Article Summation
Burns et al., (2014), in their research work, offer a critical appraisal on the uptake of health care services for childless low income adults who have just been enrolled into a public health insurance scheme. Eligibility for Medicaid (the U.S a governments’ insurance program) witnessed an expansion for eligible adults to include adults who fall below the federal poverty level (FPL) of 138%. However, the Supreme Court’s ruling which made this cap an option for states rather than an obligation meant that states could now extend the limit for persons to be covered under Medicaid Insurance. Among these people are the adults who do not have children and where not covered before under the (Affordable Care Act) ACA due to set FPL. Consequentially, the expansion of health insurance coverage to this population has the potential of causing a massive effects on the healthcare sector chief among being increased access to healthcare services. However, various factors will affect access to the needed healthcare services. Using a regression discontinuity study design, Burns et al., (2014) establishes the cause effect relationship of having a public insurance and the implications on healthcare services including outpatient services, emergency wings, and inpatient services for a period of 2 years in Rural Wisconsin. Based on the research findings, insuring the public, mores so the poor adults resulted in an increased increase in access to outpatient services and inpatient services. Consequentially, the study findings indicate that increasing public insurance has a correlation with improved access to healthcare services among the poor community especially for inpatient and outpatient services. Additionally, the rate of the uninsured persons is checked with increased Medicaid coverage.
A case manager may find Burns et al., (2014) findings quite useful in practice on various fronts.
First, it offers insights into the uptake of healthcare services especially among the uninsured childless adults living in poverty. This information is compared in the two year study period retrospectively and compared with uptake of healthcare services after Medicaid Insurance is given. The increase in uptake of outpatient and inpatient services in Wisconsin is beneficial to a case manager in healthcare resources planning especially for inpatient and outpatient services.
Secondly, the increased use of Medicaid Insurance is essential in forecasting resource allocation in regions where expected increase in healthcare services is expected.
Thirdly, the article offers statistical inferences on socioeconomic differences and their impact on healthcare services. This information is not only relevant in research work but can also be used in epidemiological models used in determining gender disparities with regard to access to healthcare services.
Additionally, the lack of uptake of ED services is quite telling. This finding is documented to be consistent with similar studies. Consequentially, the findings suggest that preventative care is addressed with increased public insurance but not behavioral health care. Such views can help case managers in finding better ways of improving pertinent behavioral health concern issues.
Finally, the article may be beneficial for a case manager in policy formation. As an evidence based practice, the inferences drawn from the study may be used and adopted in diverse healthcare setup in guiding practice especially in outpatient and inpatient wings. Future implications and potential study areas for case managers must look into the reasons for a low ED uptake among the childless insured adults from poor regions.
Reference
Burns, M. E., Dague, L., DeLeire, T., Dorsch, M., Friedsam, D., Leininger, L. J., & Voskuil, K. (2014). The Effects of Expanding Public Insurance to Rural Low‐Income Childless Adults. Health services research, 49(S2), 2173-2187.
