ArticleBMC health services research2021
Comparing health care use and costs among new Medicaid enrollees before and during the COVID-19 pandemic.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Using Ambulatory Care Sensitive Conditions to Assess Primary Health Care Performance during Disasters: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Effects of State Medicaid Expansions Affecting Parental Eligibility on Children's Healthcare Access and Health During the COVID-19 Pandemic.Maternal and child health journal · 2026Article
- Pediatric Diabetes Prevalence Among Medicaid Beneficiaries.JAMA network open · 2026Article
- Differences in Medicaid Enrollment and Spending Before and During the COVID-19 Pandemic.JAMA network open · 2025Article
- The impact of Medicaid expansion on state expenditures through the COVID-19 era.Health services research · 2024Article
- Risk of Potentially Preventable Hospitalizations After SARS-CoV-2 Infection.JAMA network open · 2024Article
- The Influence of the COVID-19 Pandemic on Hospitalizations for Ambulatory Care-Sensitive Conditions in Split-Dalmatia County, Croatia.Medicina (Kaunas, Lithuania) · 2024Article
- Indirect impact of the COVID-19 pandemic on the incidence of non-COVID-19 infectious diseases: a region-wide, patient-based database study in Japan.Public health · 2023Observational
- Long-haul COVID: healthcare utilization and medical expenditures 6 months post-diagnosis.BMC health services research · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
BACKGROUND AND
objectiveTo characterize health care use and costs among new Medicaid enrollees before and during the COVID pandemic. Results can help Medicaid non-expansion states understand health care use and costs of new enrollees in a period of enrollment growth. RESEARCH
designRetrospective cross-sectional analysis of North Carolina Medicaid claims data (January 1, 2018 - August 31, 2020). We used modified Poisson and ordinary least squares regression analysis to estimate health care use and costs as a function of personal characteristics and enrollment during COVID. Using data on existing enrollees before and during COVID, we projected the extent to which changes in outcomes among new enrollees during COVID were pandemic-related. SUBJECTS: 340,782 new enrollees pre-COVID (January 2018 - December 2019) and 56,428 new enrollees during COVID (March 2020 - June 2020). MEASURES: We observed new enrollees for 60-days after enrollment to identify emergency department (ED) visits, nonemergent ED visits, primary care visits, potentially-avoidable hospitalizations, dental visits, and health care costs.
resultsNew Medicaid enrollees during COVID were less likely to have an ED visit (-46 % [95 % CI: -48 %, -43 %]), nonemergent ED visit (-52 % [95 % CI: -56 %, -48 %]), potentially-avoidable hospitalization (-52 % [95 % CI: -60 %, -43 %]), primary care visit (-34 % [95 % CI: -36 %, -33 %]), or dental visit (-36 % [95 % CI: -41 %, -30 %]). They were also less likely to incur any health care costs (-29 % [95 % CI: -30 %, -28 %]), and their total costs were 8 % lower [95 % CI: -12 %, -4 %]. Depending on the outcome, COVID explained between 34 % and 100 % of these reductions.
conclusionsNew Medicaid enrollees during COVID used significantly less care than new enrollees pre-COVID. Most of the reduction stems from pandemic-related changes in supply and demand, but the profile of new enrollees before versus during COVID also differed.
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