Health Care Use and Spending for Medicaid Enrollees in Federally Qualified Health Centers Versus OtherPrimary Care Settings.

Nocon RS1, Lee SM1, Sharma R1, Ngo-Metzger Q1, Mukamel DB1, Gao Y1, White LM1, Shi L1, Chin MH1, Laiteerapong N1, Huang ES1.

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Abstract

OBJECTIVES:

To compare health care use and spending of Medicaid enrollees seen at federally qualified health centers versus non-health centersettings in a context of significant growth.

METHODS:

Using fee-for-service Medicaid claims from 13 states in 2009, we compared patients receiving the majority of their primary care infederally qualified health centers with propensity score-matched comparison groups receiving primary care in other settings.

RESULTS:

We found that health center patients had lower use and spending than did non-health center patients across all services, with 22% fewer visits and 33% lower spending on specialty care and 25% fewer admissions and 27% lower spending on inpatient care. Total spending was 24% lower for health center patients.

CONCLUSIONS:

Our analysis of 2009 Medicaid claims, which includes the largest sample of states and more recent data than do previous multistate claims studies, demonstrates that the health center program has provided a cost-efficient setting for primary care for Medicaidenrollees. (Am J Public Health. Published online ahead of print September 15, 2016: e1-e9. doi:10.2105/AJPH.2016.303341).