Evaluating Quality and Value of US Ambulatory Care Delivered Among Medicaid Expansion/Non-Expansion States, 2012-2015

NCT05319743 | Completed

• 1 other identifier: 22-001139
• Study Type: observational
• Target: 200,000
• Locations: 1 country
• Sites: 1

Brief Summary

Quasi-experimental pre-post analysis of the rate of high-value and low-value care services between states that expanded Medicaid and states that did not expand Medicaid January 1, 2014, for adult ambulatory visits, using visit-level survey data from the National Ambulatory Medical Care Survey January 1, 2012 - December 31, 2015.

Conditions

Medicaid Expansion

Keywords

High-value care; Low-value care

Outcome Measures

Primary Outcomes (1)

• Rate of low-value and high-value services for adult ambulatory visits.

  Ex. Numerator = count of high value services provided for adult visits in Medicaid expansion states in 2012/ Denominator = Count of adult visits in Medicaid expansion state in 2012 that had the potential to receive a high value service.

  pre (01/01/2012 - 12/31/2013) and post (01/01/2014 - 12/31/2015) Medicaid expansion

Secondary Outcomes (3)

• Adult ambulatory visit volume changes

  pre (01/01/2012 - 12/31/2013) and post (01/01/2014 - 12/31/2015) Medicaid expansion

• Rate of low-value and high-value services for Medicaid adult ambulatory visits

  pre (01/01/2012 - 12/31/2013) and post (01/01/2014 - 12/31/2015) Medicaid expansion

• Rate of low-value and high-value services for "New" Medicaid adult ambulatory visits.

  pre (01/01/2012 - 12/31/2013) and post (01/01/2014 - 12/31/2015) Medicaid expansion

Other Outcomes (1)

• Sensitivity analysis: repeat primary and secondary analysis with all adult visits, Medicaid visits, and "New" Medicaid visits

  pre (01/01/2012 - 12/31/2013) and post (01/01/2014 - 12/31/2015) Medicaid expansion

Study Arms (2)

Medicaid expansion states

Eight Medicaid expansion states: (experimental group): Arizona, California, Illinois, Massachusetts, New Jersey, Ohio, Washington

Other: Medicaid Expansion

Non-Medicaid expansion states

Five states that did not expand Medicaid (control group): Florida, Georgia, North Carolina, Texas, Virginia

Interventions

Medicaid Expansion OTHER

Expansion of Medicaid, 01/01/2014

Medicaid expansion states

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

NAMCS Adult Visits between 01/01/2012 and 12/31/2015. The data source is a nationally representative probability sample of U.S. ambulatory care visits

You may qualify if:

• ≥18 years old
• Visits between 01/01/2012 and 12/31/2015

You may not qualify if:

• \<18 years old
• Visits before 01/01/2012
• Visits after 12/31/2015

Sponsors & Collaborators

• University of California, Los Angeles: lead
• University of Michigan: collaborator

Study Sites (1)

The University of Michigan

Ann Arbor, Michigan, 48109, United States

Location

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Medicine

Study Record Dates

• First Submitted: March 31, 2022
• First Posted: April 8, 2022
• Study Start: October 1, 2021
• Primary Completion: May 1, 2022
• Study Completion: May 1, 2022
• Last Updated: February 3, 2023

Record last verified: 2023-02

Data Sharing

• IPD Sharing: Will share

Locations

US (1)