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Impact of Ohio Medicaid

Impact of Ohio Medicaid Eric Seiber, PhD Ohio State University. Many changes in Ohio Medicaid since 2004 Ohio Family Health Survey Changes include: Eligibility changes for parents, foster youth, and disabled children

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Impact of Ohio Medicaid

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  1. Impact of Ohio Medicaid Eric Seiber, PhD Ohio State University

  2. Many changes in Ohio Medicaid since 2004 Ohio Family Health Survey Changes include: Eligibility changes for parents, foster youth, and disabled children New federal documentation rules for eligibility Expansion of Medicaid managed care Medicaid Changes

  3. What is the net effect of these changes? early 2004 to late 2008 Examining Medicaid beneficiaries: Access Utilization Comparing Medicaid for entire year to: Private coverage for the entire year (ESI, Privately purchased) Uninsured and Part year coverage Statewide and by Region Effect of Changes

  4. Children – Ages 0 – 17 Medicaid coverage entire year All Medicaid Children Medicaid Managed Care Markets In 2004, Mandatory counties, Preferred, None/Vol By 2008, all counties were mandatory participation Private coverage entire year Uninsured and Part year coverage Children Groups

  5. Adults – Ages 18 – 64 Medicaid coverage entire year All Medicaid adults Healthy Start/Healthy Families Aged, Blind, Disabled (ABD) Undetermined Medicaid Private coverage entire year Uninsured and Part year coverage Adult Groups

  6. Access Usual source of sick care Rates care as High Quality Harder to obtain care last three years Not obtaining medical care Problems seeing specialist Not obtaining dental care Delayed treatment for cost Major medical cost last 12 months Not obtaining needed drugs Utilization Well Child Visit last 12 mo Doctor visit last 12 mo Never a doctor visit Dentist visit last 12 mo Never a dentist visit Never received eye care Hospital stay last 12 mo ER visit last 12 mo Indicators

  7. Key Findings - Children Not Obtaining Needed Medical Care, 2004 and 2008

  8. Key Findings - Children Any Problem Seeing Specialist, 2004 and 2008

  9. Key Findings - Children Delayed Treatment due to Cost, 2004 and 2008

  10. Key Findings - Children Any Emergency Room Visit last 12 months, 2004 and 2008

  11. Key Findings - Children Overnight Hospital Stay Last 12 months, 2004 and 2008

  12. Key Findings - Children Any Emergency Room Visit last 12 months, 2004 and 2008

  13. Key Findings - Children Rates their Health Care as High Quality, 2004 and 2008

  14. Compared to the privately insured, Medicaid children report: Equivalent access to outpatient services Equivalent self-assessed quality of care Equivalent or fewer problems seeing specialists Less likely to identify cost as a barrier to care Key Findings - Children

  15. Medicaid Children from 2004 to 2008: Inpatient and ER utilization declined Largest utilization changes in counties transitioning to managed care The reductions in utilization came with lower perceived quality of care Key Findings - Children

  16. Key Findings - Adults Not Obtaining Needed Medical Care, 2004 and 2008

  17. Key Findings - Adults Any Problem Seeing a Specialist, 2004 and 2008

  18. Key Findings - Adults Delayed Treatment due to Cost, 2004 and 2008

  19. Key Findings - Adults Any Emergency Room Visit last 12 months, 2004 and 2008

  20. Compared to privately insured adults, Medicaid adults report: More problems entering the health care system Fewer cost barriers once in the system The ABD population reported higher utilization yet lower access than Healthy Start/Healthy Families enrollees Key Findings - Adults

  21. Access and Utilization For low income children, Medicaid produces results similar to the privately insured Results were mixed for Medicaid adults, especially ABD adults Costs Complete picture will contrast changes in access and utilization with changes in total costs per beneficiary Conclusions

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