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Medicaid Expansion Ups Preemptive Listing for Kidney Transplant

THURSDAY, June 21, 2018 -- The proportion of new preemptive listings for kidney transplantation with Medicaid coverage increased in states with Medicaid expansion in the post-expansion era, according to a study published online June 21 in the Clinical Journal of the American Society of Nephrology.

Meera N. Harhay, M.D., from the Drexel University College of Medicine in Philadelphia, and colleagues performed a retrospective observational study of adults listed for kidney transplantation using the United Network of Organ Sharing database. Data were included for the pre-Medicaid expansion era (Jan. 1, 2011, to Dec. 31, 2013) and the post-Medicaid expansion era (Jan. 1, 2014, to Dec. 31, 2016).

The researchers observed a 59 percent relative increase in Medicaid-covered preemptive listings from the pre- to post-expansion period in the 24 states that fully implemented Medicaid expansion, compared with an 8.8 percent increase among 19 Medicaid non-expansion states. The adjusted proportion of listings with Medicaid coverage decreased by 0.3 percent (4.0 to 3.7 percent) among non-expansion states compared with a 3.0 percent increase (7 to 10 percent) among expansion states from the pre- to post-expansion period. Medicaid expansion correlated with absolute increases in Medicaid coverage by 1.4, 4.0, 5.9, and 5.3 percent among white, black, Hispanic, and other listings, respectively.

"Medicaid expansion was associated with an increase in the proportion of new preemptive listings for kidney transplantation with Medicaid coverage, with larger increases in Medicaid-coverage among racial and ethnic minority listings than among white listings," the authors write.

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Posted: June 2018