Anna Morenz

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Journals/Publications

• Joo, J. H., Au, D. H., Morenz, A. M., Wu, M., Agusala, B., & Liao, J. M. (2025). Informing Advanced Primary Care Management: Trends From Care Coordination Among Medicare Beneficiaries in 2020-2023. The Permanente journal, 29(4), 148-151.
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  Medicare recently began reimbursing for new advanced primary care management (APCM) services, which builds directly on the design of principal, chronic, and transitional care management. As APCM is anticipated to achieve similar goals and can be used similarly to predecessor services, practice and policy leaders would benefit from insight about collective use of principal, chronic, and transitional care management as APCM adoption begins in the United States.
• Joo, J. H., Morenz, A. M., Dang, M. D., Cardin, J. R., & Liao, J. M. (2025). Care management services at safety-net clinics in the United States. Frontiers in health services, 5, 1646788.
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  Federally qualified health centers and rural health centers are key parts of the United States ambulatory safety-net care system. Medicare has sought to encourage care coordination at these safety-net clinics by reimbursing clinicians directly for delivering care management services. In this paper, we described long-term trends in utilization of care management services for Medicare patients at federally qualified health centers and rural health centers vs. non-federally qualified health centers and non-rural health centers. General care management service utilization increased by 207% with 2,251 services submitted in 2023. Denial rates for general care management services increased over time, with 42% of submitted services being denied in 2018, compared to 64% of submitted services being denied in 2023. Compared to general care management services, transitional care management services were delivered far less frequently at federally qualified health centers and rural health centers, with a total of 237 services submitted across the entire six-year study period, and zero services submitted in several study years. Among these services, 188 (79%) were reimbursed with a corresponding cost of $31,551. Despite their greater salience and need for care coordination at safety-net clinics in the United States, there was little utilization of care management services delivered to Medicare patients and reimbursed through the physician fee schedule. The low uptake may reflect a preference for care management services administered outside of Medicare.
• Marcotte, L. M., Khor, S., Reddy, A., Morenz, A., Nelson, K., Akinsoto, N., Lee, E. S., Onstad, S., & Wong, E. S. (2025). An analysis of multilevel factor contributions to breast cancer screening inequities in an academic health system. Cancer, 131(3), e35734.
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  Breast cancer screening (BCS) inequities are evident at national and local levels, and many health systems want to address these inequities, but may lack data about contributing factors. The objective of this study was to inform health system interventions through an exploratory analysis of potential multilevel contributors to BCS inequities using health system data.
• Morenz, A. M., Coronado, G. D., Zhou, L., Valenzuela, C., & Liao, J. M. (2025). Associations Between Transportation Barriers in the Context of Other Social Needs and Cancer Screening Adherence. AJPM focus, 4(5), 100385.
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  Socioeconomic inequities in breast and cervical cancer screening persist and may be driven by unmet social needs, such as transportation barriers. The association between transportation barriers and screening adherence, while adjusting for other social needs, remains poorly characterized.
• Morenz, A. M., Ganguly, A. P., Kessler, L., & Coronado, G. D. (2025). Asking About Cervical Cancer Screening in National Surveys: Implications for Health Literacy and Research. American journal of preventive medicine, 69(1), 107625.
• Morenz, A. M., Nance, R. M., Mixson, L. S., Feinberg, J., Smith, G., Korthuis, P. T., Pho, M. T., Jenkins, W. D., Friedmann, P. D., Stopka, T. J., Fanucchi, L. C., Miller, W. C., Go, V. F., Westergaard, R., Seal, D. W., Zule, W. A., Crane, H. M., Delaney, J. A., & Tsui, J. I. (2025). Barriers to accessing medications for opioid use disorder among rural individuals. The International journal on drug policy, 140, 104805.
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  Individuals with opioid use disorder living in rural areas face barriers to accessing medications for treatment (MOUD), including finding prescribing clinicians and difficulties with transportation. This study sought to describe self-reported barriers to MOUD access in rural areas and associations between desired MOUD type and barriers encountered or perceived.
• Morenz, A. M., Nichols, J., Snyder, A., Perkins, J., Prince, D. K., Ganzarski, O., Hussein, Z., Kim, N. J., Dick, A., & Ng, Y. H. (2025). Exploring Caregiver Support as a Potential Mediator of Neighborhood Socioeconomic Disadvantage and Reduced Likelihood of Liver Transplant Waitlisting. Transplantation direct, 11(4), e1782.
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  Individuals from socioeconomically disadvantaged neighborhoods may be at risk of inequitable access to the liver transplant (LT) waitlisting (WL), but mechanisms mediating this relationship are not well understood. We assessed whether area deprivation index (ADI), a measure of neighborhood socioeconomic deprivation, was associated with LT WL and assessed whether caregiver support, a potentially modifiable factor, mediated this relationship.
• Morenz, A. M., Prince, D. K., Nichols, J., Snyder, A., Perkins, J., Ganzarski, O., Hussein, Z., Young, B. A., & Ng, Y. H. (2025). Association between Area Deprivation Index, Kidney Transplant Waitlisting, and Reasons for Denial. Clinical journal of the American Society of Nephrology : CJASN.
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  Neighborhood socioeconomic disadvantage may impact kidney transplant (KT) access and reasons for waitlist denial. We assessed (1) the association between Area Deprivation Index (ADI) and time-to-KT waitlisting and (2) whether evaluation outcomes differ by ADI quartile.
