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Medicaid Increases Emergency-Department Use: Evidence from Oregon's Health Insurance Experiment

Author(s)
Finkelstein, Amy; Taubman, Sarah L.; Allen, Heidi L.; Wright, Bill J.; Baicker, Katherine
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Creative Commons Attribution-Noncommercial-Share Alike 3.0 http://creativecommons.org/licenses/by-nc-sa/3.0/
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Abstract
In 2008, Oregon initiated a limited expansion of a Medicaid program for uninsured, low-income adults, drawing names from a waiting list by lottery. This lottery created a rare opportunity to study the effects of Medicaid coverage by using a randomized controlled design. By using the randomization provided by the lottery and emergency-department records from Portland-area hospitals, we studied the emergency department use of about 25,000 lottery participants over about 18 months after the lottery. We found that Medicaid coverage significantly increases overall emergency use by 0.41 visits per person, or 40% relative to an average of 1.02 visits per person in the control group. We found increases in emergency-department visits across a broad range of types of visits, conditions, and subgroups, including increases in visits for conditions that may be most readily treatable in primary care settings.
Date issued
2014-01
URI
http://hdl.handle.net/1721.1/84052
Department
Massachusetts Institute of Technology. Department of Economics
Journal
Science
Publisher
American Association for the Advancement of Science (AAAS)
Citation
Taubman, S. L. et al. “Medicaid Increases Emergency-Department Use: Evidence from Oregon’s Health Insurance Experiment.” Science (2014): n. pag.
Version: Author's final manuscript
ISSN
0036-8075
1095-9203

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