NORC at the University of Chicago, Bethesda, MD.
Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA.
Med Care. 2024 Jan 1;62(1):3-10. doi: 10.1097/MLR.0000000000001887. Epub 2023 Jul 14.
The Supplemental Nutrition Assistance Program (SNAP) provides financial assistance to low-income individuals and families to help them purchase food. However, when participants experience short-term disenrollment from the program, known as churn, it can disrupt their health care usage patterns or result in acute health care needs due to the loss of financial benefits and time burden required to reapply for SNAP.
The objective of this study was to examine the changes in health care expenditures and acute care utilization during periods of SNAP churn compared with nonchurn periods among those who churn during the study period.
Longitudinal analysis of Pennsylvania Medicaid claims data for enrollees participating in SNAP between 2016 and 2018 using individual fixed-effects models. We add to the literature by estimating whether these changes varied based on the amount of SNAP benefit lost, or differed between adults and children.
We found that SNAP churn was associated with reductions in pharmacy and primary care spending across all SNAP benefit levels and age groups. Specifically, our findings indicate a reduction of 4%-6% in pharmacy expenditures for adults and 2%-4% for children. Moreover, there was a 3%-4% decrease in primary care expenditures for adults and a 4%-6% decrease for children. Acute care utilization did not significantly change during a SNAP churn period.
Our findings of decreases in pharmacy and primary care spending suggest that preventing SNAP churn may help reduce instances where adult and child participants forgo necessary care.
补充营养援助计划（SNAP）为低收入个人和家庭提供经济援助，以帮助他们购买食物。然而，当参与者经历短期的项目退出，即 churn，这可能会打乱他们的医疗保健使用模式，或者由于失去经济福利和重新申请 SNAP 的时间负担而导致急性医疗保健需求。
本研究的目的是检验在研究期间经历 churn 的参与者与非 churn 期间相比，在 SNAP churn 期间医疗保健支出和急性护理利用的变化。
使用个体固定效应模型对 2016 年至 2018 年期间参与 SNAP 的宾夕法尼亚州医疗补助索赔数据进行纵向分析。我们通过估计这些变化是否基于 SNAP 福利的损失量而有所不同，或者在成年人和儿童之间是否存在差异，为文献做出了补充。
我们发现，SNAP churn 与所有 SNAP 福利水平和年龄组的药房和初级保健支出减少有关。具体来说，我们的研究结果表明，成年人的药房支出减少了 4%-6%，儿童的支出减少了 2%-4%。此外，成年人的初级保健支出减少了 3%-4%，儿童的支出减少了 4%-6%。急性护理利用在 SNAP churn 期间没有显著变化。
我们发现药房和初级保健支出减少的结果表明，防止 SNAP churn 可能有助于减少成年和儿童参与者放弃必要护理的情况。
