Tracking policy changes and health impacts of access to specific forms of care among Medicaid populations

Session Submission Type: Panel

Abstract

Vision loss is associated with falls and hip fractures, difficulties in performing the activities of daily living, social isolation and loneliness, depression, cognitive impairment, and increased mortality. Most vision loss can be corrected with an up-to-date prescription for corrective lenses, but many adults do not have routine vision coverage. In a recent KFF poll, one-quarter of adults reported delaying or going without vision services due to cost.

Routine eye exams and glasses are an optional adult benefit in state Medicaid programs. Previous research demonstrates that when states provide these benefits, Medicaid-enrolled adults are more likely to visit the eye doctor and experience improvements in vision. However, literature to date has focused on younger adults under age 65 without dual Medicare enrollment and has largely remained silent on health outcomes beyond vision. Moreover, there is no comprehensive longitudinal database describing state-level routine vision benefits. The lack of reliable state-by-year level data limits research on the effect of vision benefits on outcomes and the role that vision benefits play as a financial lever that is used by states to manage their Medicaid programs.

In this session, we present new evidence on the association between Medicaid routine vision benefits and health outcomes among dual Medicare and Medicaid enrolled adults. We examine the association between North Carolina's January 2019 addition of routine eye exams and glasses coverage and fall-related inpatient and emergency department discharges. We also examine the association between routine vision benefits and eye care access, out-of-pocket spending, and recent diagnoses of systemic health problems that can be identified durign an eye exam using national data from the Medicare Current Beneficiary Survey. Finally, we present a new longitudinal policy database that documents state-level policies from 2000-2023 and highlight its features in an application to the National Health Interview Survey.

Policy Area

• Health Policy

Chair

• Aja Kennedy, Tufts University

Discussant

• Xuechao (Jane) Qian, Ball State University

Organizer

• Brandy Lipton, University of California Irvine

Individual Presentations

• Impacts of Medicaid Vision Coverage on Eye Care Use, Out-of-Pocket Spending, and Diagnoses Among Duals - Presenting Author: Brandy Lipton, University of California Irvine

• A Longitudinal Database of Medicaid Routine Vision Coverage Policies, 2000-2023 - Presenting Author: Michel H. H. Boudreaux, University of Maryland, College Park

• Balancing Incentives Meets Medicaid Expansion: Reshaping Long-Term Care Populations - Presenting Author: Megdalynn Fisher, Florida International University