Friday, July 17, 2015

Study: Medicaid Enrollment Made No Statistical Improvement in Blood Pressure, Cholesterol, Blood Sugar, or Heart Attack Rate

The Oregon Health Insurance Experiment is a randomized, controlled study made possible by a lottery process used in 2008 to expand Medicaid coverage to some in the state. The study addresses coverage take-up rates and the characteristics of enrollees; use of health services; health outcomes and measures of well-being; enrollee finances and medical debt. Health Affairs just published a policy brief on the study and the two below paragraphs struck me as our nation has invested so much, under PPACA, in expanding Medicaid to cover one-third more enrollees:
...The experiment ... allowed researchers to examine the impact of coverage on people's health. A survey and health screenings conducted about two years following the lottery revealed mixed results on the impact of [Oregon Health Plan] enrollment on health status. While enrollment increased the probability that people reported themselves to be in good to excellent health (compared with fair or poor health) by 24 percent, certain objective measures of physical health did not show significant signs of improvement. 
Specifically, there was no statistically significant effect on measures of blood pressure, cholesterol, or blood sugar or on the diagnosis of, or medication for, blood pressure issues or high cholesterol. Medicaid enrollment also did not reduce the predicted risk of a cardiovascular event within ten years and did not significantly change the probability that a person was a smoker or obese. It did, however, raise rates of diabetes detection and management, and it reduced observed rates of depression by 30 percent....