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Community Health Center Utilization Following the 2008 Medicaid Expansion in Oregon: Implications for the Affordable Care Act.


ABSTRACT: To assess longitudinal patterns of community health center (CHC) utilization and the effect of insurance discontinuity after Oregon's 2008 Medicaid expansion (the Oregon Experiment).We conducted a retrospective cohort study with electronic health records and Medicaid data. We divided individuals who gained Medicaid in the Oregon Experiment into those who maintained (n?=?788) or lost (n?=?944) insurance coverage. We compared these groups with continuously insured (n?=?921) and continuously uninsured (n?=?5416) reference groups for community health center utilization rates over a 36-month period.Both newly insured groups increased utilization in the first 6 months. After 6 months, use among those who maintained coverage stabilized at a level consistent with the continuously insured, whereas it returned to baseline for those who lost coverage.Individuals who maintained coverage through Oregon's Medicaid expansion increased long-term utilization of CHCs, whereas those with unstable coverage did not.This study predicts long-term increase in CHC utilization following Affordable Care Act Medicaid expansion and emphasizes the need for policies that support insurance retention.

SUBMITTER: Hatch B 

PROVIDER: S-EPMC4894650 | biostudies-other | 2016 Apr

REPOSITORIES: biostudies-other

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Community Health Center Utilization Following the 2008 Medicaid Expansion in Oregon: Implications for the Affordable Care Act.

Hatch Brigit B   Bailey Steffani R SR   Cowburn Stuart S   Marino Miguel M   Angier Heather H   DeVoe Jennifer E JE  

American journal of public health 20160218 4


<h4>Objectives</h4>To assess longitudinal patterns of community health center (CHC) utilization and the effect of insurance discontinuity after Oregon's 2008 Medicaid expansion (the Oregon Experiment).<h4>Methods</h4>We conducted a retrospective cohort study with electronic health records and Medicaid data. We divided individuals who gained Medicaid in the Oregon Experiment into those who maintained (n = 788) or lost (n = 944) insurance coverage. We compared these groups with continuously insure  ...[more]

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