Health Policy at the Ground Level: The Impact of Marketplace Guides on Healthcare Utilization

In response to provisions of the Patient Protection and Affordable Care Act (ACA) that became effective in 2014, Christiana Care Health System (CCHS) hired 12 market place guides (MPGs) to assist eligible uninsured individuals with enrollment in insurance and provide referrals to meet patients’ healthcare needs. Policy experts predicted that new insurance coverage would lead to an increase in healthcare utilization, particularly of emergency services, in spite of overarching market pressures to drive utilization to the lowest-cost environment. CCHS MPGs had the potential to influence the type and setting of the healthcare services that the newly insured accessed. This presentation will explore the impact of CCHS MPGs in influencing healthcare utilization within the CCHS network by this subset of patients compared to unassisted Medicaid and uninsured patients in the pre- and post-ACA periods.

Deann Gavney is a part-time student in the Doctor of Public Health (DrPH) in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. She is employed full-time as the Division Administrator for Johns Hopkins Rheumatology, where her responsibilities include oversight of the clinical practice, financial performance management, faculty and staff human resource management and recruitment, and sponsored project administration. The DrPH program has been an opportunity to develop a skillset in health outcomes research and consider current topics in public health from a managerial perspective.

The Innovative Discoveries Series, sponsored by the Delaware Clinical & Translational Science ACCEL program and the Christiana Care Value Institute, features informal presentations on topics relevant to current research and healthcare practice, led by knowledgeable and experienced presenters. There are offerings for researchers, healthcare providers, and community members of varying levels of experience.

These free talks are held Fridays at noon at Christiana Hospital but can be viewed from your home or office computer. Earn CMEs by participating in-person or online. Lunch is served and all are welcome to attend.

To see the full calendar of events, visit the Value Institute Events page or the ACCEL website, or subscribe to the ID Series mailing list.

Contact Sarahfaye Dolman at with any questions.


  • Deann Gavney