Medicaid/CHIP

Publicly-funded programs that cover medical and long-term care for low-income adults, children, and people with disabilities. Medicaid expansion is one of the central tools to increase insurance coverage rates through the Affordable Care Act.

Healthcare Utilization and Spending for Children with Mental Health Conditions in Medicaid

Stephanie Doupnik, MD
Feb. 1, 2020

Stephanie K. Doupnik, Jonathan Rodean, James Feinstein, James C. Gay, Julia Simmons, Jessica L. Bettenhausen, Jessica L. Markham, Matt Hall, Bonnie T. Zima, Jay G. Berry

Abstract [from journal]

Objective: To examine how characteristics vary between children with any mental health (MH) diagnosis who have typical spending and the highest spending; to identify independent predictors of highest spending; and to examine drivers of spending groups.

Methods: This retrospective analysis utilized 2016 Medicaid claims from 11 states and included 775,945 children ages 3-17 years with any MH diagnosis and at least 11 months of continuous coverage. We compared demographic characteristics and Medicaid expenditures

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Association of a Targeted Population Health Management Intervention with Hospital Admissions and Bed-Days for Medicaid-Enrolled Children

David M. Rubin, MD, MSCE
Dec. 2, 2019

David M. Rubin, Chén C. Kenyon, Douglas Strane, Elizabeth Brooks, Genevieve P. Kanter,  Xianqun Luan, Tyra Bryant-Stephens, Roberto Rodriguez, Emily F. Gregory,  Leigh Wilson, Annique Hogan, Noelle Stack,...

Abstract [from journal]

Importance: As the proportion of children with Medicaid coverage increases, many pediatric health systems are searching for effective strategies to improve management of this high-risk population and reduce the need for inpatient resources.

Objective: To estimate the association of a targeted population health management intervention for children eligible for Medicaid with changes in monthly hospital admissions and bed-days.

Design, Setting, and Participants: This quality...

Are Medicaid Coverage Gaps Associated with Higher Health Care Resource Utilization and Costs in Patients with Schizophrenia?

Oct. 8, 2019

Dominic Pilon, Antoine C. El Khoury, Ameur M. Manceur, Maryia Zhdanava, Carmela Benson, Patrick Lefebvre, Jalpa A. Doshi
 

Abstract [from journal]

The objective was to assess the association of Medicaid coverage gaps with health care resource utilization (HRU) and costs of patients with schizophrenia. Patients with schizophrenia were identified from the Medicaid database. The beginning of the first eligible gap was defined as the index date. Per-patient per-month (PPPM) HRU and costs before versus after a gap were assessed, and the association between gap duration and PPPM HRU and costs was examined up to 12 months post index. Together with 95% confidence intervals, HRU differences were reported

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Health Care Safety-Net Programs After The Affordable Care Act

Issue Brief
Oct. 1, 2019

Prior to the Affordable Care Act (ACA), health care safety-net programs were the primary source of care for over 44 million uninsured people. While the ACA cut the number of uninsured substantially, about 30 million people remain uninsured, and many millions more are vulnerable to out-of-pocket costs beyond their resources. The need for the safety net remains, even as the distribution and types of need have shifted. This brief reviews the effects of the ACA on the funding and operation of safety-net institutions. It highlights the challenges and opportunities that health care reform presents to safety-net programs, and how they have adapted and evolved to continue to serve our most vulnerable residents.

THRIVE: Addressing Patients’ Social Needs after Hospitalization

Jul. 30, 2019

Imagine being discharged from the hospital to a two-room apartment badly in need of repair. Your electricity has been cut off and you can barely remember the discharge instructions. You were told to see a specialist in a week, but it will take you 90 minutes one-way on public transportation to get there. Confused about follow-up and juggling the complexities of life, what do you do?

Primary Care Appointments for Medicaid Beneficiaries With Advanced Practitioners

Jul. 1, 2019

Lena Leszinsky, Molly Candon

Abstract [from journal]

Primary care access in Medicaid improved after the Patient Protection and Affordable Care Act despite millions of new beneficiaries. One possible explanation is that practices are scheduling more appointments with advanced practitioners. To test this theory, we used data from a secret shopper study in which callers simulated new Medicaid patients and requested appointments with 3,742 randomly selected primary care practices in 10 states. Conditional on scheduling an appointment, simulated patients asked whether the practitioner...

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