Preventable hospitalization and medicaid managed care: does race matter?

Area of Science:

• Health Services Research
• Health Disparities
• Public Health Policy

Background:

• Medicaid managed care (MMC) aims to improve healthcare access and outcomes for low-income populations.
• Racial and ethnic disparities persist in preventable hospitalization rates.
• Understanding MMC's impact across different demographic subgroups is crucial for equitable healthcare delivery.

Purpose of the Study:

• To examine preventable hospitalization patterns among Medicaid patients across different racial/ethnic groups.
• To assess the effectiveness of Medicaid managed care (MMC) in reducing preventable hospitalizations in diverse populations.
• To compare MMC's impact on hospitalizations in urban versus rural settings.

Main Methods:

• Logistic regression models were applied to analyze hospital discharge data from New York, Pennsylvania, and Wisconsin.
• Preventable hospitalizations were compared with marker admissions (urgent, primary care-insensitive admissions).
• Data included residents aged 20-64 from the Healthcare Cost and Utilization Project State Inpatient database.

Main Results:

• In urban New York, MMC benefited White patients but not minority groups.
• In rural Wisconsin, MMC showed effectiveness for minority populations.
• No consistent evidence showed MMC benefiting a specific racial group across all states or a specific state across all racial groups.

Conclusions:

• Medicaid managed care (MMC) effectiveness in reducing preventable hospitalizations is not uniform across racial/ethnic groups or states.
• Racial/ethnic disparities in preventable hospitalizations were significantly lower in Medicaid managed care populations compared to private fee-for-service patients.
• Targeted strategies may be needed to optimize MMC benefits for all racial and ethnic subgroups.