Highlights
- •The ACA increased Medicaid coverage for benign endocrine surgical procedures.
- •Medicaid Expansion states had lower rates of uninsured patients.
- •Medicaid patients have increased odds of undergoing thyroid operations.
- •Medicaid patients have lower odds of undergoing parathyroid or adrenal operations.
Abstract
•Background: The Affordable Care Act's Medicaid expansion increased insurance coverage and access
to care for endocrine cancers, though impact on benign endocrine disease is unknown.
•Methods: Patients undergoing operations for benign thyroid, parathyroid, and adrenal disease
were collected from the Vizient® Clinical Data Base from 2009 to 2016 and grouped
by state Medicaid expansion status in January 2014. Insurance coverage was analyzed
by difference-in-differences analysis, and logistic regression evaluated odds of operation
by insurance status.
•Results: 134,242 patients were included. Medicaid coverage in expansion states increased
for all operations (Adj-DD 5.78%, p < 0.001) with decreases in uninsured and private
insurance. Medicaid patients had increased odds of undergoing thyroid operations (OR
1.56, p < 0.001) and decreased odds of parathyroid (OR 0.68, p < 0.001) or adrenal
operations (OR 0.70, p < 0.001) versus private insurance.
•Conclusion: Medicaid expansion increased insurance coverage for benign endocrine disease, however,
barriers remain for Medicaid patients with parathyroid and adrenal disease.
Keywords
Abbreviations:
ME (Medicaid expansion), ACA (Affordable Care Act), DD (Difference-in-differences), Adj (Adjusted), ICD (International Classification of Diseases)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 25, 2022
Accepted:
October 18,
2022
Received in revised form:
September 20,
2022
Received:
August 4,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
