Oregon Medicaid Expenditures After the 2014 Affordable Care Act Medicaid Expansion

Details

• Alternative Title:
  Med Care
• Personal Author:
  Springer, Rachel ; Marino, Miguel ; O’Malley, Jean P ; Lindner, Stephan ; Huguet, Nathalie ; DeVoe, Jennifer E
• Description:
  Background
  
  There is interest in assessing healthcare utilization and expenditures among new Medicaid enrollees after the 2014 Medicaid expansion. Recent studies have not differentiated between newly enrolled individuals and those returning after coverage gaps.
  
  Objectives
  
  To assess healthcare expenditures among Medicaid enrollees in the 24 months after Oregon’s 2014 Medicaid expansions and examine whether expenditure patterns were different among the newly, returning, and continuously insured.
  
  Research Design
  
  Retrospective cohort study using inverse-propensity weights to adjust for differences between groups.
  
  Subjects
  
  Oregon adult Medicaid beneficiaries insured continuously from 2014-2015 who were either newly, returning, or continuously insured.
  
  Measures
  
  Monthly expenditures for inpatient care, prescription drugs, total outpatient care, and subdivisions of outpatient care: emergency department (ED), dental, mental and behavioral health (MBH), primary care (PC), and specialist care.
  
  Results
  
  After initial increases, newly and returning insured outpatient expenditures dropped below continuously insured. Expenditures for ED and dental services among the returning insured remained higher than among the newly insured. Newly insured MBH, PC, and specialist expenditures plateaued higher than returning insured. Prescription drug expenditures increased over time for all groups, with continuously insured highest and returning insured lowest. All groups had similar inpatient expenditures over 24 months post-Medicaid expansion.
  
  Conclusions
  
  Our findings reveal that outpatient expenditures for new non-pregnant, non-dual-eligible Oregon Medicaid recipients stabilized over time after meeting pent-up demand, and prior insurance history affected the mix of services that individuals received. Policy evaluations should consider expenditures over at least 24 months and should account for enrollees’ prior insurance histories.
  
  
• Keywords:
  Ambulatory Care Cohort Studies Female Health Expenditures Health Insurance Health Services Accessibility Humans Insurance, Health Insurance Coverage Male Medicaid Medical Expenditures Oregon Patient Protection And Affordable Care Act Policy Evaluation Retrospective Studies United States

  More +
• Source:
  Med Care. 56(5):394-402
• Pubmed ID:
  29578955
• Pubmed Central ID:
  PMC5893375
• Document Type:
  Journal Article
• Funding:
  U18DP006116/ACL HHSUnited States/ ; R01 CA204267/CA/NCI NIH HHSUnited States/ ; R01 HS024270/HS/AHRQ HHSUnited States/ ; U18 DP006116/DP/NCCDPHP CDC HHSUnited States/ ; R01 CA181452/CA/NCI NIH HHSUnited States/
• Volume:
  56
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7f56c9afb5c3c9f900de1eb182edff021d1d8094e057a26b80494ec6860c76ad
• Download URL:
  https://stacks.cdc.gov/view/cdc/53229/cdc_53229_DS1.pdf
• File Type:
  [PDF - 660.43 KB ]