Study: Medicaid interruptions lead to unnecessary hospitalizations

A new Commonwealth Fund-sponsored study has found that Medicaid beneficiaries who experienced interruptions in their benefits had a substantially higher risk of hospitalization for ambulatory care-sensitive conditions ("Interruptions in Medicaid Coverage and Risk for Hospitalization for Ambulatory Care–Sensitive Conditions,” Annals of Internal Medicine, Dec. 16, 2008).

The study of adult California Medicaid beneficies with asthma, congestive heart failure, chronic obstructive pulmonary disease, diabetes and pneumonia, was led by Andrew Bindman, MD, of the University of California, San Francisco.

The study found that interruptions in coverage were common throughout the United States because of state rules governing eligibility and requirements that beneficiaries prove eligibility annually. The study’s authors contend that adopting policies that reduce administrative burdens on beneficiaries would decrease lapses in coverage and corresponding negative health outcomes that increase cost.