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MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population.

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  • Additional Information
    • Subject Terms:
    • Subject Terms:
    • NAICS/Industry Codes:
      621498 All Other Outpatient Care Centers
      624190 Other Individual and Family Services
      913910 Other local, municipal and regional public administration
      623220 Residential Mental Health and Substance Abuse Facilities
      621494 Community health centres
      525190 Other Insurance Funds
      524298 All Other Insurance Related Activities
      524292 Third Party Administration of Insurance and Pension Funds
      923130 Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
      622110 General Medical and Surgical Hospitals
    • Abstract:
      Studies of Medicaid expansion have produced conflicting results about whether the expansion is having a positive impact on health and the cost and efficiency of care delivery. To explore the issue further, we examined MetroHealth Care Plus, a Centers for Medicare and Medicaid Services (CMS) waiver program in Ohio composed of three safety-net organizations that enrolled 28,295 uninsured poor patients in closed-panel care during 2013. All participating organizations used electronic health records and patient-centered medical homes, publicly reported performance in a regional health improvement collaborative, and accepted a budget-neutral cap approved by CMS. We compared changes between 2012 and 2013 in achieving quality standards for diabetes and hypertension among 3,437 MetroHealth Care Plus enrollees to changes among 1,150 patients with the same conditions who remained uninsured in both years. Compared to continuously uninsured patients with diabetes, MetroHealth Care Plus enrollees with diabetes improved significantly more on composite standards of care and intermediate outcomes. Among enrollees with hypertension, blood pressure control improvements were insignificantly larger than those in the continuously uninsured group with hypertension. Across all 28,295 enrollees, 2013 total costs of care were 28.7 percent below the budget cap, providing cause for optimism that a prepared safety net can meet the challenges of Medicaid expansion. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of Health Affairs is the property of Project HOPE/HEALTH AFFAIRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1President, Better Health Partnership, Cleveland, Ohio
      2Professor, Departments of Medicine and of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
      3Director, Case Western Reserve University Center for Health Care Research and Policy, MetroHealth Medical Center, Cleveland, Ohio
      4Director, Better Heath Partnership
      5Professor, Departments of Medicine and of Epidemiology and Biostatistics, Case Western Reserve University
      6Case Western Reserve University Center for Health Care Research and Policy, MetroHealth Medical Center
      7Professor, Department of Medicine, Case Western Reserve University
      8President and executive director, Center for Community Solutions, Cleveland
    • ISSN:
      0278-2715
    • Accession Number:
      10.1377/hlthaff.2014.1380
    • Accession Number:
      108315401
  • Citations
    • ABNT:
      CEBUL, R. D. et al. MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population. Health Affairs, [s. l.], v. 34, n. 7, p. 1121–1130, 2015. DOI 10.1377/hlthaff.2014.1380. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=108315401&custid=s8280428. Acesso em: 8 jul. 2020.
    • AMA:
      Cebul RD, Love TE, Einstadter D, Petrulis AS, Corlett JR. MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population. Health Affairs. 2015;34(7):1121-1130. doi:10.1377/hlthaff.2014.1380.
    • AMA11:
      Cebul RD, Love TE, Einstadter D, Petrulis AS, Corlett JR. MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population. Health Affairs. 2015;34(7):1121-1130. doi:10.1377/hlthaff.2014.1380
    • APA:
      Cebul, R. D., Love, T. E., Einstadter, D., Petrulis, A. S., & Corlett, J. R. (2015). MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population. Health Affairs, 34(7), 1121–1130. https://doi.org/10.1377/hlthaff.2014.1380
    • Chicago/Turabian: Author-Date:
      Cebul, Randall D., Thomas E. Love, Douglas Einstadter, Alice S. Petrulis, and John R. Corlett. 2015. “MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population.” Health Affairs 34 (7): 1121–30. doi:10.1377/hlthaff.2014.1380.
    • Harvard:
      Cebul, R. D. et al. (2015) ‘MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population’, Health Affairs, 34(7), pp. 1121–1130. doi: 10.1377/hlthaff.2014.1380.
    • Harvard: Australian:
      Cebul, RD, Love, TE, Einstadter, D, Petrulis, AS & Corlett, JR 2015, ‘MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population’, Health Affairs, vol. 34, no. 7, pp. 1121–1130, viewed 8 July 2020, .
    • MLA:
      Cebul, Randall D., et al. “MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population.” Health Affairs, vol. 34, no. 7, July 2015, pp. 1121–1130. EBSCOhost, doi:10.1377/hlthaff.2014.1380.
    • Chicago/Turabian: Humanities:
      Cebul, Randall D., Thomas E. Love, Douglas Einstadter, Alice S. Petrulis, and John R. Corlett. “MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population.” Health Affairs 34, no. 7 (July 2015): 1121–30. doi:10.1377/hlthaff.2014.1380.
    • Vancouver/ICMJE:
      Cebul RD, Love TE, Einstadter D, Petrulis AS, Corlett JR. MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population. Health Affairs [Internet]. 2015 Jul [cited 2020 Jul 8];34(7):1121–30. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=108315401&custid=s8280428