• Morenz, A. M., Wong, E. S., Zhou, L., Chen, C. P., Zerzan-Thul, J., & Liao, J. M. (2025). Neighborhood Socioeconomic Disadvantage and Acute Care Utilization in Washington State Medicaid: A Retrospective Cohort Study. Journal of general internal medicine, 40(3), 595-602.
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  Neighborhood disadvantage has been associated with potentially preventable acute care utilization among Medicare beneficiaries, but this association has not been studied in a Medicaid population, which is important for informing more equitable care and policies for this population.
• Morenz, A., & Liao, J. M. (2025). Factoring neighborhood context into readmission risk: An outstanding question for health systems and policymakers. Journal of hospital medicine, 20(5), 532-533.
• Staloff, J. A., Joo, J. H., Morenz, A. M., Zhou, L., Frogner, B. K., & Liao, J. M. (2025). National Trends of Telehealth Use in Medicare Annual Wellness Visits. Journal of the American Board of Family Medicine : JABFM, 38(2), 375-377.
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  In response to COVID-19, Medicare began reimbursing for Annual Wellness Visits (AWVs) via telehealth in March 2020. Little is known about nationwide utilization of telehealth AWVs as a preventive care service among Medicare beneficiaries.
• Staloff, J. A., Morenz, A. M., Hayes, S. A., Bhatia-Lin, A. L., & Liao, J. M. (2025). Area-Level socioeconomic disadvantage and access to primary care: A rapid review. Health affairs scholar, 3(4), qxaf066.
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  Social drivers of health aggregate geographically, contributing to health inequities that primary care access may mitigate. Two area-level measures of social disadvantage are the Area Deprivation Index and Social Vulnerability Index. This rapid review aimed to assess the association between these measures and primary care access. We conducted a rapid review of US studies published through February 11, 2025. Included studies were categorized as defining primary care access by self-reported access to primary care, geographic accessibility, or utilization. We analyzed 31 studies, of which 68% ( = 9/13 Area Deprivation Index, = 12/18 Social Vulnerability Index) found that greater area-level social disadvantage was consistently associated with reduced primary care access. This association was most consistently observed in studies measuring primary care access via self-report ( = 2/2), vaccine uptake ( = 5/7), and via a higher odds of using telephone vs audio-visual or in-person primary care in areas of high socioeconomic disadvantage ( = 5/5). These findings have implications for telemedicine payment policy and care redesign. The possible expiration of Medicare's expanded telemedicine reimbursement may disproportionately reduce access points to primary care for individuals living in high socioeconomic disadvantage areas. These findings also support the need for community-level interventions to increase access to primary care administered vaccines.
• Stimpson, J. P., Liao, J. M., Morenz, A. M., Joo, J. H., & Wilson, F. A. (2025). A difference-in-differences analysis of Medicaid expansion and state paid sick leave laws on colorectal cancer screening. Cancer, 131(10), e35904.
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  Colorectal cancer (CRC) screening disparities persist among populations with limited health care access. Although Medicaid expansion and paid sick leave could address these barriers, there is limited data on the combined impact of these policies and CRC screening.
• Stimpson, J. P., Park, S., Morenz, A. M., Gurley, T., & Wilson, F. A. (2025). Examining Employment Status, Paid Sick Leave, and Access to Care in Relation to Colorectal Cancer Screening Among U.S. Workers: A Structural Equation Modeling Approach. Cancer control : journal of the Moffitt Cancer Center, 32, 10732748251347731.
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  IntroductionThis cross-sectional study examined the relationship between paid sick leave and colorectal cancer (CRC) endoscopy screening among employed adults, including the examination of potential pathways.MethodsWe analyzed data from 15,352 employed adults aged 45-75 from the 2021 and 2023 National Health Interview Survey. A generalized structural equation model (GSEM) assessed the direct and indirect pathways between employment status (full-time vs part-time), paid sick leave, health insurance, usual source of care, and CRC endoscopy screening. Survey weights were applied to ensure nationally representative estimates.ResultsFull-time employment was positively associated with paid sick leave (OR = 6.57, 95% CI: 5.85, 7.38) and health insurance (OR = 1.30, 95% CI: 1.07, 1.59). Paid sick leave increased the likelihood of having a usual source of care (OR = 1.57, 95% CI: 1.31, 1.87) and was directly associated with CRC screening (OR = 1.15, 95% CI: 1.03, 1.28). Health insurance increased the likelihood of having a usual source of care (OR = 5.32, 95% CI: 4.30, 6.58) and CRC screening (OR = 3.22, 95% CI: 2.58, 4.02). Usual source of care was also associated with CRC screening (OR = 3.53, 95% CI: 2.89, 4.32).ConclusionsPaid sick leave was associated with CRC endoscopy utilization both directly and indirectly through improved healthcare access. Workplace policies that expand paid sick leave, alongside efforts to strengthen insurance coverage and primary care access, may reduce barriers to CRC endoscopy screening and improve population health.
• Stimpson, J. P., Tamirisa, K., Morenz, A. M., Adhikari, E. H., & Rodriguez Francis, J. K. (2025). Trust typologies and HPV awareness in the U.S.: a latent class analysis. Vaccine, 62, 127606.
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  Despite longstanding public health efforts, awareness of human papillomavirus (HPV) and the HPV vaccine remains suboptimal. Patterns of trust in health information sources may contribute to lack of HPV prevention awareness.
• Wong, E. S., Morenz, A. M., Hsu, A., Deen, J. F., Lin, J. Y., Liao, J. M., & Reddy, A. (2025). Factors Associated with Use of Telemedicine Among American Indian and Alaska Native Medicaid Beneficiaries. Journal of general internal medicine, 40(11), 2795-2798.

Poster Presentations

• Scott, C., Morenz, A., & Abbate, K. (2025, November).

  Referrals Are Note Enough: A QI Initiative to Improve Breast Cancer Screening in a Student-run, Free Clinic

  . American College of Physicians Arizona Chapter Annual Meeting.