The Cumulative Effect of Expanding the Breadth and Scope of Coverage for Substance Use Disorder Treatment on Behavioral Health Acute Inpatient Admissions: Evidence from Virginia Medicaid

Shiva Salehian (), Peter Cunningham, Andrew Barnes and Shoou-Yih Daniel Lee
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Shiva Salehian: Department of Health Policy, School of Population Health, Virginia Commonwealth University, Richmond, VA 23219, USA
Peter Cunningham: Department of Health Policy, School of Population Health, Virginia Commonwealth University, Richmond, VA 23219, USA
Andrew Barnes: Department of Health Policy, School of Population Health, Virginia Commonwealth University, Richmond, VA 23219, USA
Shoou-Yih Daniel Lee: Department of Health Policy, School of Population Health, Virginia Commonwealth University, Richmond, VA 23219, USA

IJERPH, 2024, vol. 21, issue 6, 1-10

Abstract: We evaluated the impact of Medicaid policies in Virginia (VA), namely the Addiction and Recovery Treatment Services (ARTS) program and Medicaid expansion, on the number of behavioral health acute inpatient admissions from 2016 to 2019. We used Poisson fixed-effect event study regression and compared average proportional differences in admissions over three time periods: (1) prior to ARTS; (2) following ARTS but before Medicaid expansion; (3) post-Medicaid expansion. The number of behavioral health acute inpatient admissions decreased by 2.6% (95% CI [−5.1, −0.2]) in the first quarter of 2018 and this decrease gradually intensified by 4.9% (95% CI [−7.5, −2.4]) in the fourth quarter of 2018 compared to the second quarter of 2017 (beginning of ARTS) in VA relative to North Carolina (NC). Following the first quarter of 2019 (beginning of Medicaid expansion), decreases in VA admissions became larger relative to NC. The average proportional difference in admissions estimated a decrease of 2.7% (95% CI, [−4.1, −0.8]) after ARTS but before Medicaid expansion and a decrease of 2.9% (95% CI, [−6.1, 0.4]) post-Medicaid expansion compared to pre-ARTS in VA compared to NC. Behavioral health acute inpatient admissions in VA decreased following ARTS implementation, and the decrease became larger after Medicaid expansion.

Keywords: Medicaid; mental health; acute inpatient care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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