In a area without little data supporting theories this study provides some surprising results to some.
Study: Expanding Medicaid doesn’t reduce ER trips. It increases them
January 2 at 2:00 pmhttp://www.washingtonpost.com/blogs/...ncreases-them/The Science study is part of a much larger research project that looks at Oregon's 2008 Medicaid expansion, where the state had limited funding to expand the public program to a set number of low-income residents. Oregon used a lottery to determine who would gain access to coverage, and that created a unique opportunity for researchers: The chance to study what happens when some people are randomly assigned to receive health insurance, and others are not.
Previous research on the Oregon Medicaid expansion has found that enrolling in the public program increased hospital visits, primary care trips and prescription drug use. That left an unanswered question: Were new Medicaid enrollees going their primary care doctor instead of the emergency department, or, were they using more of all types of health-care services?
This study suggests the latter answer: With financial barriers removed, Medicaid patients see their primary care doctor more -- and also go to the emergency department at an increased frequency. Medicaid enrollees made, on average, 1.43 trips to the emergency department during the 18-month study period, compared to an average of 1.02 visits among those who entered the Medicaid lottery but did not gain coverage.
With 130,000 in just medicaid coverage to be added this year Oregon went in a crisis mode and the 40% ER increase includes a 9% reduction over last year by reducing medicaid services.
More visits and drugs, but not better physical health.
In 2008, the state of Oregon initiated an ambitious health care policy that allowed researchers to shed light on the effects of guaranteeing Medicaid coverage for low-income adults. The results have been closely followed in large part because insurance for the poor is a major component of the Affordable Care Act—aka Obamacare—that will soon be rolled out across the country.
http://www.slate.com/articles/health...universal.htmlThe early results from the experiment, based on surveys performed a year following initial Medicaid assignment and released in the summer of 2011, seemed promising. I described them for Slate in an article titled “Does Health Coverage Make People Healthier?” The answer then was a tentative yes: Oregon Medicaid applicants who were randomly assigned to receive insurance reported that they utilized more preventive care, felt in better health, were more stable financially, and overall just a whole lot happier than those who didn’t win the insurance lottery. At the time, conservative commentators cautioned that the liberal media—of which I am a proud member—were overhyping the study’s implications. The results were promising but far from conclusive; they weren’t based on actual health outcomes but instead things like health care usage (trips to the doctor, use of preventive care, and so on) and self-reported health status (“Are you in poor, fair, or excellent health?”) rather than actual health outcomes.
And the Now that the clinical results have started to come in, it’s time for liberal media types like myself to eat some humble pie. Today’s New England Journal article presents a set of findings showing that Medicaid had no effect on a set of conditions where you would expect proper health management to make a difference. There are effective treatment protocols for hypertension, cholesterol, and diabetes, yet insurance status had no effect on blood pressure, cholesterol levels, or glycated hemoglobin (a measure of diabetic blood sugar control).
But does show better mental health, less depression with less of their money spent on healthcare by those under medicaid.