At Federally Funded Health Centers, Medicaid Expansion Was Associated With Improved Quality Of Care

被引:105
作者
Cole, Megan B. [1 ]
Galarraga, Omar [1 ]
Wilson, Ira B. [1 ]
Wright, Brad [2 ]
Trivedi, Amal N. [1 ]
机构
[1] Brown Univ, Sch Publ Hlth, Dept Hlth Serv Policy & Practice, Providence, RI 02912 USA
[2] Univ Iowa, Coll Publ Hlth, Dept Hlth Management & Policy, Iowa City, IA USA
基金
美国医疗保健研究与质量局;
关键词
SAFETY-NET; MASSACHUSETTS; MORTALITY; SERVICES; MODELS; ACCESS; REFORM;
D O I
10.1377/hlthaff.2016.0804
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
In 2014 many uninsured, low-income nonelderly adults gained access to health insurance in states that expanded Medicaid eligibility under the Affordable Care Act. Federally funded community health centers were likely to be particularly affected by this expansion because many of their patients were uninsured and low income. We used a difference-in-differences approach to compare changes among 1,057 such centers in expansion versus nonexpansion states from 2011 to 2014, in terms of their patients' insurance coverage, the number of patients they served, and the quality of care they provided. Medicaid expansion was associated with large increases (12 percentage points) in Medicaid coverage and corresponding declines (11 percentage points) in uninsurance rates. The numbers of patients served increased in both expansion and nonexpansion states, and the magnitude of increase did not differ significantly between the groups of states. Medicaid expansion was associated with improved quality on four of eight measures examined: asthma treatment, Pap testing, body mass index assessment, and hypertension control. This analysis suggests that states' decisions about Medicaid expansion have important consequences for health center patients, with expansion improving treatment and outcomes of chronic disease and bolstering the use of recommended preventive services.
引用
收藏
页码:40 / 48
页数:9
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