Emergency department visits related to injuries and behavioral health conditions are also classified (or classified separately). 3 Emergency department visits were stratified by severity using the New York University algorithm, which classifies visits based on their likelihood that the primary diagnosis will fall into 1 of 4 subgroups: (1) emergent, not preventable, (2) emergent but potentially preventable, (3) emergent but primary care treatable, and (4) nonemergent. In this study, the authors examined 80.6 million outpatient ED visits from the Healthcare Cost and Utilization Project State Emergency Department Databases and a difference-in-differences design to evaluate changes in the rate of outpatient ED use in 2 Medicaid expansion states (New York and Massachusetts) vs 2 nonexpansion states (Georgia and Florida) from 2011 to 2017. Their simple yet revealing study further contributes to the literature by noting that Medicaid expansion is a good value for states and is likely to reap long-term benefits in the form of better population health and lower health care spending. Giannouchos and colleagues 3 examine whether Medicaid expansion was associated with improvements in the use of what is often one of the most expensive health care settings: the emergency department (ED). However, answering this question largely hinges on the extent to which Medicaid expansion improves the efficiency of health care use and spending. 2 However, there are lingering concerns about the ramifications of using a publicly funded coverage mechanism for a large proportion of the population for state and federal budgets.Ī crucial question for many policy makers is whether Medicaid expansion offers value over alternative pathways to expand coverage, such as greater investment in subsidized insurance exchanges. 1 Beyond increasing health insurance enrollments, Medicaid expansion has resulted in a net savings for participating states overall (largely owing to enhanced federal cost-sharing) and numerous economic and health benefits for enrollees. Since 2014, approximately 14 million low-income US individuals, most of whom were uninsured before, have gained health insurance coverage through Medicaid expansion alone. Expansion of Medicaid through the Affordable Care Act has been one of the most consequential health and social program reforms in recent decades.
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