Examination of Changes in Health Status Among Michigan Medicaid Expansion Enrollees From 2016 to 2017
| Autor: | Minal R. Patel, John Z. Ayanian, Edith C. Kieffer, Erin Beathard, Erica Solway, Susan Dorr Goold, Renuka Tipirneni, Sarah J. Clark, Jeffrey T. Kullgren, Sunghee Lee, Zachary Rowe, Tammy Chang, Jennifer Skillicorn, Matthias Kirch |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Health plan
Adult Male Michigan Health Status education Health benefits Surveys and Questionnaires Medicine Humans Minority Health Patient Reported Outcome Measures health care economics and organizations Original Investigation Demography Response rate (survey) business.industry Medicaid Research Health Policy General Medicine Odds ratio Health Status Disparities Middle Aged Mental health Health equity United States Telephone survey Online Only Chronic Disease Female business |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | This survey study examines the self-reported health of enrollees in Michigan’s Medicaid expansion, the Healthy Michigan Plan, among respondents to surveys in 2016 and 2017. Key Points Question What longitudinal changes in self-reported health status and days of poor health among racial, ethnic, urban/rural, and very-low-income subgroups of enrollees are associated with Medicaid expansion? Findings In this survey study of 3097 respondents, reports of fair or poor health and days of poor physical health decreased over time among enrollees, especially among non-Hispanic black enrollees and those with very low incomes. There were no statistically significant differences in the number of days of poor mental health or the number of days of usual activities missed owing to poor physical or mental health over time. Meaning These findings suggest that within Medicaid expansion, the health of vulnerable populations is improving. Importance Evidence about the health benefits of Medicaid expansion has been mixed and has largely come from comparing expansion and nonexpansion states. Objective To examine the self-reported health of enrollees in Michigan’s Medicaid expansion, the Healthy Michigan Plan (HMP), over time. Design, Setting, and Participants A telephone survey from January 1 to October 31, 2016 (response rate, 53.7%), and a follow-up survey from March 1, 2017, to January 31, 2018 (response rate, 83.4%), were conducted in Michigan, which expanded Medicaid in 2014 through a Section 1115 waiver permitting state-specific modifications. Four thousand ninety HMP beneficiaries aged 19 to 64 years with at least 12 months of HMP coverage and at least 9 months in a Medicaid health plan were eligible to participate. Data were analyzed from April 1 to November 30, 2018. Main Outcomes and Measures Surveys measured demographic characteristics and health status. Analyses included weights for sampling probability and nonresponse. Comparisons between 2016 and 2017 included those who responded to both surveys (n = 3097). Results Of the 3097 respondents to the 2017 follow-up survey, 2388 (77.1%) were still enrolled in HMP (current enrollees) and 709 (22.9%) were no longer enrolled when surveyed (former enrollees). Among all follow-up respondents, a weighted 37.5% (95% CI, 35.3%-39.9%) were aged 19 to 34 years, 34.0% (95% CI, 31.8%-36.2%) were aged 35 to 50 years, and 28.5% (95% CI, 26.7%-30.3%) were aged 51 to 64 years; 53.0% (95% CI, 50.8%-55.3%) were female. Respondents who reported fair or poor health decreased from 30.7% (95% CI, 28.7%-32.8%) in 2016 to 27.0% (95% CI, 25.1%-29.0%) in 2017 (adjusted odds ratio [AOR], 0.66 [95% CI, 0.53-0.81]; P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|