Expanding Medicaid eligibility is associated with significant improvements in care for low-income patients with coronary artery disease, heart failure, heart rhythm issues and cerebrovascular disease, according to new research published in BMC Health Services Research.[1]
The study’s authors tracked a variety of trends, including several outcomes related to high-value preventive care, in eight states that chose to expand Medicaid eligibility in 2014 and five states that did not. Data included approximately 143 million patients with a mean age of 56 years old who received care from 2012 to 2015.
In the expansion states— Arizona, California, Illinois, Massachusetts, New Jersey, New York, Ohio and Washington—adults with an annual income of less than approximately $20,000 were made eligible for Medicaid. This expansion led to noteworthy increases in Medicaid visits (16.2 per 100 adults) and new Medicaid visits (3.1 per 100 adults) without affecting visits among patients on Medicare or commercial insurance.
Most of the team’s work focused on the following high-value outcomes: prescriptions for antiplatelet, statins and beta blockers among coronary artery disease patients; prescriptions for beta blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers among heart failure patients; prescriptions for anticoagulants among atrial fibrillation patients, prescriptions for antiplatelet agents among cerebrovascular disease patients; prescriptions for statins among diabetes mellitus patients; treatment for depression; and treatment for osteoporosis.
Overall, Medicaid expansion was associated with a 19% increase in the likelihood that a new Medicaid patient would receive one of these high-value prescriptions or treatments. In states that did not expand Medicaid eligibility, the likelihood of a new Medicaid patient receiving one of those prescriptions or treatments decreased by 24%.
“Expanding Medicaid not only expanded low-income adults’ overall access to healthcare, but it also specifically expanded access to preventive care that could pay off down the road in better health,” lead author Aaron Parzuchowski, MD, MPH, MSc, a lecturer in internal medicine at Michigan Medicine, said in a prepared statement. “At the same time, concerns that other patients would receive less care, or more hurried care with less focus on prevention, did not pan out.”
Parzuchowski et al. estimated that an additional 3.5 million adults would qualify for Medicaid if 10 states that have not expanded eligibility—including Florida and Texas—chose to make that change now.
Read the full analysis here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.