Robert M. La Follette School of Public Affairs
Tuesday, June 4, 2013

Greater public health insurance boosts outpatient care, emergency room usage, study finds

Expanded public health insurance coverage increases access to outpatient care and reduces hospitalizations, new research by La Follette School professor Thomas DeLeire and 1999 alum Kristen Voskuil finds.

In an article published in June in the journal Health Affairs, the University of Wisconsin–Madison Population Health Institute team looked at Wisconsin's 4-year-old public insurance program — the BadgerCare Plus Core Plan — for childless adults with incomes up to 200 percent of the federal poverty level. 

DeLeire, Voskuil and co-authors Laura Dague, Lindsey Leininger and Donna Friedsam compared administrative claims data from 2008-09, the program's first year, with data on participants who were automatically enrolled in January 2009 and who tended to have very low incomes. The authors found that, after 12 months in the program, participants showed a 29 percent increase in outpatient visits, a 46 percent increase in emergency department use, and a 59 percent decrease in hospitalizations, including a 46 percent decline for preventable hospitalizations.

"These results demonstrate that expanding public insurance coverage has the potential to increase access to outpatient care and reduce hospitalizations," DeLeire says. "In addition, we find that unless consumers have sufficient access to primary care, coverage expansions may also increase in emergency department visits, shrinking any corresponding cost savings."

As a result of the provisions of the federal Affordable Care Act, states are expanding or considering expanding Medicaid coverage to low-income adults without dependent children. "Our results speak directly to the potential of these expansions to improve health and to reduce costs by increasing access to outpatient care and reducing hospitalizations," DeLeire says. "They also suggest that states need to prepare for the possibility of a large increase in the demand for outpatient services."

Insured People Use Hospital Less, Study Finds, June 3, 2013, Wisconsin Public Radio

Medicaid coverage reduces hospitalizations, Wisconsin study finds, June 3, 2013, Wisconsin State Journal

Costs of expanding health coverage reduced by fewer hospital stays, study shows, June 3, 2013, Milwaukee Journal-Sentinel

Public Health Insurance Boosts Outpatient Care, Cuts Hospital Admissions, June 3, 2013, University of Wisconsin-Madison School of Medicine and Public Health