Department of Health Policy and Management, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
Med Care. 2022 Nov 1;60(11):839-843. doi: 10.1097/MLR.0000000000001774. Epub 2022 Aug 26.
Nearly half a million newly eligible people enrolled in Louisiana Medicaid following its expansion.
To evaluate postexpansion utilization trends in Louisiana Medicaid.
We plotted utilization trends for expansion and traditional Medicaid beneficiaries and conducted regression analyses to evaluate differences in monthly trends for over 2 years following expansion.
We restricted our sample to a balanced panel of beneficiaries aged 18-64. The expansion population included beneficiaries who enrolled in the first month of eligibility. The nonexpansion group enrolled at least a year pre-expansion.
Monthly office visits, emergency department visits, and inpatient stays per 1000 enrollees, drawn from the Louisiana Medicaid Data Warehouse claims database.
Compared with trends among traditional Medicaid beneficiaries, expansion beneficiaries utilized 4.59 [ P =0.08] more monthly office visits per 1000 enrollees in their first year, increasing to 6.33 [ P <0.01] more per month thereafter. Monthly emergency department visit trends were not statistically significantly different in the first year but were 0.71 [ P <0.01] monthly visits lower for expansion beneficiaries thereafter. Trends in monthly inpatient stays were 0.23 [ P =0.02] stays per 1000 enrollees higher in the first year for expansion beneficiaries but were not statistically significantly different thereafter.
Louisiana Medicaid expansion beneficiaries experienced lower initial rates of office visits compared with traditional Medicaid beneficiaries, but these rates consistently increased over the first 2 years after expansion. The expansion population had uniformly higher levels of emergency department and inpatient visits throughout the study period. After the first postexpansion year, emergency department visits among expansion beneficiaries fell relative to traditional beneficiaries while inpatient utilization trends leveled off after an initial increase.
路易斯安那州医疗补助计划（Medicaid）扩大覆盖范围后，近 50 万人新符合资格。
评估路易斯安那州医疗补助计划扩大覆盖范围后的利用趋势。
我们绘制了扩张受益人和传统医疗补助受益人的利用趋势，并进行回归分析，以评估扩张后超过 2 年的每月趋势差异。
我们将样本限制在 18-64 岁的平衡受益人群体中。扩张人群包括在资格开始的第一个月内注册的受益人。非扩张组在扩张前至少注册了一年。
每月每位注册者的门诊就诊次数、急诊就诊次数和住院次数，数据来自路易斯安那州医疗补助数据仓库的索赔数据库。
与传统医疗补助受益人的趋势相比，扩张受益人的第一年每月门诊就诊次数增加了 4.59 次（P=0.08），此后每月增加了 6.33 次（P <0.01）。在第一年，急诊就诊趋势在统计学上没有显著差异，但此后每月减少了 0.71 次（P <0.01）。每月住院人次的趋势在扩张受益人的第一年增加了 0.23 次（P=0.02），但此后在统计学上没有显著差异。
与传统医疗补助受益人相比，路易斯安那州医疗补助计划扩张受益人的初始门诊就诊率较低，但在扩张后的前 2 年，这些就诊率持续上升。在整个研究期间，扩张人群的急诊和住院就诊率一直较高。在扩张后的第一年，扩张受益人的急诊就诊率相对于传统受益人的就诊率下降，而住院利用率在最初增加后趋于平稳。
