Medicaid expansion ups access to rehab in young adults with injury

(HealthDay)—For young adults hospitalized for injury, the first year of implementation of Medicaid expansion under the Affordable Care Act correlated with significant increases in Medicaid coverage, reductions in lack of insurance, and increases in discharge to rehabilitation, according to a study published online June 6 in JAMA Surgery.

Manzilat Akande, M.D., M.P.H., from Nationwide Children's Hospital in Columbus, Ohio, and colleagues examined changes in insurance coverage and risk adjusted outcomes among adults aged 19 to 44 years who were hospitalized for injuries before and after Medicaid expansion (2012 to 2013 versus 2014) using the Healthcare Cost and Utilization Project State Inpatient Databases. Data were included for 141,187 trauma patients hospitalized across 11 Medicaid expansion states.

The researchers found that Medicaid expansion correlated with an increase in Medicaid coverage (from 16.7 to 34.9 percent), a reduction in lack of insurance (from 27.8 to 12.7 percent), and an increase in discharge to rehabilitation (from 11.4 to 12.6 percent) (all P < 0.001). No significant decreases were seen in in-hospital mortality, failure to rescue, or unplanned readmissions.

"We found significant gains in Medicaid coverage, reductions in uninsured rates, and improved access to rehabilitation during the first year of Medicaid expansion," the authors write. "As data become available, further research into the effects of Medicaid expansion on trauma care and outcomes in more recent years is warranted."

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