Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Medicaid increases use of health care, decreases financial strain, improves health

07.07.2011
Researchers from Harvard School of Public Health (HSPH), Massachusetts Institute of Technology (MIT), the National Bureau of Economic Research (NBER), and Providence Health & Services have found that expanding low income adults' access to Medicaid substantially increases health care use, reduces financial strain on covered individuals, and improves their self-reported health and well-being. This is the first study to evaluate the impact of insuring the uninsured in the U.S. using a randomized controlled trial, the gold standard in medical and scientific studies.

The study will be released as working paper 17190 on the website of the National Bureau of Economic Research (NBER) on July 7, 2011 (www.nber.org).

"This study shows that Medicaid substantially expands access to and use of care for low-income adults relative to being uninsured," said Katherine Baicker, professor of health economics at HSPH and co-principal investigator of the study. Medicaid, which is jointly funded by the federal and state governments, covers the health care costs of eligible low-income individuals and families. The 2010 Affordable Care Act expands Medicaid to cover additional low income adults in all states in 2014.

In 2008, Oregon held a lottery to accept additional low-income, uninsured residents into its Medicaid program; about 90,000 applied for the 10,000 available openings. The researchers collected data on the lottery participants from many sources – including hospital records and mail surveys – and compared outcomes between those randomly selected by the lottery and those not selected in order to determine the impact of Medicaid.

Although many previous studies compare health or health care use between the insured and uninsured, inferring the impact of health insurance from such comparisons is difficult because differences between the insured and uninsured, such as in income, employment, or initial health, may affect the health and health care outcomes studied. This study is the first to avoid this problem by taking advantage of the random assignment created by the Oregon lottery.

Based on the first year of this ongoing study, some of the key findings show that Medicaid coverage:

Increases health care use:

Increases the likelihood of using outpatient care by 35%, using prescription drugs by 15%, and being admitted to the hospital by 30%, but does not seem to have an effect on use of emergency departments. This translates into about a 25% increase in annual health care spending.

Increases the use of recommended preventive care such as mammograms by 60% and cholesterol monitoring by 20%.

Increases access to care: Increases the probability individuals report having a regular office or clinic for their primary care by 70% and the likelihood they report having a particular doctor that they usually see by 55%.

Reduces financial strain: Decreases the probability of having to borrow money or skip paying other bills to pay for health care by 40%, and decreases the probability of having an unpaid medical bill sent to a collection agency by 25%. Declines in unpaid medical bills also benefit health care providers, since the vast majority of such debts are never paid.

Improves reported health: Increases the probability that people report themselves in good to excellent health (compared with fair or poor health) by 25% and increases the probability of not being depressed by 10%.

"Some people wonder whether Medicaid coverage has any effect. The study findings make clear that it does. People reported that their physical and mental health were substantially better after a year of insurance coverage, and they were much less likely to have to borrow money or go into debt to pay for their care," said Amy Finkelstein, professor of economics at MIT and co-principal investigator of the study.

The current study is part of a broader research program that will follow the lottery participants for an additional year and will also directly measure health outcomes, including cholesterol, diabetic blood sugar control, blood pressure, and obesity.

Additional authors include: Sarah Taubman, NBER; Bill Wright, Providence Health & Services; Mira Bernstein, NBER; Jonathan Gruber, MIT and NBER, Joseph P. Newhouse, HSPH, Harvard Medical School, Harvard Kennedy School, and NBER; Heidi Allen, Providence Health & Services; and the Oregon Health Study Group.

Support for the study was provided by the National Institute on Aging, Office of the Assistant Secretary for Planning and Evaluation (Department of Health and Human Services), California HealthCare Foundation, Centers for Medicare & Medicaid Services, the John D. and Catherine T. MacArthur Foundation, Robert Wood Johnson Foundation, Sloan Foundation, Smith Richardson Foundation, and U.S. Social Security Administration. The study was conducted with the cooperation of the State of Oregon.

Visit the HSPH website for the latest news, press releases and multimedia offerings.

Harvard School of Public Health (http://www.hsph.harvard.edu) is dedicated to advancing the public's health through learning, discovery, and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit: http://www.hsph.harvard.edu

Marge Dwyer | EurekAlert!
Further information:
http://www.hsph.harvard.edu

Further reports about: HSPH Providence Universität Harvard health care health services

More articles from Studies and Analyses:

nachricht A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg

nachricht Urbanization to convert 300,000 km2 of prime croplands
27.12.2016 | Mercator Research Institute on Global Commons and Climate Change (MCC) gGmbH

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

Im Focus: Newly proposed reference datasets improve weather satellite data quality

UMD, NOAA collaboration demonstrates suitability of in-orbit datasets for weather satellite calibration

"Traffic and weather, together on the hour!" blasts your local radio station, while your smartphone knows the weather halfway across the world. A network of...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Satellite-based Laser Measurement Technology against Climate Change

17.01.2017 | Machine Engineering

Studying fundamental particles in materials

17.01.2017 | Physics and Astronomy

Multiregional brain on a chip

16.01.2017 | Power and Electrical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>