Changes in health care use and costs after a break in Medicaid coverage among persons with depression

Academic Article


  • Objective: The objective of this study was to assess changes in individual beneficiaries' utilization and expenditures that occur when individuals with depression, who often require maintenance treatment, return to Medicaid after a period of interrupted Medicaid coverage. Methods: Data from 1999 to 2002 Florida Medicaid claims from and eligibility files for beneficiaries with depression whose coverage was interrupted (N = 1,946) were used to assess individual changes in the number of inpatient episodes, length of inpatient stay, emergency department visits, and total Medicaid expenditures between the three-month period immediately before and the three-month period immediately after an interruption in coverage. Multivariate analyses were used to assess how beneficiary characteristics are associated with changes in utilization and expenditures. Results: The number of inpatient episodes increased by .054 episode (p<.001), the length of inpatient stay increased by .32 day (p<.001), the number of emergency department visits increased by .57 visit (p<.001), and total Medicaid expenditures increased by $430 (p<.001) in the three-month period after an interruption in coverage of more than one month. Individuals with depression who qualified for Medicaid because of a disability had a greater likelihood of experiencing higher expenditures after an interruption than individuals who were not disabled. Conclusions: Utilization of emergency and inpatient services and Medicaid expenditures significantly increased for beneficiaries with depression when they returned to Medicaid after experiencing a temporary loss in coverage, especially for beneficiaries with a documented disability. These findings point to the need for further research to assess the impact of interruptions in Medicaid.
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    Digital Object Identifier (doi)

    Author List

  • Harman JS; Hall AG; Zhang J
  • Start Page

  • 49
  • End Page

  • 54
  • Volume

  • 58
  • Issue

  • 1