Tuesday, May 7, 2013

New Oregon Medicaid Study Asserts that Coverage is Key

Last week, the New England Journal of Medicine released a study of the Oregon Medicaid program, and the effects of enrollment on low-income individuals’ health and finances.  The ongoing study, launched in 2008, has tracked health indicators, mental health outcomes and financial well-being of a group of low-income individuals newly enrolled in Medicaid, and compared it to a group of uninsured individuals.   The headline is that after about two years, Medicaid appears to have substantially increased patients’ use of necessary medical services, reduced the rate of depression, and reduced the financial strain that previously limited their access to care.

The unfortunate situation in 2008 was that the Oregon Medicaid program was limited in capacity; however this served as an opportunity to create a control group to understand the effects of Medicaid coverage.  A lottery was created in 2008 for which 90,000 signed up, but not all of these were enrolled in Medicaid due to budget constraints, creating two populations (those enrolled and those not enrolled in Medicaid) to study.  So far results are mixed; according to the study, Medicaid enrollees are more likely to access health services and be diagnosed for diabetes, but blood pressure, cholesterol and diabetic blood sugar levels were the roughly the same among both populations.  The most dramatic difference was that Medicaid appears to reduce observed rates of depression by 30%, but the financial impact to low-income individuals was also significant:  Medicaid for the enrolled population virtually eliminated out-of-pocket catastrophic medical expenditures, reducing by 50% the probability of having to borrow money or skip paying other bills because of other medical expenses.

The links below provide more information and analysis of the recently released report:

The Oregon Health Insurance Experiment:  http://www.nber.org/oregon/index.html