On the third anniversary of Governor Edwards’ Medicaid expansion, Tulane releases a report comparing pre and post-expansion quality of life for the expansion’s 475,000 enrollees. The results show some significant, positive improvements, highlighted by a 66 percent drop in the number of people who report they did not take medication as prescribed due to cost.
Monthly trips to the ER by expansion recipients were down about 22 percent. Tulane Department of Health Policy and Management chair Mark Diana says repeat visitors saw a nearly nine percent drop in total visits. “People who were going two, three, four times a month to the emergency department, we saw those people, their utilization also dropped. For the Medicaid program that is clearly going to represent some cost savings.”
The distance an expansion patient had to travel to get care dropped by one to four miles on average. Diana says for the Medicaid population it can be the difference between seeing and not seeing a doctor when sick. “If you are relying on public transportation, or you have to somehow or another secure transportation, that can be a big difference to someone in those circumstances.”
That decrease in distance may be linked to the 12 percent increase in the number of providers who accepted at least 10 Medicaid patients a year after the expansion. The largest declines in miles traveled were related to trips to see a gynecologist and obstetrician.
Providers who accept Medicaid saw a 35 percent increase in Medicaid patients post-expansion. Diana says that’s resulted in a substantial increase in the use of nurse practitioners and physician assistants. “That suggests to me that physicians are using physician’s assistants and nurse practitioners to provide primary care. For routine primary care that makes a lot of sense.”
The expansion increased the household income limit for Medicaid recipients 16,764 dollars a year.
