The impact of expansion on preventive service utilization by Louisiana's traditional medicine population
This thesis analyzes the effect of Medicaid expansion on the usage of preventive healthcare services by Louisiana’s traditional Medicaid population. This work seeks to further our understanding of the implications of increasing health insurance coverage in the United States. This will address a lack of research on the impact of Medicaid expansion on existing beneficiaries. The Background provides the reader with an overview of chronic diseases, preventive healthcare services, and racial disparities in health outcomes, and concludes with an explanation of Medicaid expansion, concerns and issues related to this policy, and a synopsis of existing research at the state level. The Data and Methodology section explains how the appropriate study samples and outcome variables were created and analyzed to assess the time trends in the utilization of three preventive services before and after Louisiana’s Medicaid expansion, measured as monthly rates over a twenty-five-month period. The Results section presents the average change in the monthly rate of service usage that occurred in the year before expansion, the level of change that happened in the expansion month, and the average change in the monthly rate over the year following expansion for each of the three services included. For each service, the changes in utilization are further examined among a sub-sample of only Black patients and a sub-sample of only White patients to investigate potential racial disparities in service utilization. The Discussion interprets these findings and explains how this data addresses the impact that Medicaid expansion had on traditional beneficiaries. This thesis concludes that expansion was not detrimental to the traditional Medicaid population in Louisiana and did not contribute to racial disparities in utilization of preventive care in this study sample.