Interruptions in Medicaid coverage linked to increased hospitalization

Dec 15, 2008

Interruptions in Medicaid coverage are associated with a higher rate of hospitalization for conditions that can often be treated in an ambulatory care setting, including asthma, diabetes, and hypertension, according to a new study in today's issue of the Annals of Internal Medicine. The analysis, which examines interrupted Medicaid coverage and hospitalization rates, finds that increased risk for hospitalization is highest in the first three months after an interruption in Medicaid coverage.

The study suggests that when states require enrollees to demonstrate eligibility on a more frequent basis, they may see an increase in hospitalizations for common health conditions: lacking insurance to cover the costs of primary care, many former Medicaid enrollees end up in hospitals and are then re-enrolled in Medicaid. The study of California adults, conducted by researchers at San Francisco General Hospital (SFGH) Medical Center and University of California San Francisco (UCSF), was supported by the Commonwealth Fund.

Federal rules require states to re-determine Medicaid beneficiary eligibility at least once every 12 months but some states do so more often. During most of the time of this study, 1998 to 2002, California—which has the largest Medicaid program in the U.S.—required beneficiaries to report on their eligibility every 3 months. California has since reduced the frequency of eligibility determination.

"Although states may attempt to save money in the short term by dropping Medicaid coverage for those who cannot keep up with frequent reporting requirements, this study shows that disruptions in coverage come at the risk of increased hospitalization for conditions that can typically be treated in a less expensive primary care setting," said lead author Andrew B. Bindman, M.D., a professor of medicine at UCSF and chief of general internal medicine at SFGH.

The analysis of Medicaid enrollment and hospital discharge data for more than four million California adults examines the number of Medicaid beneficiaries who experienced interrupted coverage and their hospitalization rates between 1998 and 2002.

During the study period, one in six Medicaid beneficiaries in the U.S. resided in California. More than 62% of eligible beneficiaries experienced interruptions in their Medicaid coverage during the study period, with an average interruption of 25 months.

The study authors recommend that states implement policies to reduce the frequency of interruptions in Medicaid coverage, to help prevent health events that require hospitalization and thereby reduce high-cost hospital spending.

As more individuals lose jobs as the result of the current economy, states can expect to see an increase in the number of people enrolling in Medicaid. An increasing number of states, grappling with their own budget shortfalls, are assessing how frequently Medicaid beneficiaries should be required to demonstrate eligibility.

"Individuals are more likely to seek Medicaid coverage during an economic downturn—at the same time states are more likely to face budget shortfalls and are likely to seek ways to cut health care costs. States will need to ensure that people have access to the Medicaid program when they need it most," said Commonwealth Fund President Karen Davis.

Source: Commonwealth Fund

Explore further: Obama: 8 million signed up for health care

add to favorites email to friend print save as pdf

Related Stories

States stop circumcisions funds amid budget crisis

Jun 24, 2011

(AP) -- A nationwide debate about circumcisions for newborn boys, combined with cash-strapped public health budgets, has Colorado taking sides with 17 other states that no longer fund Medicaid coverage of ...

Seniors' sex lives are up -- and so are STD cases

May 17, 2011

Across the nation, and especially in communities that attract a lot of older Americans, the free-love generation is continuing to enjoy an active - if not always healthy - sex life.

Texas man gets first full face transplant in US

Mar 21, 2011

(AP) -- A Texas construction worker horribly disfigured in a power line accident has undergone the nation's first full face transplant in hopes of smiling again and feeling kisses from his 3-year-old daughter.

5 Americans: How health care law affects them

Feb 03, 2011

(AP) -- A couple on Medicare got a rebate check to help with prescription drug costs. A Chicago man with diabetes got health insurance through a new government program. And a Philadelphia businessman is hoping his company ...

Recommended for you

Obama: 8 million signed up for health care (Update)

6 hours ago

President Barack Obama said Thursday 8 million Americans have signed up for health care through new insurance exchanges, besting expectations and offering new hope to Democrats who are defending the law ahead ...

User comments : 0

More news stories

Turning off depression in the brain

Scientists have traced vulnerability to depression-like behaviors in mice to out-of-balance electrical activity inside neurons of the brain's reward circuit and experimentally reversed it – but there's ...

Hackathon team's GoogolPlex gives Siri extra powers

(Phys.org) —Four freshmen at the University of Pennsylvania have taken Apple's personal assistant Siri to behave as a graduate-level executive assistant which, when asked, is capable of adjusting the temperature ...

Better thermal-imaging lens from waste sulfur

Sulfur left over from refining fossil fuels can be transformed into cheap, lightweight, plastic lenses for infrared devices, including night-vision goggles, a University of Arizona-led international team ...