Poster #68 - Medicaid Managed Care and Emergency Department Utilization: A North Carolina Analysis

• In Event: Friday Poster Reception

Abstract

In July 2021, North Carolina Medicaid switched from a traditional fee-for-service model to a Medicaid managed care (MMC) network. This thesis explores the effect of this policy change on Emergency Department (ED) utilization for Medicaid beneficiaries in North Carolina. Utilizing the Healthcare Utilization Project State Emergency Database for NC (a private data source), linear difference-in-difference models were used to estimate the change in ED visits between the treatment group, Medicaid beneficiaries, and two control groups, non-Medicaid 19–64-year-olds and 65+ NC residents. Initial hypotheses predict a decline in ED visits that arise for two possible reasons: 1) better management of healthcare and 2) disruption of care for Medicaid beneficiaries. The results indicate a statistically significant decline in ED visits, about 11 - 16% decline from pre-policy visit rates, for Medicaid beneficiaries after the mandatory switch to managed care. The reduction in visits was most persistent for those related to chronic condition treatment. Furthermore, we find evidence consistent with both medical care disruption and better management of health as drivers of the decline in ED visits. Determining the cause of these patterns should be explored by deeper analyses of trends in other healthcare delivery avenues (i.e. PCP appointments or hospital admissions) post-policy implementation. 

Author

• Temitope Ayokunmi Ojo, Duke University
  Presenting Author