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New Study: Medicaid Enrollees With Serious Chronic Conditions Have Far Superior Clinical Experiences Compared To Uninsured

by Cathryn Donaldson

November 13, 2018

As a result, these patients are much better able to manage their health conditions than people without insurance, helping them to stay healthy and productive.

WASHINGTON, D.C. – Americans with asthma, diabetes or serious mood disorders who are enrolled in the Medicaid program have far superior clinical experiences than people without coverage, according to new research released today by America’s Health Insurance Plans (AHIP). The results from this report are significant—and consistent with previous AHIP research on access to care—demonstrating that Medicaid delivers better care, results in better health outcomes, and improves chronic conditions for millions of Americans every day.

Asthma, diabetes and serious mood disorders affect tens of millions of Americans, and cost hundreds of billions of dollars to treat. Medical care and emergency room costs are far higher if patients do not have the access to care needed to help them successfully manage their condition. Coverage and care must be effective to improve the health and financial stability of patients—which is why AHIP researchers undertook this study.

More than 75 million Americans are currently covered by Medicaid and the Children’s Health Insurance Program (CHIP), according to the Centers for Medicare and Medicaid Services (CMS).  Those covered include veterans, children, seniors, and people with disabilities. Nearly 55 million people—representing more than 70 percent of total Medicaid enrollment—rely on private health plans for their Medicaid coverage.

This study analyzed data from people who were uninsured, covered by a Medicaid private health plan, or covered by a commercial health plan. AHIP researchers compared clinical care and prescription drug utilization patterns from 2013-2015 among people diagnosed with one of three chronic conditions: asthma, diabetes, or mood disorders. The care each group received was then compared to determine how closely it matched recommended treatment guidelines.

The data showed that people covered by Medicaid typically receive care consistent with clinical treatment guidelines, enabling people with Medicaid to manage their serious chronic health conditions more effectively than people who are uninsured. More specifically:

  • Medicaid enrollees with asthma received inhalers and recommended medicines far more often than patients without coverage. People with asthma and no health coverage also went to emergency rooms and saw other doctors more frequently.
  • Medicaid enrollees with diabetes received monitoring services like annual cholesterol tests, eye exams, and foot exams more often than people without health care coverage.
  • Medicaid enrollees with mood disorders like major depressive disorder or bipolar disorder were much more likely to receive a recommended combination of medication and psychotherapy treatments than uninsured people.

“Health insurance providers know that Medicaid must work for the people who rely on it—and the hardworking taxpayers who pay for it,” said Matt Eyles, AHIP president and CEO. “This new report proves that Medicaid works, and adds to a growing body of evidence that Medicaid is an essential, critical safety net for millions of Americans.”

The full report, including the methodology and findings, can be found here. This study also echoes findings from AHIP’s earlier research, showing Medicaid enrollees have significantly better access to health care and preventive services than those without coverage.