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Deirdre Bloome wins ASA award for work on racial inequality and intergenerational transmission

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David Lam is new director of Institute for Social Research

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Next Brown Bag

Monday, Oct 12
Joe Grengs, Policy & Planning for Social Equity in Transportation

Transportation Brokerage Services and Medicaid Beneficiaries' Access to Care

Publication Abstract

Kim, J., Edward Norton, and S.C. Stearns. 2009. "Transportation Brokerage Services and Medicaid Beneficiaries' Access to Care." Health Services Research, 44(1): 145-161.

To examine the effect of capitated transportation brokerage services on Medicaid beneficiaries' access to care and expenditures. The study period from 1996 to 1999 corresponds to the period of a natural experiment during which Georgia and Kentucky implemented transportation brokerage services. Effects were estimated for asthmatic children and diabetic adults. We used difference-in-differences models to assess the effects of transportation brokerage services on access to care, measured by Medicaid expenditures and health services use. The study design is strengthened by the staggered implementation dates between states and within each state. For asthmatic children, transportation brokerage services increased nonemergency transportation expenditures and the likelihood of using any services; reductions in monthly expenditures more than offsetting the increased transportation costs. For diabetic adults, nonemergency transportation costs decreased despite increased monthly use of health services; average monthly medical expenditures and the likelihood of hospital admission for an ambulatory care-sensitive condition (ACSC) also decreased. The shift to transportation brokerage services improved access to care among Medicaid beneficiaries and decreased the expenditures. The increase in access combined with reduced hospitalizations for asthmatic children and ACSC admissions for diabetic adults are suggestive of improvements in health outcomes.

DOI:10.1111/j.1475-6773.2008.00907.x (Full Text)

Country of focus: United States of America.

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