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Member Research & Reports

Member Research & Reports

BU: Medicaid Expansion Increases Volume and Quality of Care in Rural Areas

A new study led by a Boston University School of  Public Health (BUSPH) researcher finds the first two years of Medicaid expansion under the Affordable Care Act, 2014 and 2015, bolstered the quality and receipt of care for millions of low-income patients, especially those in rural areas.

The study, published in the June issue of Health Affairs, looked at community health centers, which mostly serve low-income and  disproportionately uninsured patients.The researchers used nationally representative data collected by the Health Resources and  Services Administration (HRSA) on 1,009 community health centers in each year, including all 578 community health centers in states that had expanded Medicaid by 2014.

They found community health centers in expansion states saw an 11.44 percentage point decline in uninsurance and a 13.15 percentage point increase in Medicaid  coverage among their patients after two years of Medicaid expansion, compared with similar community health centers in non-expansion states. Rural community health centers also showed improvements in asthma treatment, body mass index screening and follow-up, and hypertension  control, along with substantial increases in 18 types of  visits — particularly for mammograms, abnormal breast findings,  alcohol-related disorder, and other substance use disorders.

“Rural areas appear to disproportionately benefit from expanding  Medicaid, even though rural states have been less likely to expand  eligibility,” says lead author Dr. Megan Cole, assistant professor of health law, policy & management at BUSPH. “These  findings may be particularly important to more rural states like Maine,  Idaho, and Nebraska, who are actively considering or trying to implement  Medicaid expansion, as well as for states that are considering  repealing Medicaid expansion or imposing restrictions on eligibility.”
Read more about the study