title: Health Care Use and Spending for Medicaid Enrollees in Federally Qualified Health Centers Versus Other Primary Care Settings.
abstract: To compare health care use and spending of Medicaid enrollees seen at federally qualified health centers versus non-health center settings in a context of significant growth.
  
  
  
  Using fee-for-service Medicaid claims from 13 states in 2009, we compared patients receiving the majority of their primary care in federally qualified health centers with propensity score-matched comparison groups receiving primary care in other settings.
  
  
  
  We found that health center patients had lower use and spending than did non-health center patients across all services, with 22% fewer visits and 33% lower spending on specialty care and 25% fewer admissions and 27% lower spending on inpatient care. Total spending was 24% lower for health center patients.
  
  
  
  Our analysis of 2009 Medicaid claims, which includes the largest sample of states and more recent data than do previous multistate claims studies, demonstrates that the health center program has provided a cost-efficient setting for primary care for Medicaid enrollees.
authors.affiliation: At the time of this study, Robert S. Nocon and Sang Mee Lee were with the Department of Public Health Sciences, University of Chicago, Chicago, IL. Yue Gao, Marshall H. Chin, Neda Laiteerapong, and Elbert S. Huang were with the Department of Medicine, University of Chicago. Ravi Sharma is with the Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Quyen Ngo-Metzger is with the Agency for Healthcare Research and Quality, Rockville. Dana B. Mukamel and Laura M. White were with the Department of Medicine, University of California, Irvine. Leiyu Shi is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Nocon
authors.affiliation: At the time of this study, Robert S. Nocon and Sang Mee Lee were with the Department of Public Health Sciences, University of Chicago, Chicago, IL. Yue Gao, Marshall H. Chin, Neda Laiteerapong, and Elbert S. Huang were with the Department of Medicine, University of Chicago. Ravi Sharma is with the Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Quyen Ngo-Metzger is with the Agency for Healthcare Research and Quality, Rockville. Dana B. Mukamel and Laura M. White were with the Department of Medicine, University of California, Irvine. Leiyu Shi is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Sang Mee
authors.initials: SM
authors.lastname: Lee
authors.affiliation: At the time of this study, Robert S. Nocon and Sang Mee Lee were with the Department of Public Health Sciences, University of Chicago, Chicago, IL. Yue Gao, Marshall H. Chin, Neda Laiteerapong, and Elbert S. Huang were with the Department of Medicine, University of Chicago. Ravi Sharma is with the Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Quyen Ngo-Metzger is with the Agency for Healthcare Research and Quality, Rockville. Dana B. Mukamel and Laura M. White were with the Department of Medicine, University of California, Irvine. Leiyu Shi is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Ravi
authors.initials: R
authors.lastname: Sharma
authors.affiliation: At the time of this study, Robert S. Nocon and Sang Mee Lee were with the Department of Public Health Sciences, University of Chicago, Chicago, IL. Yue Gao, Marshall H. Chin, Neda Laiteerapong, and Elbert S. Huang were with the Department of Medicine, University of Chicago. Ravi Sharma is with the Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Quyen Ngo-Metzger is with the Agency for Healthcare Research and Quality, Rockville. Dana B. Mukamel and Laura M. White were with the Department of Medicine, University of California, Irvine. Leiyu Shi is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Quyen
authors.initials: Q
authors.lastname: Ngo-Metzger
authors.affiliation: At the time of this study, Robert S. Nocon and Sang Mee Lee were with the Department of Public Health Sciences, University of Chicago, Chicago, IL. Yue Gao, Marshall H. Chin, Neda Laiteerapong, and Elbert S. Huang were with the Department of Medicine, University of Chicago. Ravi Sharma is with the Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Quyen Ngo-Metzger is with the Agency for Healthcare Research and Quality, Rockville. Dana B. Mukamel and Laura M. White were with the Department of Medicine, University of California, Irvine. Leiyu Shi is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Dana B
