Acute Care Utilization in Medicaid Enrollees Differs by Patient Rurality, Race, and Ethnicity

Area of Science:

• Health Services Research
• Rural Health Disparities
• Medicaid Policy

Background:

• Limited research exists on acute care use and costs for rural Medicaid enrollees nationally.
• Few studies explore how rurality levels and race/ethnicity interact with healthcare utilization in this population.

Purpose of the Study:

• To compare Medicaid acute care utilization patterns across different levels of rurality and race/ethnicity.
• To identify rural populations with potentially unmet healthcare needs or receiving insufficient care.

Main Methods:

• Utilized 2019 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) data.
• Analyzed inpatient, outpatient, and prescription data for over 50 million Medicaid enrollees.
• Employed statistical models to assess associations between rurality, race/ethnicity, and healthcare utilization outcomes.

Main Results:

• Rural Medicaid enrollees showed lower rates of inpatient stays (12.6%-18.2% lower) and emergency department visits (11.0% lower in isolated areas) compared to urban enrollees.
• Average inpatient length-of-stay and per-member spending were also lower for rural enrollees.
• Healthcare utilization varied significantly by race/ethnicity, with Hispanic enrollees exhibiting the lowest utilization.

Conclusions:

• Rural Medicaid enrollees generally exhibit lower acute care utilization and expenditures.
• Significant heterogeneity by rurality and race/ethnicity highlights specific rural subgroups with potentially higher healthcare needs.
• Findings underscore the need for tailored healthcare strategies for diverse rural Medicaid populations.