Community health center utilization following the 2008 medicaid expansion in Oregon: Implications for the affordable care act

B. Hatch, S.R. Bailey, S. Cowburn, M. Marino, H. Angier and J.E. DeVoe

American Journal of Public Health, 2016, vol. 106, issue 4, 645-650

Abstract: Objectives. To assess longitudinal patterns of community health center (CHC) utilization and the effect of insurance discontinuity after Oregon's 2008 Medicaid expansion (the Oregon Experiment). Methods.Weconducted a retrospective cohort studywith electronic health records and Medicaid data. We divided individuals who gained Medicaid in the Oregon Experiment into those whomaintained (n = 788) or lost (n = 944) insurance coverage.We compared these groups with continuously insured (n = 921) and continuously uninsured (n = 5416) reference groups for community health center utilization rates over a 36-month period. Results. Both newly insured groups increased utilization in the first 6 months. After 6 months, use among those who maintained coverage stabilized at a level consistent with the continuously insured, whereas it returned to baseline for those who lost coverage. Conclusions. Individuals who maintained coverage through Oregon's Medicaid expansion increased long-termutilization of CHCs,whereas thosewithunstable coverage did not. Policy implications. This study predicts long-term increase in CHC utilization following Affordable Care Act Medicaid expansion and emphasizes the need for policies that support insurance retention.

Keywords: adolescent; adult; economics; electronic health record; health care delivery; health care policy; health center; health insurance; human; insurance; legislation and jurisprudence; male; medicaid; medically uninsured; middle aged; Oregon; retrospective study; trends; United States; utilization, Adolescent; Adult; Community Health Centers; Electronic Health Records; Health Services Accessibility; Humans; Insurance Coverage; Insurance, Health; Male; Medicaid; Medically Uninsured; Middle Aged; Oregon; Patient Protection and Affordable Care Act; Retrospective Studies; United States (search for similar items in EconPapers)
Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2016.303060_7

DOI: 10.2105/AJPH.2016.303060

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