to Medicare Medication Therapy Management eligibility · 2026 · DOI

  • Although some studies suggest that integrating medical and pharmacy benefits leads to reduced medical costs, the mechanism remains unclear.

    Bundling medical and pharmacy benefits: Impact on medical costs · 2026 · DOI

  • Introduction In 2005, the Centers for Medicare and Medicaid Services introduced the Coverage with Evidence Development program for items and services with limited evidence of benefit and harm for Medicare beneficiaries, aiming to generate evidence to determine whether they meet the statutory “reasonable and necessary” criteria for coverage.

    Characterization of studies considered and required under Medicare’s coverage with evidence development program · 2025 · DOI

  • There is limited knowledge of how US managed care professionals view and prioritize quality metrics/performance measures, care models, alternative payment models, and clinical pathways in oncology settings.

    Evolving oncology care management trends in the United States: A survey among health care decision makers · 2024 · DOI

  • Further research on health outcomes and their impact on utilization can help determine the most efficient level and appropriateness of the use of health care services.

    Which factors influence health services utilization in Bulgaria? Results of a cross-sectional survey · 2024 · DOI

  • Little is known about the extent of prior authorization requirements in otolaryngology.

    Medicare Advantage Prior Authorization Requirements for Otolaryngologic Procedures in 2021 · 2024 · DOI

  • Future research should examine how emerging technologies, including artificial intelligence in clinical decision-making, interact with these cultural mechanisms, amplifying or transforming classificatory hierarchies depending on the institutional cultures in which they are embedded (31).

    Knowing equity, doing equity: healthcare cultures and why reforms stall in everyday care · 2026 · DOI

  • Rather, the data suggest that ethical tension emerges when activity-based reimbursement is insufficiently balanced by continuity-oriented quality safeguards, structural support for complex care, and organizational conditions that protect professional autonomy and patient-centeredness.

    Ethical perceptions of DRG-based hospital financing among physicians and hospital managers in Germany: a cross-sectional survey · 2026 · DOI

  • There is a need to understand the effectiveness of programs like Rx Kids in reducing administrative burdens.

    Lessons for Program Uptake: The 2024 Rx Kids Universal and Unconditional Cash Prescription Program in Flint, Michigan · 2026 · DOI

  • The paper highlights the need for improved access to healthcare, particularly for marginalized populations.

    Re-evaluating the access imperative in healthcare in the United States · 2026 · DOI

  • The paper does not estimate job protection eligibility given the complexity of legal statutes involved and the lack of monitoring or enforcement by paid leave programs.

    Are State Paid Family and Medical Leave Programs a Safety Net for Working Single Mothers? · 2026 · DOI

  • The lack of a federal paid leave program for workers' health and caregiving needs in the United States. The variety of employment-based eligibility rules in existing state paid leave programs that may limit access for low- and middle-income single mothers.

    Are State Paid Family and Medical Leave Programs a Safety Net for Working Single Mothers? · 2026 · DOI

  • Future research could explore the role of charity in healthcare systems in other countries. Future research could examine the impact of charitable spending on healthcare outcomes.

    ‘Free From Doubt’? The border between charity and the state in the British National Health Service, 1948–74 · 2026 · DOI

  • The study highlights the need to examine the role of charity in healthcare systems.

    ‘Free From Doubt’? The border between charity and the state in the British National Health Service, 1948–74 · 2026 · DOI

  • Prior studies have focused on common causes of morbidity and mortality, with limited analysis of rare diseases. There is a need for analysis of Medicaid service utilization by beneficiaries with rare diseases.

    Medicaid Service Utilization by Beneficiaries with Rare Diseases · 2026 · DOI

  • The transition from a volume-driven system to a value-based care ecosystem requires significant changes in healthcare delivery and reimbursement. The development of standardized approaches to measuring and reimbursing healthcare services based on patient outcomes is a major challenge. The implementation of VBC models in different healthcare settings requires careful consideration of local context and needs.

    Foundations and Operational Mechanics of Value-Based Care · 2026 · DOI

  • The lack of a comprehensive framework for implementing value-based care in healthcare systems. The need for a standardized approach to measuring and reimbursing healthcare services based on patient outcomes.

    Foundations and Operational Mechanics of Value-Based Care · 2026 · DOI

  • The study aims to examine the effect of the DIP payment reform on conventional and traditional medicine expenditures.

    Healthcare Provision Shifts Under DIP Reform: From Conventional Medicine to Traditional Medicine · 2026 · DOI

  • Distinguish the mechanisms behind the observed financial impact of pregnancy and childbirth among Louisiana Medicaid beneficiaries, including billing or administrative issues, care received from providers who do not accept Medicaid, or services not fully covered or successfully adjudicated - Investigate the relationship between structural disadvantages, such as poverty, job loss, and pregnancy-related morbidity…

    The Financial Impact of Pregnancy and Childbirth Among Louisiana Medicaid Beneficiaries · 2026 · DOI

  • Investigation of the impact of hybrid DRGs on the quality of care and referral criteria, - Analysis of the cost-effectiveness of outpatient and inpatient…

    Retrospective empirical analysis of the success rate of inguinal hernia operations in outpatient and inpatient sectors: a cohort study · 2026 · DOI

  • Selection bias, - Coding quality, - Economically motivated coding, - Limited to adult…

    Retrospective empirical analysis of the success rate of inguinal hernia operations in outpatient and inpatient sectors: a cohort study · 2026 · DOI

Most-cited papers in Healthcare Policy and Management

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This page shows what the Healthcare Policy and Management literature already flags as unresolved. To narrow it to your specific question, search the Research Gap Finder: the search is free with a free account and lists the papers closest to your topic first. Unlocking that topic (50 credits, charged once) fills the comparison table from our 7.9M-paper local library and writes the gaps from its rows.

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Open questions raised by papers listed on this page include: (1) Little is known about how childbirth influences credit scores and debt (“The Financial Impact of Pregnancy and Childbirth Among Louisiana Medicaid…”, 2026); (2) Despite a wide adoption of observation status policy for Medicare beneficiaries with diverse conditions across United States, little is known about population-level changes in observation status use for children (“Rising Use of Observation Status for Pediatric Populations in Six States,…”, 2026); (3) Medicaid HCBS programs vary significantly by state, yet little is known about how Medicaid HCBS program structures and generosity differ, which impedes rigorous evaluation of the effectiveness of different HCBS programs (“State Design and Use of Medicaid 1915(c) Waivers and Related Benefits to…”, 2026); (4) Many plans have adopted predictive modeling and cost-based criteria; however, their equity implications remain unclear (“Machine learning evaluation of racial and ethnic inclusion under alternative…”, 2026); (5) Although some studies suggest that integrating medical and pharmacy benefits leads to reduced medical costs, the mechanism remains unclear (“Bundling medical and pharmacy benefits: Impact on medical costs”, 2026). 480 gap statements have been mined from Healthcare Policy and Management papers in our 7.9M-paper local library, which holds 6,493 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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