title: Estimating demand for care after a medicaid expansion: lessons from Oregon.
abstract: To estimate how the Affordable Care Act's Medicaid expansions will affect demand for services, we measured ambulatory care utilization among adult patients who gained insurance during Oregon's 2008 Medicaid expansion. Using electronic health record data from 67 community health centers, we assessed pre- and postcoverage utilization among patients who gained insurance, compared with patients continuously insured or uninsured. In comparisons of the pre- and postcoverage periods, mean annual encounters among persons who gained insurance increased 22% to 35%, but declined in the comparison groups. These findings suggest that providers should expect a significant increase in demand among patients who gain Medicaid coverage through the Affordable Care Act.
authors.affiliation: Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Drs Gold and Fortmann); Oregon Health & Science University, Department of Family Medicine, Portland (Drs Bailey, Marino, Heintzman, and DeVoe); Oregon Health & Science University, Department of Public Health & Preventive Medicine, Division of Biostatistics, Portland (Ms O'Malley); and OCHIN, Inc, Portland, Oregon (Messrs Hoopes and Cowburn and Dr Nelson).
authors.forename: Rachel
authors.initials: R
authors.lastname: Gold
authors.forename: Steffani R
authors.initials: SR
authors.lastname: Bailey
authors.forename: Jean P
authors.initials: JP
authors.lastname: OʼMalley
authors.forename: Megan J
authors.initials: MJ
authors.lastname: Hoopes
authors.forename: Stuart
authors.initials: S
authors.lastname: Cowburn
authors.forename: Miguel
authors.initials: M
authors.lastname: Marino
authors.forename: John
authors.initials: J
authors.lastname: Heintzman
authors.forename: Christine
authors.initials: C
authors.lastname: Nelson
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Fortmann
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: DeVoe
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D003151:Community Health Centers / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000191:economics*; D008875:Middle Aged; D009922:Oregon; D058991:Patient Protection and Affordable Care Act; D014481:United States