By Heather Angier, Brigit Hatch, Miguel Marino, & William JA Pinnock
There is little doubt about the association between health insurance and receipt of needed care. Yet, a debate continues around the impact of health insurance on measurable health outcomes. This led us at OHSU and OCHIN to assess this relationship and examine changes in measurable health outcomes among patients with chronic diseases seen in community health centers – clinics that see patients regardless of insurance status – during the 2008-2011 Oregon Medicaid expansion.
We are excited to announce that we have chronicled our findings in a new research publication which used electronic health records and Medicaid data to develop a more detailed picture of how disease indicators changed for adult patients with uncontrolled diabetes, high blood pressure, and high cholesterol. Patients with chronic conditions who gained Medicaid were compared to those who remained uninsured but continued to receive healthcare services. We decided upon this comparison so we could determine the difference between those two groups. Specifically, we looked at hemoglobin A1c for those with diabetes, systolic and diastolic blood pressure for those with high blood pressure, and low-density lipoprotein for those with high cholesterol.
After we concluded our analysis, we found all patients who received healthcare experienced improvement in health outcomes. Those who gained Medicaid were significantly more likely achieve control of their chronic condition (blood sugar for patients with diabetes; blood pressure for patients with hypertension), but patients with high cholesterol experienced similar changes in cholesterol regardless of insurance status.
You may be asking yourself – these are interesting findings and all, but what’s the takeaway? Well, our findings highlight the effectiveness and importance of healthcare provided at community health centers. Our study also suggests that increased access to health insurance is associated with measurable improvement in health outcomes for patients with chronic disease. Our findings add to a growing body of literature on the importance of health insurance coverage and healthcare access for all members of society, regardless of status and life circumstances. But maybe most importantly, we can look at these findings, this paper, and this blog post as important steps forward in finally ending the debate surrounding the impact of health insurance on measurable health outcomes.