Low income adults have long struggled with the cost of healthcare. Many have simply lacked access to affordable insurance. Often, this results in an accumulation of health problems and symptoms, which often leads to increased costs. These costs would be reduced if preventative care and early detection tests were performed. Frequently, for the low-income population, the first contact with a healthcare provider occurs at an emergency room, after a medical problem has grown acute and dangerous.
Medicaid expansion has sought to bring affordable coverage to this population. In Minnesota, many non-disabled, low-income adults became eligible for healthcare when the state expanded Medicaid coverage in 2011. This year, two studies published in Medical Care Research and Review revealed that very low-income, adult Medicaid recipients in Hennepin County, MN had drastically increased health outcomes when they received their care through a Medicaid Accountable Care Organization (ACO), https://twin-cities.umn.edu/news-events/study-shows-integrated-care-affects-health-care-use-among-vulnerable-adults, In view of the findings, ACOs may come to play a more active role in managing healthcare for vulnerable adults.
The studies, conducted in the 2012 to 2014 time period, analyzed claims data to determine utilization rates in the given population. One study showed that Medicaid recipients enrolled in ACO Hennepin Health showed an 11-percent increase in primary care physician visits and a 51 percent increase in emergency room visits. They also showed an increase in dental visits. Overall, the recipients have increased utilization but also rely on emergency departments for a large proportion of care. Nathan Shippee, Ph.D., an assistant professor in the division of health policy and management at the University of Minnesota’s School of Public Health, sees the results as encouraging. He stated that the increased utilization should, as other studies indicate, lead to a long-term increase in health outcomes.
An additional study conducted on very low income Hennipen County Medicaid Recipients indicated that integrative care provided by the ACO greatly improved life quality. Of the studies 35 participants, 66 percent reported having a diagnosed mental illness. 46 percent of those with a mental illness reported receiving consistent medical care. This care improved their quality of life.
For AROs, providing consistent mental health treatment and the ability of patients to connect with and trust their primary care team emerged as some of the most important benefits. By using an integrative approach that provides patients with access to a trusted primary care physician and access to specialist services when needed, healthcare outcomes have improved for this Medicaid population.