People with chronic conditions or mental health issues enrolled in Medicaid managed care plans have better clinical experiences than people without health insurance and in some cases better than those with other commercial health plans, according to a new report from America’s Health Insurance Plans (AHIP).
Researchers found that Medicaid enrollees with mood disorders were more likely to receive a “recommended combination of medication and psychotherapy treatments” than uninsured people. More than 30% of adult patients use combined psychology and recommended mood disorder medications, according to the report. That’s almost 10 percentage points higher than people in commercial health plans and about 15 percentage points higher than people who are uninsured.
The study compared clinical care and prescription drug utilization from 2013 to 2015 for people who were uninsured, covered by a Medicaid managed care plan and covered by a commercial health plan.
Private payers are increasingly wading into Medicaid. However, Medicaid managed care hasn’t been successful everywhere, such as in Iowa, which reportedly saw almost three times higher Medicaid costs after moving to managed care.
Despite those issues, Medicaid managed care accounts for nearly 55 million of the program’s 75 million members across the country. Some states have more than 90% of their Medicaid population in managed care plans. A recent HHS Office of the Actuary report predicted that states moving Medicaid to managed care organizations will play a major role in the program’s future.
Another recent report, from A2 Strategy Group, found that Medicaid managed care plan enrollment increased in recent years despite 1.1 million fewer people covered by Medicaid this year compared to a year ago.
That number will likely grow after voters in Nebraska, Idaho and Utah recently approved Medicaid expansion. Virginia is also expanding the program in 2019 and Maine is expected to expand next year once Gov. Paul LePage leaves office.
AHIP’s findings show that Medicaid can improve care for people with chronic illness and mental health issues. Those two areas contribute heavily to growing healthcare costs. AHIP found that asthma, diabetes and serious mood disorders cost hundreds of billions of dollars annually. So, any programs that can improve those outcomes will get a close look from payers.
That’s especially true given that the recent actuary report projected the program’s expenditures will increase at an average annual rate of 5.7% over the next decade.
In its report, AHIP said asthmatic Medicaid enrollees received inhalers and recommended medicines more commonly than uninsured people. Also, uninsured people with asthma were more likely to get care in emergency rooms and visit doctors more frequently.
The report also found that diabetic Medicaid enrollees received monitoring services, eye tests and foot exams more often than uninsured people.