Louisiana Medicaid Expansion and Pent-Up Demand.
Journal
Medical care
ISSN: 1537-1948
Titre abrégé: Med Care
Pays: United States
ID NLM: 0230027
Informations de publication
Date de publication:
01 11 2022
01 11 2022
Historique:
pubmed:
30
8
2022
medline:
18
10
2022
entrez:
29
8
2022
Statut:
ppublish
Résumé
Nearly half a million newly eligible people enrolled in Louisiana Medicaid following its expansion. To evaluate postexpansion utilization trends in Louisiana Medicaid. We plotted utilization trends for expansion and traditional Medicaid beneficiaries and conducted regression analyses to evaluate differences in monthly trends for over 2 years following expansion. We restricted our sample to a balanced panel of beneficiaries aged 18-64. The expansion population included beneficiaries who enrolled in the first month of eligibility. The nonexpansion group enrolled at least a year pre-expansion. Monthly office visits, emergency department visits, and inpatient stays per 1000 enrollees, drawn from the Louisiana Medicaid Data Warehouse claims database. Compared with trends among traditional Medicaid beneficiaries, expansion beneficiaries utilized 4.59 [ P =0.08] more monthly office visits per 1000 enrollees in their first year, increasing to 6.33 [ P <0.01] more per month thereafter. Monthly emergency department visit trends were not statistically significantly different in the first year but were 0.71 [ P <0.01] monthly visits lower for expansion beneficiaries thereafter. Trends in monthly inpatient stays were 0.23 [ P =0.02] stays per 1000 enrollees higher in the first year for expansion beneficiaries but were not statistically significantly different thereafter. Louisiana Medicaid expansion beneficiaries experienced lower initial rates of office visits compared with traditional Medicaid beneficiaries, but these rates consistently increased over the first 2 years after expansion. The expansion population had uniformly higher levels of emergency department and inpatient visits throughout the study period. After the first postexpansion year, emergency department visits among expansion beneficiaries fell relative to traditional beneficiaries while inpatient utilization trends leveled off after an initial increase.
Sections du résumé
BACKGROUND
Nearly half a million newly eligible people enrolled in Louisiana Medicaid following its expansion.
OBJECTIVES
To evaluate postexpansion utilization trends in Louisiana Medicaid.
RESEARCH DESIGN
We plotted utilization trends for expansion and traditional Medicaid beneficiaries and conducted regression analyses to evaluate differences in monthly trends for over 2 years following expansion.
SUBJECTS
We restricted our sample to a balanced panel of beneficiaries aged 18-64. The expansion population included beneficiaries who enrolled in the first month of eligibility. The nonexpansion group enrolled at least a year pre-expansion.
MEASURES
Monthly office visits, emergency department visits, and inpatient stays per 1000 enrollees, drawn from the Louisiana Medicaid Data Warehouse claims database.
RESULTS
Compared with trends among traditional Medicaid beneficiaries, expansion beneficiaries utilized 4.59 [ P =0.08] more monthly office visits per 1000 enrollees in their first year, increasing to 6.33 [ P <0.01] more per month thereafter. Monthly emergency department visit trends were not statistically significantly different in the first year but were 0.71 [ P <0.01] monthly visits lower for expansion beneficiaries thereafter. Trends in monthly inpatient stays were 0.23 [ P =0.02] stays per 1000 enrollees higher in the first year for expansion beneficiaries but were not statistically significantly different thereafter.
CONCLUSIONS
Louisiana Medicaid expansion beneficiaries experienced lower initial rates of office visits compared with traditional Medicaid beneficiaries, but these rates consistently increased over the first 2 years after expansion. The expansion population had uniformly higher levels of emergency department and inpatient visits throughout the study period. After the first postexpansion year, emergency department visits among expansion beneficiaries fell relative to traditional beneficiaries while inpatient utilization trends leveled off after an initial increase.
Identifiants
pubmed: 36038517
doi: 10.1097/MLR.0000000000001774
pii: 00005650-202211000-00007
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
839-843Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
B.W. reports secondary employment at ConcertAI (1120 Massachusetts Ave, Cambridge, MA 02138) for unrelated cancer research. The remaining authors declare no conflicts of interest.
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