July 31, 2019 Tulane study finds better access to care for Louisianans following Medicaid expansionPutting off care, delaying taking medications less common following expansion

Baton Rouge, Louisiana, Jul 31, 2019 - Fewer Louisianans report that they have to put off seeing a doctor or that they are unable to take their medications as prescribed thanks to Louisiana’s Medicaid expansion, according to a Tulane University study released today by Gov. Edwards and the Louisiana Department of Health.

On his first full day in office, Gov. John Bel Edwards signed an executive order expanding the Medicaid program in Louisiana. The expansion went into effect in July of 2016 and has since boosted Louisianans’ access to medical care.

The Tulane University study found that among Louisianans in the newly-eligible population:

• Annual doctor visits: The number of people who report they were unable to see a doctor in the past year due to cost dropped by 26.6%.
• Cost of medications: The number of people who report they did not take medication as prescribed due to cost dropped by 66.4%.
• Waiting for care: The number of people who report they were unable to get care soon enough decreased by 58%.
• A personal doctor: The number of people who report they had one person they think of as their personal doctor rose by 4.2%.
• Fewer emergency room visits: Emergency department visits per 1,000 Medicaid expansion enrollees decreased from 115 visits per month to 90 visits per month between 2016 and 2018.

“Medicaid expansion is saving lives, creating jobs throughout the state, saving money and building a foundation for a healthier Louisiana.  This study shows that we are moving in the right direction and people are getting the care they need,” said Governor Edwards. “Additionally, while other states have seen rural hospitals close, zero have closed in Louisiana because of our wise choice to expand Medicaid.”

Dr. Rebekah Gee, secretary of the Louisiana Department of Health, said since expansion in 2016, hundreds of thousands of Louisianans now have access to life-saving healthcare. 

“More people can afford their medications and are seeing a regular doctor rather than making costly visits to the emergency room. Not only does this improve health outcomes for our most vulnerable citizens, it reduces costs and improves value in our state’s healthcare system,” Gee said.

The distance traveled when seeking care declined by between 1 and 4 miles, on average, after Medicaid expansion, according to the Tulane study. The number of providers who treated Medicaid patients increased from 9,730 providers pre-expansion to 11,035 providers post-expansion.

Edwards added that an LSU economic impact study released last year found expansion has leveraged federal funds into $3.57 billion of economic activity. Combining the results of both reports, he said, “We have further evidence that Medicaid expansion is critical for the health of Louisiana, cutting the uninsured rate in half. We cannot go back.”

The Tulane study evaluated general measures of access including affordability of care, wait times for appointments and time elapsed since last accessing care. In particular, the study focused on access to and availability of medical care, utilization and provider participation.

Under Medicaid expansion, the state extended coverage to all adults earning up to 138% of the federal poverty level. The Tulane study sampled Medicaid patients who became eligible for coverage as a result of expansion, with enrollment occurring between July 1, 2016 and December 31, 2016 and who maintained continuous Medicaid enrollment for at least one full year.

“We examined standard measures of access to care covering distance and time to access care, utilization of a variety of health services that reflect access to primary care, and the level of provider participation. We found improvement in all aspects of access to care for beneficiaries of Medicaid Expansion, which is consistent with the findings from other states that have also expanded Medicaid,” said Mark Diana, PhD, chair, Department of Health Policy and Management at Tulane University.

Provider participation was evaluated by focusing in general on providers with at least 10 Medicaid claims in a given month, and was the only area of the report that presented a cause for concern. While the number of providers for Medicaid patients has risen under expansion, participation rates among specialists have declined recently. However, there are still more specialists treating Medicaid patients since expansion than there were prior to expansion.

The study was funded by the Department of Health through the LSU Center for Healthcare Value & Equity.

Click here for the complete report.