title: How often do catastrophic injury victims become Medicaid recipients?
abstract: BACKGROUND
  People without adequate insurance may separate financially from their families and move onto Medicaid after a catastrophic injury. Medicaid then covers all of their medical care costs. No estimates for Medicaid conversions due to injury exist in the literature.
  
  
  OBJECTIVE
  To estimate Medicaid conversions due to injury for people 21-64 years old.
  
  
  METHODS
  This study analyzes the 2003 Medicaid Analytic eXtract files (the most recently available in 2009) for 14 states. For each state, we assigned a conversion cutoff date by examining the pattern of admissions after enrollment. The last day before the injury hospital admission rate decreased to its background level was considered as a cutoff date for conversions.
  
  
  METHODS
  Medicaid enrollees aged 21 to 64 years who received coverage due to a catastrophic injury.
  
  
  METHODS
  Acute Medicaid conversions per 100 acute injury hospital admissions, estimated conversions remaining at least 1 year on Medicaid, and life-time public medical cost of disabled Medicaid recipients.
  
  
  RESULTS
  Around 2.55% of all hospitalized injury patients not previously covered by Medicaid enrolled to cover their hospital bills. The average disabled recipient on Medicaid (possibly combined with Medicare) for 30 years has public medical payments exceeding $345,000.
  
  
  CONCLUSIONS
  The Medicaid postinjury enrollment policy provides important financial support to safety-net hospitals, provides better access to long-term care for trauma patients who need it, and permits states to offload costs to the federal government.
authors.affiliation: Pacific Institute for Research and Evaluation Beltsville, Beltsville, MD 20705, USA. zaloshnja@pire.org
authors.forename: Eduard
authors.initials: E
authors.lastname: Zaloshnja
authors.forename: Ted R
authors.initials: TR
authors.lastname: Miller
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Coben
authors.forename: Claudia
authors.initials: C
authors.lastname: Steiner
mesh_terms: D000328:Adult; D000367:Age Factors; D002388:Catastrophic Illness / Q000191:economics / Q000453:epidemiology; D005260:Female; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008875:Middle Aged; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000191:economics* / Q000453:epidemiology; D055815:Young Adult