Health Service Utilization and State Costs Among Adults Aging With Early-Acquired Physical Disabilities in Medicaid Managed Care

• Published in: Journal of aging and health 2019-12, Vol.31 (10_suppl), p.97S-123S
• Main Authors: Yamaki, Kiyoshi, Wing, Coady, Mitchell, Dale, Owen, Randall, Heller, Tamar
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aging; Disabled Persons - rehabilitation; Expenditures; Fee-for-Service Plans - economics; Female; Health Expenditures; Health services; Health Services Accessibility - economics; Health services utilization; Health technology assessment; Humans; Male; Managed Care Programs - economics; Medicaid; Medicaid - economics; Middle Aged; Quasi-experimental methods; United States
• ISSN: 0898-2643; 1552-6887
• DOI: 10.1177/0898264318808192

Objective: We evaluated the impact of Medicaid managed care (MMC) on health service use and state costs among adults with early-acquired physical disabilities. Method: Using claims data, we tracked utilization of the emergency department (ED), inpatient admissions, outpatient physician visits, and state expenditures on enrollees who transitioned to MMC (n = 881). The inverse propensity score weight and a difference-in-differences regression model were used to estimate the impact of MMC using their counterparts who remained in fee-for-service (n = 1,552) as the comparison group. Results: MMC reduced ED use by 3.2% points/month (p < .001). Relative to younger enrollees (age ⩽45 years), MMC reduced inpatient admissions of older enrollees (age ⩾46 years) by 3.3% points/month (p < .001), and state expenditures by US$839/month (p < .01). Discussion: MMC could reduce the hospital service use of and state spending on enrollees with early-acquired physical disabilities. This impact may vary depending on the enrollees’ age.