Medicaid Participation among Liver Transplant Candidates after the Affordable Care Act Medicaid Expansion

Journal of the American College of Surgeons
Dmitry TuminSylvester M Black

Abstract

The 2014 Medicaid expansion in participating states increased insurance coverage among people with chronic health conditions, but its implications for access to surgical care remain unclear. We investigated how Medicaid expansion influenced the insurance status of candidates for liver transplantation (LT) and transplant center payor mix. Data on LT candidates aged 18 to 64 years, in 2012 to 2013 (pre-expansion) and 2014 to 2015 (post-expansion), were obtained from the United Network for Organ Sharing registry. Change between the 2 periods in the percent of LT candidates using Medicaid was compared between expansion and nonexpansion states. Multivariable logistic regression was used to determine how Medicaid expansion influenced individual LT candidates' likelihood of using Medicaid insurance. The study included 33,017 LT candidates, of whom 29,666 had complete data for multivariable analysis. Medicaid enrollment increased by 4% after Medicaid expansion in participating states. One-quarter of the transplant centers in these states experienced ≥10% increase in the proportion of LT candidates using Medicaid insurance. Multivariable analysis confirmed that Medicaid expansion was associated with increased odds of LT candidates using...Continue Reading

Citations

Aug 21, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Raymond J LynchSeth J Karp
Jan 30, 2019·Current Opinion in Organ Transplantation·Makenzie Cook, Edward Zavala
Feb 28, 2019·Transplant International : Official Journal of the European Society for Organ Transplantation·J W Awori HayangaGhulam Abbas
Mar 16, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Raymond J LynchSeth J Karp
Aug 21, 2019·Transplant International : Official Journal of the European Society for Organ Transplantation·J W Awori HayangaHeather K Hayanga
Mar 27, 2018·Digestive Diseases and Sciences·Clifford AkatehSylvester M Black
Nov 14, 2020·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Krystal L KarununganPeyman Benharash
Dec 6, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Smriti Rajita KumarDavid Goldberg
Jun 13, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Nabeel A WahidRussell Rosenblatt

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