Increased Utilization of Ambulatory Occupational Therapy and Physical Therapy After Medicaid Expansion

Abstract

ObjectiveTo determine if Medicaid expansion in 2014 improved utilization of ambulatory physical therapy and occupational therapy. DesignSecondary data, pre-post analysis study using a difference in differences approach. The study compared utilization rates and likelihood of an ambulatory therapy visit for Medicaid ambulatory therapy patients in the pre-expansion (2012-2013) period and postexpansion (2014-2015) period. A descriptive analysis of utilization and logistic regression with a difference in differences approach of the odds of a therapy visit was conducted. SettingNot applicable. ParticipantsThe 2012-2015 public use data files of the Medical Expenditure Panel Survey- Household Component. Main Outcome MeasuresDescriptive results and the odds ratio of an ambulatory therapy visit were determined. ResultsAbout 788,233 more Medicaid beneficiaries had an ambulatory therapy visit after Medicaid expansion. By subpopulation, the increases in utilization were greatest for beneficiaries from low-income households and beneficiaries living in the west census region. Policy change increased the odds of a therapy visit for a Medicaid beneficiary by 27%. ConclusionsUtilization of ambulatory therapy by Medicaid beneficiaries increased after Medicaid expansion.