Trends in Hospital Utilization After Medicaid Expansion
Bibliographic Data
BACKGROUND: Medicaid expansion was associated with an increase in hospitalizations funded by Medicaid. Whether this increase reflects an isolated payer shift or broader changes in case-mix among hospitalized adults remains uncertain. RESEEARCH DESIGN: Difference-in-differences analysis of discharge data from 4 states that expanded Medicaid in 2014 (Arizona, Iowa, New Jersey, and Washington) and 3 comparison states that did not (North Carolina, Nebraska, and Wisconsin). SUBJECTS: All nonobstetric hospitalizations among patients aged 19-64 years of age admitted between January 2012 and December 2015. MEASURES: Outcomes included state-level per-capita rates of insurance coverage, several markers of admission severity, and admission diagnosis. RESULTS: We identified 6,516,576 patients admitted during the study period. Per-capita admissions remained consistent in expansion and nonexpansion states, though Medicaid-covered admissions increased in expansion states (274.6-403.8 per 100,000 people vs. 268.9-262.8 per 100,000; P 0.05 for all comparisons). CONCLUSIONS: Medicaid expansion was associated with a shift in payers among nonelderly hospitalized adults without significant changes in case-mix or in several markers of acuity. These findings suggest that Medicaid expansion may reduce uncompensated care without shifting admissions practices or acuity among hospitalized adults
Comorbidity · Emergency department · Environmental health · Health care · Health insurance · Medicaid · Per capita · Population · Psychiatry · Demography · Emergency Medicine · Healthcare Policy and Management · Heart Failure Treatment and Management · Internal Medicine · Medicine · Primary Care and Health Outcomes
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| Unique citing works | 5 |
|---|---|
| Citations per year | 0,71 |
| Citation span | 2019 - 2023 (5) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 5 |