Medicaid Expansion Coverage Effects Grew In 2015 With Continued Improvements In Coverage Quality

Decker, Sandra L.; Lipton, Brandy J.; Sommers, Benjamin D.

doi:10.1377/hlthaff.2016.1462

Cited by 50 publications

(47 citation statements)

References 9 publications

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“…Enrollment in Medicaid, a government‐sponsored program that covers health care costs for low‐income individuals and families in the United States, increased from 35 million to over 74 million between 2000 and 2017 . Implementation of two policies during this period, the Health Insurance Flexibility and Accountability initiative and the Affordable Care Act (ACA), significantly increased Medicaid enrollment in some states and not others, creating natural experiments to study the population‐level impact of Medicaid . A large body of evidence stemming from these experiments suggests Medicaid has positive effects on access to care, health, and financial security .…”

Section: Introductionmentioning

confidence: 99%

Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014

Winkelman

Segel

Davis

2018

Health Services Research

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Objectives To examine the person‐level impact of Medicaid enrollment on costs, utilization, access, and health across previously uninsured racial/ethnic groups. Data Source Medical Expenditure Panel Survey, 2008‐2014. Study Design We pooled multiple 2‐year waves of data to examine the direct impact of Medicaid enrollment among uninsured Americans. We compared changes in outcomes among nonpregnant, uninsured individuals who gained Medicaid (N = 963) to those who remained uninsured (N = 9784) using a difference‐in‐differences analysis. Principal Findings Medicaid enrollment was associated with significant increases in total health care costs and total prescription drug costs and a significant decrease in out‐of‐pocket costs. Among those who gained Medicaid, prescription drug use increased significantly relative to those who remained uninsured. Medicaid enrollment was also associated with a significant increase in reporting a usual source of care, a decrease in foregone care, and significant improvements in severe psychological distress. Changes in total prescription drug costs and total prescription drug fills differed significantly across each racial/ethnic group. Conclusions Among a national sample of uninsured individuals, Medicaid enrollment was associated with substantial favorable changes in out‐of‐pocket costs, prescription drug use, and access to care. Our findings suggest Medicaid is an important tool to reduce insurance‐related disparities among Americans.

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Section: Introductionmentioning

confidence: 99%

Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014

Winkelman

Segel

Davis

2018

Health Services Research

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“…Expanded Medicaid eligibility has been associated with reductions in uninsurance, 8,9 mortality, 10 and psychological distress, 9 as well as increases in glucose checks for patients with diabetes 11 and visits for preventive care and chronic conditions. 11,12 In CHCs, Medicaid expansion has been associated with marginal increases in total visits and mental health visits, 13 as well as gains in insurance coverage and quality of care after one year.…”

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confidence: 99%

Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients

et al. 2018

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Medicaid expansion had great potential to affect community health centers (CHCs), particularly in rural areas, because their patients are predominantly low income and disproportionately uninsured. Using data for 2011-15 on all CHCs, we found that after two years Medicaid expansion was associated with an 11.44-percentage-point decline in the share of CHC patients who were uninsured and a 13.15-percentage-point increase in the share with Medicaid. Changes in quality and volume were consistently observed in rural CHCs in expansion states, which had relative improvements in asthma treatment, body mass index screening and follow-up, and hypertension control, along with substantial increases in volumes for eighteen of twenty-one types of visits-particularly those for mammograms, abnormal breast findings, alcohol-related disorder, and other substance abuse disorder. Similar relative gains were not observed in urban CHCs in expansion states. Repealing or phasing out Medicaid expansion could reverse observed gains in quality and service use and could be particularly detrimental to low-income rural populations.

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“…The RMSFE several years out from the last year of estimation are stable, though the year 2014 appears to be difficult to estimate. The difficulty of forecasting for 2014 may be due to first year of Medicaid expansion under the Patient Protection and Affordable Care Act [31][32][33][34]. The mean of the multi-step ahead RMSFE over 2007 to 2014 is 0.0574, and seems to be slightly elevated for the years 2012 and 2013 immediately after the break in the BRFSS survey methodology.…”

Section: Out-of-sample Forecast Performancementioning

confidence: 99%

Predictive validation and forecasts of short-term changes in healthcare expenditure associated with changes in smoking behavior in the United States

2020

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ObjectivesOut-of-sample forecasts are used to evaluate the predictive adequacy of a previously published national model of the relationship between smoking behavior and real per capita health care expenditure using state level aggregate data. In the previously published analysis, the elasticities between changes in state adult current smoking prevalence and mean cigarette consumption per adult current smoker and healthcare expenditures were 0.118 and 0.108 This new analysis provides evidence that the model forecasts out-of-sample well. MethodsOut-of-sample predictive performance was used to find the best specification of trend variables and the best model to bridge a break in survey data used in the analysis. Monte-Carlo simulation was used to calculate forecast intervals for the effect of changes in smoking behavior on expected real per capita healthcare expenditures. OPEN ACCESSCitation: Lightwood J, Anderson S, Glantz SA (2020) Predictive validation and forecasts of shortterm changes in healthcare expenditure associated with changes in smoking behavior in the United States. PLoS ONE 15(1): e0227493. https://doi. SAG and as a consulting agreement with SA. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The decreases of 5% each year. Given the limitations of time series modelling in a relatively short time series, the effect of changes in smoking behavior may occur over several years, even though the model contains only one lag for the explanatory variables. ConclusionReductions in smoking produce substantial savings in real per capita healthcare expenditure in short to medium term. A 5% relative drop in smoking prevalence (about a 0.87% reduction in absolute prevalence) combined with a 5% drop in consumption per remaining smoker (about 16 packs/year) would be followed by a $31.5 billion reduction in healthcare expenditure (in 2014 dollars).

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Medicaid Expansion Coverage Effects Grew In 2015 With Continued Improvements In Coverage Quality

Cited by 50 publications

References 9 publications

Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014

Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014

Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients

Predictive validation and forecasts of short-term changes in healthcare expenditure associated with changes in smoking behavior in the United States

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