Variations in the patients’ hospital care experience by states’ strategy for Medicaid expansion: 2009-2013

Our investigation evaluates the extent of differences in the patient’s hospital experience due to variations among state strategies to adopt, or not adopt, their Medicaid plans to the 2010 ACA legislation. Using ten HCAHPS measures, we analyze patient hospital experience data for the 2009 - 2013 per...

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Autores principales:	Edmund Becker, Kenton Johnston, Jaeyong Bae, Jason Hockenberry, Ariel Avgar, Sandra Liu, Ira Wilson, Arnold Milstein
Formato:	article
Lenguaje:	EN
Publicado:	The Beryl Institute 2015
Materias:	patient hospital experience patient satisfaction value-based purchasing hcahps affordable care act state medicaid expansion Medicine (General) R5-920 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/7cc6b0807a1f40b9b5e4324ee24fbcf1
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spelling	oai:doaj.org-article:7cc6b0807a1f40b9b5e4324ee24fbcf12021-11-15T03:55:59ZVariations in the patients’ hospital care experience by states’ strategy for Medicaid expansion: 2009-20132372-0247https://doaj.org/article/7cc6b0807a1f40b9b5e4324ee24fbcf12015-04-01T00:00:00Zhttps://pxjournal.org/journal/vol2/iss1/18https://doaj.org/toc/2372-0247Our investigation evaluates the extent of differences in the patient’s hospital experience due to variations among state strategies to adopt, or not adopt, their Medicaid plans to the 2010 ACA legislation. Using ten HCAHPS measures, we analyze patient hospital experience data for the 2009 - 2013 period for all 50 states and the District of Columbia grouped by those states that (1) did not expand, (2) expanded Medicaid through Section 1115 waivers, (3) expanders early, and (4) expanded Medicaid concurrent with the new ACA legislation. Our findings reveal that those states that opted out of Medicaid expansion typically started with higher patient experience scores in 2009 on all 10 HCAHPS hospital measures and maintained their higher scores levels for all five years over the other three state expansion strategies for most measures. While states that were early expanders and those that expanded concurrent with the ACA implementation generally show higher growth rates over the five-year period for most HCAHPS measures when compared to states that opted out of the Medicaid expansion, our multivariate results indicate that their rates of growth were not statistically superior to those states that opted out of the expansion. We conclude that while there have been concerns that the patients in opt-out states would experience lower levels of satisfaction from their state’s actions, the patient experience scores in these states show that they perform better or as well as those states that expanded early, expanded under waivers, and expanded with the implementation of the ACA legislation.Edmund BeckerKenton JohnstonJaeyong BaeJason HockenberryAriel AvgarSandra LiuIra WilsonArnold MilsteinThe Beryl Institutearticlepatient hospital experiencepatient satisfactionvalue-based purchasinghcahpsaffordable care actstate medicaid expansionMedicine (General)R5-920Public aspects of medicineRA1-1270ENPatient Experience Journal (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	patient hospital experience patient satisfaction value-based purchasing hcahps affordable care act state medicaid expansion Medicine (General) R5-920 Public aspects of medicine RA1-1270
spellingShingle	patient hospital experience patient satisfaction value-based purchasing hcahps affordable care act state medicaid expansion Medicine (General) R5-920 Public aspects of medicine RA1-1270 Edmund Becker Kenton Johnston Jaeyong Bae Jason Hockenberry Ariel Avgar Sandra Liu Ira Wilson Arnold Milstein Variations in the patients’ hospital care experience by states’ strategy for Medicaid expansion: 2009-2013
description	Our investigation evaluates the extent of differences in the patient’s hospital experience due to variations among state strategies to adopt, or not adopt, their Medicaid plans to the 2010 ACA legislation. Using ten HCAHPS measures, we analyze patient hospital experience data for the 2009 - 2013 period for all 50 states and the District of Columbia grouped by those states that (1) did not expand, (2) expanded Medicaid through Section 1115 waivers, (3) expanders early, and (4) expanded Medicaid concurrent with the new ACA legislation. Our findings reveal that those states that opted out of Medicaid expansion typically started with higher patient experience scores in 2009 on all 10 HCAHPS hospital measures and maintained their higher scores levels for all five years over the other three state expansion strategies for most measures. While states that were early expanders and those that expanded concurrent with the ACA implementation generally show higher growth rates over the five-year period for most HCAHPS measures when compared to states that opted out of the Medicaid expansion, our multivariate results indicate that their rates of growth were not statistically superior to those states that opted out of the expansion. We conclude that while there have been concerns that the patients in opt-out states would experience lower levels of satisfaction from their state’s actions, the patient experience scores in these states show that they perform better or as well as those states that expanded early, expanded under waivers, and expanded with the implementation of the ACA legislation.
format	article
author	Edmund Becker Kenton Johnston Jaeyong Bae Jason Hockenberry Ariel Avgar Sandra Liu Ira Wilson Arnold Milstein
author_facet	Edmund Becker Kenton Johnston Jaeyong Bae Jason Hockenberry Ariel Avgar Sandra Liu Ira Wilson Arnold Milstein
author_sort	Edmund Becker
title	Variations in the patients’ hospital care experience by states’ strategy for Medicaid expansion: 2009-2013
title_short	Variations in the patients’ hospital care experience by states’ strategy for Medicaid expansion: 2009-2013
title_full	Variations in the patients’ hospital care experience by states’ strategy for Medicaid expansion: 2009-2013
title_fullStr	Variations in the patients’ hospital care experience by states’ strategy for Medicaid expansion: 2009-2013
title_full_unstemmed	Variations in the patients’ hospital care experience by states’ strategy for Medicaid expansion: 2009-2013
title_sort	variations in the patients’ hospital care experience by states’ strategy for medicaid expansion: 2009-2013
publisher	The Beryl Institute
publishDate	2015
url	https://doaj.org/article/7cc6b0807a1f40b9b5e4324ee24fbcf1
work_keys_str_mv	AT edmundbecker variationsinthepatientshospitalcareexperiencebystatesstrategyformedicaidexpansion20092013 AT kentonjohnston variationsinthepatientshospitalcareexperiencebystatesstrategyformedicaidexpansion20092013 AT jaeyongbae variationsinthepatientshospitalcareexperiencebystatesstrategyformedicaidexpansion20092013 AT jasonhockenberry variationsinthepatientshospitalcareexperiencebystatesstrategyformedicaidexpansion20092013 AT arielavgar variationsinthepatientshospitalcareexperiencebystatesstrategyformedicaidexpansion20092013 AT sandraliu variationsinthepatientshospitalcareexperiencebystatesstrategyformedicaidexpansion20092013 AT irawilson variationsinthepatientshospitalcareexperiencebystatesstrategyformedicaidexpansion20092013 AT arnoldmilstein variationsinthepatientshospitalcareexperiencebystatesstrategyformedicaidexpansion20092013
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Variations in the patients’ hospital care experience by states’ strategy for Medicaid expansion: 2009-2013

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