Montana Medicaid Use Reduces ER Visits and Hospitalizations

Missoula, MT (KGVO-AM News) - A report released on Tuesday by the Montana Healthcare Foundation shows that the increased enrollment in Montana Medicaid has resulted in a decrease in ER visits, hospitalizations and their associated costs.

KGVO News spoke with Aaron Wernham, CEO of the Montana Healthcare Foundation about the report.

There was Much Opposition to Medicaid Expansion, but it has Proven Itself

“We found that people are accessing a lot of the preventive services that we hope that they would with increased insurance coverage,” began Dr. Wernham. “As a primary care physician, this was very important to me to see that more than 60,000 Medicaid recipients got wellness exams in the last year. That included 1000s of screenings for you know, common potentially deadly conditions like cancer, heart disease and what have you.”

Dr. Wernham also emphasized the fact that many more Montana Medicaid recipients are getting the services they need to get and remain healthy.

“We have evidence that people are getting into care for those illnesses,” he said. “So a couple of thousand new cases of diabetes have been diagnosed and are now in treatment and then a couple thousand are in treatment for high blood pressure as well. It’s the same with breast cancer and colon cancer, which are two of the more common cancers. So again, we are seeing people using preventive care, getting diagnosed early, and getting into treatment.”

A Reduction in ER Visits and Hospitalizations - Mission Accomplished

Dr. Wernham reminds Montanans that the reason for Medicaid expansion was so that ER and hospital visits would decrease and provide more services to the general population.

“So the real question we asked this year is what is that doing to the higher cost care, such as ER (Emergency Room) and hospital use?” he asked. “What we saw there is a very significant decline in ER use. So over their years of coverage, people were using the ER about 13 percent less. In addition, we actually were able to see a change in the costs. So a little bit of a decline and how much it costs per patient in the Medicaid program and that’s about three percent over the first three years of being enrolled.”

Another point of concern for Dr. Wernham was the availability of behavioral health services for lower-income Montanans on Medicaid.

They're Trying to Increase Access to Behavioral Health Services

“One of the very important questions is, you know, how do we use this program to really strengthen the behavioral health services for mental illness and suicide prevention and substance use, which we know are big problems for a lot of Montana communities,” he said. “I think the state has a lot of work going on to try to address some of the behavioral health needs and so we'll be taking a very close look at that in the next year or two, as the state continues with its plans.”

See the report from the Montana Healthcare Foundation on the benefits of Medicaid expansion here.