April 02, 2015
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Medicaid study review shows mental health, financial protection significantly improved in participants

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Researchers reviewed the results from the Oregon Health Study and found that, while Medicaid participants in the original study were not physically healthier than participants who stayed with their current care, the program significantly improved the mental health and financial protection of these individuals.

Peter Muennig, MD, MPH, associate professor of Health Policy and Management at Columbia University's Mailman School of Public Health, and his colleagues revisited the Oregon Health Study (OHS) to address the concerns brought up by both opponents and proponents of Medicaid as a result of the study. Opponents of Medicaid concluded that the original study showed the program was not a worthwhile investment, while proponents claimed the study did not show the physical benefits of Medicaid because it was underpowered.

Peter Muennig, MD, MPH

Peter Muennig

“Both the pro-Medicaid and the anti-Medicaid groups were right,” Muennig told Healio.com/Psychiatry.  “Medicaid doesn’t do much for one’s physical health, but it is more than worth the cost.”

In the original study, the OHS researchers found that while Medicaid had no significant impact on physical health, the use of preventative testing reduced rates of depression and increased positive perceptions of overall health.

Muennig and colleagues performed a post hoc power analysis and cost-benefit analysis in addition to a more sensitive joint test to analyze physical health than was employed in the original study.

They found the study had a statistical power of 69% after removing participants with missing values, leaving 6,315 participants in the Medicaid group and 5,769 participants in the control group. The joint test used by the researchers found no significant differences in laboratory biomarkers between either group, which included participants older than 50 years and participants with pre-existing conditions.

For the Medicaid cost-benefit analysis, Muennig and colleagues used the value of the significant reduction in clinical depression relative to Medicaid to create a cost-benefit estimate. They calculated the cost of Medicaid per individual and used the EQ-5D score change associated remission of moderate depression to calculate the final quality-adjusted life-year (QALY) analysis for each individual in the program. Overall, they found participants had $62,000 per QALY gained while enrolled in Medicaid.

“The OHS produced clear benefits for the recipients with respect to financial protection (what many would argue health insurance is meant for) and reduced depression, increased diagnosis and treatment of diabetes and increased preventive medical care,” the researchers wrote. — by Jeff Craven

Disclosure: The authors report no relevant financial disclosures.