Increased Utilization of Ambulatory Occupational Therapy and Physical Therapy After Medicaid Expansion

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Abstract

Objective: To determine if Medicaid expansion in 2014 improved utilization of ambulatory physical therapy and occupational therapy. Design: Secondary data, pre-post analysis study using a difference in differences approach. The study compared utilization rates and likelihood of an ambulatory therapy visit for Medicaid ambulatory therapy patients in the pre-expansion (2012-2013) period and postexpansion (2014-2015) period. A descriptive analysis of utilization and logistic regression with a difference in differences approach of the odds of a therapy visit was conducted. Setting: Not applicable. Participants: The 2012-2015 public use data files of the Medical Expenditure Panel Survey- Household Component. Main Outcome Measures: Descriptive results and the odds ratio of an ambulatory therapy visit were determined. Results: About 788,233 more Medicaid beneficiaries had an ambulatory therapy visit after Medicaid expansion. By subpopulation, the increases in utilization were greatest for beneficiaries from low-income households and beneficiaries living in the west census region. Policy change increased the odds of a therapy visit for a Medicaid beneficiary by 27%. Conclusions: Utilization of ambulatory therapy by Medicaid beneficiaries increased after Medicaid expansion.

Original languageEnglish (US)
JournalArchives of Physical Medicine and Rehabilitation
DOIs
StatePublished - Jan 1 2019

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Occupational Therapy
Medicaid
Therapeutics
Information Storage and Retrieval
Censuses
Health Expenditures
Logistic Models
Odds Ratio
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

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title = "Increased Utilization of Ambulatory Occupational Therapy and Physical Therapy After Medicaid Expansion",
abstract = "Objective: To determine if Medicaid expansion in 2014 improved utilization of ambulatory physical therapy and occupational therapy. Design: Secondary data, pre-post analysis study using a difference in differences approach. The study compared utilization rates and likelihood of an ambulatory therapy visit for Medicaid ambulatory therapy patients in the pre-expansion (2012-2013) period and postexpansion (2014-2015) period. A descriptive analysis of utilization and logistic regression with a difference in differences approach of the odds of a therapy visit was conducted. Setting: Not applicable. Participants: The 2012-2015 public use data files of the Medical Expenditure Panel Survey- Household Component. Main Outcome Measures: Descriptive results and the odds ratio of an ambulatory therapy visit were determined. Results: About 788,233 more Medicaid beneficiaries had an ambulatory therapy visit after Medicaid expansion. By subpopulation, the increases in utilization were greatest for beneficiaries from low-income households and beneficiaries living in the west census region. Policy change increased the odds of a therapy visit for a Medicaid beneficiary by 27{\%}. Conclusions: Utilization of ambulatory therapy by Medicaid beneficiaries increased after Medicaid expansion.",
author = "Sandstrom, {Robert W.}",
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N2 - Objective: To determine if Medicaid expansion in 2014 improved utilization of ambulatory physical therapy and occupational therapy. Design: Secondary data, pre-post analysis study using a difference in differences approach. The study compared utilization rates and likelihood of an ambulatory therapy visit for Medicaid ambulatory therapy patients in the pre-expansion (2012-2013) period and postexpansion (2014-2015) period. A descriptive analysis of utilization and logistic regression with a difference in differences approach of the odds of a therapy visit was conducted. Setting: Not applicable. Participants: The 2012-2015 public use data files of the Medical Expenditure Panel Survey- Household Component. Main Outcome Measures: Descriptive results and the odds ratio of an ambulatory therapy visit were determined. Results: About 788,233 more Medicaid beneficiaries had an ambulatory therapy visit after Medicaid expansion. By subpopulation, the increases in utilization were greatest for beneficiaries from low-income households and beneficiaries living in the west census region. Policy change increased the odds of a therapy visit for a Medicaid beneficiary by 27%. Conclusions: Utilization of ambulatory therapy by Medicaid beneficiaries increased after Medicaid expansion.

AB - Objective: To determine if Medicaid expansion in 2014 improved utilization of ambulatory physical therapy and occupational therapy. Design: Secondary data, pre-post analysis study using a difference in differences approach. The study compared utilization rates and likelihood of an ambulatory therapy visit for Medicaid ambulatory therapy patients in the pre-expansion (2012-2013) period and postexpansion (2014-2015) period. A descriptive analysis of utilization and logistic regression with a difference in differences approach of the odds of a therapy visit was conducted. Setting: Not applicable. Participants: The 2012-2015 public use data files of the Medical Expenditure Panel Survey- Household Component. Main Outcome Measures: Descriptive results and the odds ratio of an ambulatory therapy visit were determined. Results: About 788,233 more Medicaid beneficiaries had an ambulatory therapy visit after Medicaid expansion. By subpopulation, the increases in utilization were greatest for beneficiaries from low-income households and beneficiaries living in the west census region. Policy change increased the odds of a therapy visit for a Medicaid beneficiary by 27%. Conclusions: Utilization of ambulatory therapy by Medicaid beneficiaries increased after Medicaid expansion.

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