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Adil Haider
Article
Association of affordable care act-related medicaid expansion with variation in utilization of surgical services
American journal of surgery
  • Tyler R McClintock, Harvard Business School, Boston, MA, USA
  • Suhas Gondi, Harvard Medical School, Boston, MA, USA
  • Ye Wang, Harvard Medical School, Boston, MA, USA
  • David F Friedlander, Harvard Medical School, Boston, MA, USA
  • Alexander P Cole, Harvard Medical School, Boston, MA, USA
  • Maxine Sun, Harvard Medical School, Boston, MA, USA
  • Nelya Melnitchouk, Harvard Medical School, Boston, MA, USA
  • Steven L Chang, Harvard Medical School, Boston, MA, USA
  • Adil H Haider, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
  • Joel S Weissman, Harvard Medical School, Boston, MA, USA
  • Quoc-Dien Trinh, Harvard Medical School, Boston, MA, USA
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Publication Date
8-1-2020
Document Type
Article
Disciplines
Abstract

Background: We aim to understand how Medicaid expansion under the ACA has affected utilization of surgical services.
Methods: The State Inpatient Databases were used to compare utilization of a broad array of surgical procedures among nonelderly adults (aged 19-64 years) in a multistate population that experienced ACA-related Medicaid expansion to one that did not. We performed a difference-in-differences (DID) analysis to determine the effect of Medicaid expansion on utilization of surgical services from 2012 to 2014.
Results: There were 259,061 cases identified in the Medicaid expansion population and 261,269 in the control population. In the expansion group, there was a smaller decrease in utilization - by a margin of 21.68 cases per 100,000 individuals (p < 0.001). Percent of surgical patients covered by Medicaid increased among the expansion group from 12.00% to 15.48% (DID = 3.93%; p < 0.001).
Conclusions: Year one of Medicaid expansion under the ACA was associated with a modest but statistically significant difference in utilization of surgical services as well as an increase in percent of surgery patients covered by Medicaid.

Citation Information
Tyler R McClintock, Suhas Gondi, Ye Wang, David F Friedlander, et al.. "Association of affordable care act-related medicaid expansion with variation in utilization of surgical services" American journal of surgery Vol. 220 Iss. 2 (2020) p. 441 - 447
Available at: http://works.bepress.com/adil_haider/116/