Inconsistent Medicaid Coverage is Associated with Negative Health Events for People with Epilepsy

J Health Care Poor Underserved. 2022;33(2):1036-1053. doi: 10.1353/hpu.2022.0079.

Abstract

Objective: Examine the association between gaps in Medicaid coverage and negative health events (NHEs) for people with epilepsy (PWE).

Methods: Using five years of Medicaid claims for PWE, we identified gaps in Medicaid coverage. We used logistic regression to evaluate the association between a gap in coverage and being in the top quartile of NHEs and factors associated with having a gap. These models adjusted for: demographics, residence, medication adherence, disease severity, and comorbidities.

Results: Of 186,616 PWE, 21.7% had a gap in coverage. The odds of being in the top quartile of NHEs per year were 66% higher among those with a gap (OR: 1.66; 95% CI: 1.61, 1.70). Being female, younger, and having psychiatric comorbidities increased the odds of having a gap.

Conclusions: Gaps in Medicaid coverage are associated with being a high utilizer during covered periods. Specific groups could be targeted with interventions to reduce churning.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Comorbidity
  • Epilepsy / complications*
  • Epilepsy / epidemiology
  • Epilepsy / therapy
  • Female
  • Humans
  • Insurance Coverage* / economics
  • Logistic Models
  • Male
  • Medicaid* / economics
  • Medication Adherence
  • Mental Disorders / complications*
  • Sex Factors
  • United States / epidemiology