Balancing investments in federally qualified health centers and Medicaid for improved access and coverage in Pennsylvania

Paul M. Griffin, Hyunji Lee, Christina Scherrer, Julie L. Swann

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Two common health disparities in the US include a lack of access to care and a lack of insurance coverage. To help address these disparities, healthcare reform will provide $11B to expand Federally Qualified Health Centers (FQHCs) over the next 5 years. In 2014, Medicaid rules will be modified so that more people will become eligible. There are, however, important tradeoffs in the investment in these two programs. We find a balanced investment between FQHC expansion and relaxing Medicaid eligibility to improve both access (by increasing the number of FQHCs) and coverage (by FQHC and Medicaid expansion) for the state of Pennsylvania. The comparison is achieved by integrating multi-objective mathematical models with several public data sets that allow for specific estimations of healthcare need. Demand is estimated based on current access and coverage status in order to target groups to be considered preferentially. Results show that for Pennsylvania, FQHCs are more cost effective than Medicaid if we invest all of the resources in just one policy. However, we find a better investment point balancing those two policies. This point is approximately where the additional expenses incurred from relaxing Medicaid eligibility equals the investment in FQHC expansion.

Original languageEnglish (US)
Pages (from-to)348-364
Number of pages17
JournalHealth Care Management Science
Volume17
Issue number4
DOIs
StatePublished - Dec 2014

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Health Professions(all)

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