authors.initials: DB
authors.lastname: Mukamel
authors.affiliation: At the time of this study, Robert S. Nocon and Sang Mee Lee were with the Department of Public Health Sciences, University of Chicago, Chicago, IL. Yue Gao, Marshall H. Chin, Neda Laiteerapong, and Elbert S. Huang were with the Department of Medicine, University of Chicago. Ravi Sharma is with the Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Quyen Ngo-Metzger is with the Agency for Healthcare Research and Quality, Rockville. Dana B. Mukamel and Laura M. White were with the Department of Medicine, University of California, Irvine. Leiyu Shi is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Yue
authors.initials: Y
authors.lastname: Gao
authors.affiliation: At the time of this study, Robert S. Nocon and Sang Mee Lee were with the Department of Public Health Sciences, University of Chicago, Chicago, IL. Yue Gao, Marshall H. Chin, Neda Laiteerapong, and Elbert S. Huang were with the Department of Medicine, University of Chicago. Ravi Sharma is with the Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Quyen Ngo-Metzger is with the Agency for Healthcare Research and Quality, Rockville. Dana B. Mukamel and Laura M. White were with the Department of Medicine, University of California, Irvine. Leiyu Shi is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Laura M
authors.initials: LM
authors.lastname: White
authors.affiliation: At the time of this study, Robert S. Nocon and Sang Mee Lee were with the Department of Public Health Sciences, University of Chicago, Chicago, IL. Yue Gao, Marshall H. Chin, Neda Laiteerapong, and Elbert S. Huang were with the Department of Medicine, University of Chicago. Ravi Sharma is with the Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Quyen Ngo-Metzger is with the Agency for Healthcare Research and Quality, Rockville. Dana B. Mukamel and Laura M. White were with the Department of Medicine, University of California, Irvine. Leiyu Shi is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Leiyu
authors.initials: L
authors.lastname: Shi
authors.affiliation: At the time of this study, Robert S. Nocon and Sang Mee Lee were with the Department of Public Health Sciences, University of Chicago, Chicago, IL. Yue Gao, Marshall H. Chin, Neda Laiteerapong, and Elbert S. Huang were with the Department of Medicine, University of Chicago. Ravi Sharma is with the Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Quyen Ngo-Metzger is with the Agency for Healthcare Research and Quality, Rockville. Dana B. Mukamel and Laura M. White were with the Department of Medicine, University of California, Irvine. Leiyu Shi is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Marshall H
authors.initials: MH
authors.lastname: Chin
authors.affiliation: At the time of this study, Robert S. Nocon and Sang Mee Lee were with the Department of Public Health Sciences, University of Chicago, Chicago, IL. Yue Gao, Marshall H. Chin, Neda Laiteerapong, and Elbert S. Huang were with the Department of Medicine, University of Chicago. Ravi Sharma is with the Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Quyen Ngo-Metzger is with the Agency for Healthcare Research and Quality, Rockville. Dana B. Mukamel and Laura M. White were with the Department of Medicine, University of California, Irvine. Leiyu Shi is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Neda
authors.initials: N
authors.lastname: Laiteerapong
authors.affiliation: At the time of this study, Robert S. Nocon and Sang Mee Lee were with the Department of Public Health Sciences, University of Chicago, Chicago, IL. Yue Gao, Marshall H. Chin, Neda Laiteerapong, and Elbert S. Huang were with the Department of Medicine, University of Chicago. Ravi Sharma is with the Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Quyen Ngo-Metzger is with the Agency for Healthcare Research and Quality, Rockville. Dana B. Mukamel and Laura M. White were with the Department of Medicine, University of California, Irvine. Leiyu Shi is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Elbert S
authors.initials: ES
authors.lastname: Huang
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005382:Financing, Personal / Q000191:economics*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data; D064876:Safety-net Providers / Q000191:economics* / Q000706:statistics & numerical data*; D014481:United States