Hospital Presumptive Eligibility Emergency Medicaid Programs: An Opportunity for Continuous Insurance Coverage?

Area of Science:

• Health Services Research
• Public Health Policy
• Health Economics

Background:

• Lack of health insurance is a significant public health issue, causing delayed care and financial hardship.
• Hospital Presumptive Eligibility (HPE) offers temporary emergency Medicaid coverage to uninsured hospital patients.
• The effectiveness of HPE in facilitating long-term Medicaid enrollment remains unclear.

Purpose of the Study:

• To assess Medicaid enrollment rates 6 months post-HPE initiation.
• To identify factors associated with successful Medicaid enrollment among HPE recipients.

Main Methods:

• A cohort study analyzed claims data from California's Department of Healthcare Services.
• Inpatients approved for HPE in California between 2016-2017 were included.
• Multivariable logistic regression models determined predictors of Medicaid enrollment within 6 months.

Main Results:

• 64.2% of 71,335 HPE recipients enrolled in Medicaid by 6 months.
• Medicaid enrollment varied significantly by county (33%-100%).
• Spanish-preferred language patients had lower enrollment odds (aOR 0.77); surgical intervention and discharge to care facilities increased odds.

Conclusions:

• HPE is often associated with successful Medicaid enrollment within 6 months in California.
• Patients requiring surgery or ongoing care are more likely to achieve Medicaid enrollment.
• Further research should explore HPE's impact on healthcare utilization and financial stability.