Community health center utilization following the 2008 medicaid expansion in Oregon: Implications for the affordable care act

Brigit Hatch, Steffani Bailey, Stuart Cowburn, Miguel Marino, Heather Angier, Jennifer Devoe

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives. To assess longitudinal patterns of community health center (CHC) utilization and the effect of insurance discontinuity after Oregon's 2008 Medicaid expansion (the Oregon Experiment). Methods.Weconducted a retrospective cohort studywith electronic health records and Medicaid data. We divided individuals who gained Medicaid in the Oregon Experiment into those whomaintained (n = 788) or lost (n = 944) insurance coverage.We compared these groups with continuously insured (n = 921) and continuously uninsured (n = 5416) reference groups for community health center utilization rates over a 36-month period. Results. Both newly insured groups increased utilization in the first 6 months. After 6 months, use among those who maintained coverage stabilized at a level consistent with the continuously insured, whereas it returned to baseline for those who lost coverage. Conclusions. Individuals who maintained coverage through Oregon's Medicaid expansion increased long-termutilization of CHCs,whereas thosewithunstable coverage did not. Policy implications. This study predicts long-term increase in CHC utilization following Affordable Care Act Medicaid expansion and emphasizes the need for policies that support insurance retention.

Original languageEnglish (US)
Pages (from-to)645-650
Number of pages6
JournalAmerican Journal of Public Health
Volume106
Issue number4
DOIs
StatePublished - Apr 1 2016

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Patient Protection and Affordable Care Act
Community Health Centers
Medicaid
Insurance
Insurance Coverage
Electronic Health Records

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Community health center utilization following the 2008 medicaid expansion in Oregon : Implications for the affordable care act. / Hatch, Brigit; Bailey, Steffani; Cowburn, Stuart; Marino, Miguel; Angier, Heather; Devoe, Jennifer.

In: American Journal of Public Health, Vol. 106, No. 4, 01.04.2016, p. 645-650.

Research output: Contribution to journalArticle

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abstract = "Objectives. To assess longitudinal patterns of community health center (CHC) utilization and the effect of insurance discontinuity after Oregon's 2008 Medicaid expansion (the Oregon Experiment). Methods.Weconducted a retrospective cohort studywith electronic health records and Medicaid data. We divided individuals who gained Medicaid in the Oregon Experiment into those whomaintained (n = 788) or lost (n = 944) insurance coverage.We compared these groups with continuously insured (n = 921) and continuously uninsured (n = 5416) reference groups for community health center utilization rates over a 36-month period. Results. Both newly insured groups increased utilization in the first 6 months. After 6 months, use among those who maintained coverage stabilized at a level consistent with the continuously insured, whereas it returned to baseline for those who lost coverage. Conclusions. Individuals who maintained coverage through Oregon's Medicaid expansion increased long-termutilization of CHCs,whereas thosewithunstable coverage did not. Policy implications. This study predicts long-term increase in CHC utilization following Affordable Care Act Medicaid expansion and emphasizes the need for policies that support insurance retention.",
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