Medicaid Advocacy and Hospital-Based Violence Intervention: A Mixed-Methods Analysis

• In Event: Exploring Social Determinants of Health Outcomes and Access to Care

Abstract

Hospital-based violence intervention programs (HVIPs) are designed to address the multifaceted needs and challenges faced by victims of violence, including poverty and limited access to healthcare. While Medicaid advocacy is increasingly recognized as a valuable component of HVIPs, empirical research on its impact remains limited. This study employs a mixed-methods approach to examine Medicaid enrollment in an HVIP housed in a level-one trauma center in the Midwest. The quantitative data is derived from hospital charges to health insurance plans and/or self-pay within 90 days of initial admission following injuries from gunshots, stabbings, and assaults. Two groups are selected for the analysis, including the HVIP participants from 2020 to 2024 and a historical control group from 2015 to 2019. Using geospatial analytical tools, a series of variables is constructed to capture the social determinants of health that influence health insurance coverage and health outcomes among patients. These social determinants along with injury severity scores are applied to ensure the equivalence of the two groups. Multivariate analysis will focus on the effect of Medicaid coverage on hospital expected revenue and contribution margin. Qualitative data from eight semi-structured interviews with HVIP participants and family members will be analyzed to identify key themes.

Authors

• Elizabeth Ann Mavis, University of Nebraska Omaha

• Carisma Jano, University of Nebraska Omaha

• Ling Ren, University of Nebraska Omaha

• Gaylene Armstrong, University of Nebraska Omaha

• Mark Foxall, University of Nebraska Omaha