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Increased Utilization of Ambulatory Occupational Therapy and Physical Therapy After Medicaid Expansion

Published:March 14, 2019DOI:https://doi.org/10.1016/j.apmr.2019.02.004

      Abstract

      Objective

      To determine if Medicaid expansion in 2014 improved utilization of ambulatory physical therapy and occupational therapy.

      Design

      Secondary data, pre-post analysis study using a difference in differences approach. The study compared utilization rates and likelihood of an ambulatory therapy visit for Medicaid ambulatory therapy patients in the pre-expansion (2012-2013) period and postexpansion (2014-2015) period. A descriptive analysis of utilization and logistic regression with a difference in differences approach of the odds of a therapy visit was conducted.

      Setting

      Not applicable.

      Participants

      The 2012-2015 public use data files of the Medical Expenditure Panel Survey- Household Component.

      Main Outcome Measures

      Descriptive results and the odds ratio of an ambulatory therapy visit were determined.

      Results

      About 788,233 more Medicaid beneficiaries had an ambulatory therapy visit after Medicaid expansion. By subpopulation, the increases in utilization were greatest for beneficiaries from low-income households and beneficiaries living in the west census region. Policy change increased the odds of a therapy visit for a Medicaid beneficiary by 27%.

      Conclusions

      Utilization of ambulatory therapy by Medicaid beneficiaries increased after Medicaid expansion.

      Keywords

      List of abbreviations:

      95% CI (95% confidence interval), MEPS (Medical Expenditure Panel Survey), MEPS-HC (Medical Expenditure Panel Survey-household component), OR (odds ratio)
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