Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients

Megan B Cole; Brad Wright; Ira B Wilson; Omar Galárraga; Amal N Trivedi

doi:10.1377/hlthaff.2017.1542

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Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients

Journal article

Open access

Peer reviewed

Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients

Megan B Cole, Brad Wright, Ira B Wilson, Omar Galárraga and Amal N Trivedi

Health affairs Web exclusive, Vol.37(6), pp.900-907

06/2018

DOI: 10.1377/hlthaff.2017.1542

PMCID: PMC6286055

PMID: 29863920

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https://www.ncbi.nlm.nih.gov/pmc/articles/6286055View

Open Access

Abstract

Medicaid expansion had great potential to affect community health centers (CHCs), particularly in rural areas, because their patients are predominantly low income and disproportionately uninsured. Using data for 2011-15 on all CHCs, we found that after two years Medicaid expansion was associated with an 11.44-percentage-point decline in the share of CHC patients who were uninsured and a 13.15-percentage-point increase in the share with Medicaid. Changes in quality and volume were consistently observed in rural CHCs in expansion states, which had relative improvements in asthma treatment, body mass index screening and follow-up, and hypertension control, along with substantial increases in volumes for eighteen of twenty-one types of visits-particularly those for mammograms, abnormal breast findings, alcohol-related disorder, and other substance abuse disorder. Similar relative gains were not observed in urban CHCs in expansion states. Repealing or phasing out Medicaid expansion could reverse observed gains in quality and service use and could be particularly detrimental to low-income rural populations.

Adolescent

Adult

Community Health Centers - economics

Community Health Centers - organization & administration

Databases, Factual

Female

Health Care Reform - legislation & jurisprudence

Humans

Insurance Coverage - economics

Insurance Coverage - statistics & numerical data

Male

Medicaid - economics

Medically Uninsured - statistics & numerical data

Middle Aged

Poverty

Primary Health Care - economics

Primary Health Care - organization & administration

Quality of Health Care

Retrospective Studies

Rural Health Services - economics

Rural Population

United States

Young Adult

Details

Title: Subtitle: Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients
Creators: Megan B Cole - Boston University
Brad Wright - University of Iowa
Ira B Wilson - Brown University
Omar Galárraga - Department of Health Services
Amal N Trivedi - Department of Health Services
Resource Type: Journal article
Publication Details: Health affairs Web exclusive, Vol.37(6), pp.900-907
DOI: 10.1377/hlthaff.2017.1542
PMID: 29863920
PMCID: PMC6286055
NLM abbreviation: Health Aff (Millwood)
ISSN: 0278-2715
eISSN: 1544-5208
Grant note: R36 HS024652 / AHRQ HHS
Language: English
Date published: 06/2018
Academic Unit: Public Policy Center (Archive)
Record Identifier: 9984364529902771

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