During the recent economic downturn, Medicaid programs in all 50 states implemented cost-saving strategies including benefit reductions, cost-sharing and tightened administrative rules. These cost-saving strategies have significant adverse impact on health care access and utilization among Medicaid beneficiaries concludes this study of 2,783 adults in the Oregon Health Plan. Importantly, the impact was felt by these patients within the first 10 months of these changes being made.

Medicaid program reductions resulted in 31 percent of enrolled adults losing coverage and 15 percent reporting disrupted coverage. Furthermore, 67 percent of those who lost coverage reported unmet health care needs, compared with 40 percent of those with disrupted coverage and 28 percent of those with stable coverage. The authors assert that as many states continue to struggle with financing their Medicaid programs and the federal budget proposes deep cuts in Medicaid funding, these findings give rise to a serious discussion about the potentially negative impacts of policy options that include increasing cost sharing or limiting enrollment in Medicaid programs. Short-Term Impacts of Coverage Loss in Medicaid Population: Early Results from a Prospective Cohort Study of the Oregon Health Plan By Matthew J. Carlson, Ph.D., et al

INSURANCE STATUS AFFECTS PHYSICIAN'S DECISIONS ON CLINICAL CARE
Physicians incorporate patients' insurance status into their clinical decision making and frequently alter their clinical management as a result. This study of 25 physicians in Washington, D.C., finds that in a single day of reporting, 88 percent of participating physicians reported making at least one change in clinical management as a result of a patient's insurance status. The physicians reported considering their patient's insurance status in nearly half of all visits and making changes in over one quarter of visits. Of the 409 physician-patient encoun
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Contact: Kristin Robinson
kristinr@aafp.org
American Academy of Family Physicians
26-Sep-2006

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