Study finds earlier diabetes diagnoses in Medicaid expansion states
People in states that expanded Medicaid under the Affordable Care Act (ACA) are far more likely to be newly identified with diabetes than in states that elected not to expand the public healthcare program, according to a study published online in Diabetes Care.
The study, by researchers at Quest Diagnostics, is believed to be one of the first nationally representative analyses of the impact of the ACA in promoting earlier diagnosis of, and potentially better outcomes for, diabetes. It showed that diabetes diagnosis rates surged in states that expanded Medicaid. Newly identified diabetes in Medicaid patients surged 23.2% in Medicaid expansion states, but increased less than 1% (0.4%) in states that chose not to expand.
Patients with diabetes were diagnosed at earlier stages in states that expanded Medicaid. As a result of being diagnosed earlier, it is likely that outcomes from the disease can be improved.
“The findings of the study indicate that Medicaid expansion states have had a positive impact on providing access to care for patients that previously may not have had access or more limited access. It’s important that healthcare professionals and decision-makers have access to data that can help inform their medical decisions,” says study lead investigator Harvey W. Kaufman, M.D., senior medical director, Quest Diagnostics. “Cost control is an issue that currently threatens the stability of our healthcare system. Taking preventative measures to curb costs from skyrocketing is a strategy that also, and more importantly, benefits the patient.”
Quest Diagnostics is said to manage the largest database of de-identified clinical laboratory data which is based on more than 20 billion test results. Researchers at Quest Diagnostics analyzed de-identified test results for people between the ages of 19 and 64 years of both genders across the United States who met the definition of newly diagnosed diabetes during the first six months of 2013 (prior to Medicaid expansion) and the first six months of 2014 (following Medicaid expansion). Newly diagnosed diabetes was determined based on at least one blood test for hemoglobin A1c, a marker of diabetes, greater than 6.4% or an ICD-9 code for diabetes mellitus with no prior diagnosis for the preceding year.