Care for Key Surgical Issues Up With ACA Medicaid Expansion
THURSDAY, Jan. 25, 2018 -- For patients with five common surgical conditions, the Affordable Care Act (ACA)'s Medicaid expansion was associated with increased probability of early presentation and of receiving optimal management, according to a study published online Jan. 24 in JAMA Surgery.
Andrew P. Loehrer, M.D., M.P.H., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues conducted a difference-in-differences study using administrative data to compare patient-level outcomes in expansion versus non-expansion states before and after ACA's Medicaid expansion (2010 to 2013 versus 2014 to 2015). Data were included for 293,529 patients aged 18 to 64 years with appendicitis, cholecystitis, diverticulitis, peripheral artery disease, or aortic aneurysm who were admitted in 27 Medicaid expansion states (225,572 patients) and 15 non-expansion states (67,957 patients).
The researchers found that the probability of being uninsured was decreased 7.5 percent and that of having Medicaid was increased 8.6 percent in association with Medicaid expansion. Medicaid expansion correlated with increases in the probability of early uncomplicated presentation and receiving optimal management (1.8 and 2.6 percent, respectively).
"Health care systems and policymakers should be aware of the influence of insurance coverage expansion (or its repeal) on presentation with and management of surgical disease," the authors write.
Vizient provided collection and maintenance of the data.
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Posted: January 2018