دورية أكاديمية
Did Medicaid Reimbursements Shape the Effects of Medicaid Expansion on Access to Health Care Among the Low-Income Population?
| العنوان: | Did Medicaid Reimbursements Shape the Effects of Medicaid Expansion on Access to Health Care Among the Low-Income Population? |
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| المؤلفون: | Benitez J; Department of Health Management & Policy, College of Public Health, University of Kentucky, Lexington, KY, USA. joseph.benitez@uky.edu., Freed SS; Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, D.C, USA., Huang H; Department of Health Management & Policy, College of Public Health, University of Kentucky, Lexington, KY, USA., Oladele T; Department of Health Management & Policy, College of Public Health, University of Kentucky, Lexington, KY, USA. |
| المصدر: | Journal of general internal medicine [J Gen Intern Med] 2024 Jun; Vol. 39 (8), pp. 1360-1368. Date of Electronic Publication: 2024 Jan 03. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 8605834 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-1497 (Electronic) Linking ISSN: 08848734 NLM ISO Abbreviation: J Gen Intern Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Secaucus, NJ : Springer Original Publication: [Philadelphia, PA] : Hanley & Belfus, [c1986- |
| مواضيع طبية MeSH: | Medicaid*/economics , Medicaid*/statistics & numerical data , Health Services Accessibility*/economics , Health Services Accessibility*/statistics & numerical data , Poverty*/economics, Humans ; United States ; Adult ; Middle Aged ; Female ; Male ; Young Adult ; Insurance Coverage/economics ; Insurance Coverage/statistics & numerical data ; Patient Protection and Affordable Care Act/economics ; Insurance, Health, Reimbursement/economics ; Behavioral Risk Factor Surveillance System |
| مستخلص: | Background: Whether variation in Medicaid reimbursement fees influenced the impacts of the Medicaid expansions is not well understood. Objective: We examine whether changes in health care access associated with Medicaid expansion are different in states with comparatively high Medicaid reimbursement rates compared against expanding in states with lower Medicaid reimbursement rates. Design: Using a difference-in-difference-in-difference (DDD or triple-difference) regression approach, we compare relative differences in Medicaid expansion effects between lower and higher reimbursement states. Participants: 512,744 low-income adults aged 20-64 in the 2011-2019 Behavioral Risk Factor Surveillance System. Main Measures: Health insurance coverage status, unmet medical needs due to cost, regular source for health care, and a regular/scheduled checkup within the past year. Key Results: Medicaid expansion has significant and positive impacts on health coverage and access in both high- and low-fee states. In states with fee levels above the median Medicare-to-Medicaid ratios, expanding Medicaid eligibility reduced uninsurance rate by 15.2 percentage point (ppt, p < 0.01), shrank the cost-associated unmet medical need by 10.3 ppt (p < 0.01), improved access to usual source of care by 1.9 ppt (p < 0.1), and increased regular checkup by 14.4 ppt (p < 0.01), while such effects in low-fee states were 11.7 ppt (p < 0.01), 8.3 ppt (p < 0.01), 3.1 ppt (p < 0.1), and 12.3 ppt (p < 0.01), respectively. Our results suggest that Medicaid expansion effect on unmet medical need due to cost in higher-reimbursing states was 2.98 ppt (p < 0.05) larger than in lower-reimbursing states. Evidence suggests modest increases in health care access were more strongly associated with expansions in higher-fee states. Conclusions: Medicaid's fee structure should be considered as a factor influencing large-scale coverage expansions. (© 2024. The Author(s), under exclusive licence to Society of General Internal Medicine.) |
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| تواريخ الأحداث: | Date Created: 20240103 Date Completed: 20240612 Latest Revision: 20240722 |
| رمز التحديث: | 20240722 |
| مُعرف محوري في PubMed: | PMC11169115 |
| DOI: | 10.1007/s11606-023-08558-w |
| PMID: | 38172410 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1525-1497 |
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| DOI: | 10.1007/s11606-023-08558-w |