Author:
Wright Brad,Anderson David,Whitaker Rebecca,Shrader Peter,Bettger Janet Prvu,Wong Charlene,Shafer Paul
Abstract
Abstract
Background and Objective
To characterize health care use and costs among new Medicaid enrollees before and during the COVID pandemic. Results can help Medicaid non-expansion states understand health care use and costs of new enrollees in a period of enrollment growth.
Research Design
Retrospective cross-sectional analysis of North Carolina Medicaid claims data (January 1, 2018 - August 31, 2020). We used modified Poisson and ordinary least squares regression analysis to estimate health care use and costs as a function of personal characteristics and enrollment during COVID. Using data on existing enrollees before and during COVID, we projected the extent to which changes in outcomes among new enrollees during COVID were pandemic-related.
Subjects
340,782 new enrollees pre-COVID (January 2018 – December 2019) and 56,428 new enrollees during COVID (March 2020 – June 2020).
Measures
We observed new enrollees for 60-days after enrollment to identify emergency department (ED) visits, nonemergent ED visits, primary care visits, potentially-avoidable hospitalizations, dental visits, and health care costs.
Results
New Medicaid enrollees during COVID were less likely to have an ED visit (-46 % [95 % CI: -48 %, -43 %]), nonemergent ED visit (-52 % [95 % CI: -56 %, -48 %]), potentially-avoidable hospitalization (-52 % [95 % CI: -60 %, -43 %]), primary care visit (-34 % [95 % CI: -36 %, -33 %]), or dental visit (-36 % [95 % CI: -41 %, -30 %]). They were also less likely to incur any health care costs (-29 % [95 % CI: -30 %, -28 %]), and their total costs were 8 % lower [95 % CI: -12 %, -4 %]. Depending on the outcome, COVID explained between 34 % and 100 % of these reductions.
Conclusions
New Medicaid enrollees during COVID used significantly less care than new enrollees pre-COVID. Most of the reduction stems from pandemic-related changes in supply and demand, but the profile of new enrollees before versus during COVID also differed.
Funder
Kate B. Reynolds Charitable Trust
Publisher
Springer Science and Business Media LLC
Reference43 articles.
1. Banthin J, Blumberg LJ, Simpson M, Buettgens M, Wang R. Changes in health insurance coverage due to the COVID-19 recession: preliminary estimates using microsimulation. Washington, DC: Urban Institute. 2020. https://www.urban.org/research/publication/changes-health-insurance-coverage-due-covid-19-recession.
2. Garrett AB, Gangopadhyaya A. How the COVID-19 Recession Could Affect Health Insurance Coverage. 2020. https://www.urban.org/research/publication/how-covid-19-recession-could-affect-health-insurance-coverage.
3. Frenier C, Nikpay SS, Golberstein E. COVID-19 Has Increased Medicaid Enrollment, But Short-Term Enrollment Changes Are Unrelated To Job Losses: Study examines influence COVID-19 may have had on Medicaid enrollment covering the period of March 1 through June 1, 2020 for 26 states. Health Aff (Millwood). 2020;39(10):1822–1831.
4. North Carolina Department of Health and Human Services. Enrollment Dashboard: North Carolina Medicaid and Health Choice Enrollment, by County and Program Aid Category. https://medicaid.ncdhhs.gov/reports/dashboards#enroll. Published 2021. Accessed July 22, 2021, 2021.
5. Baicker K, Finkelstein A. The Effects of Medicaid Coverage — Learning from the Oregon Experiment. N Engl J Med. 2011;365(8):683–685.
Cited by
7 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献