Informing North Carolina’s COVID-19 Pandemic Response: Projected Service Needs of Medicaid Beneficiaries

Overview

We sought to understand how Medicaid reform can affect health for low income, vulnerable North Carolinians by conducting three related statewide projects that collected baseline data and monitored three key domains where we saw the potential for widening health disparities as North Carolina shifts to Medicaid Managed Care (MMC). See below for details on each of the project domains.

Insurance Coverage Churn

We explored how changes in insurance coverage impact health care utilization and outcomes for Medicaid-insured North Carolinians. We described churn (proportion of enrollees experiencing brief gaps in insurance coverage) among Medicaid-insured children and adults. We also documented disparities in churn based on sociodemographic characteristics, identify beneficiary groups with the highest rates of churn, and evaluate the impacts of churn on utilization and outcomes.

Project Team: Rushina Cholera, MD, PhD; David Anderson, MS; Charlene Wong, MD, MSHP; Rebecca Whitaker, PhD, MSPH; Janet Prvu Bettger, ScD, FAHA; Sudha Raman, PhD; Brad Hammill, DrPH; Kevin Keith, MD, MPH; Jessica Beliveau, MPH, PMP

Fact Sheet: Churn Patterns Among Youth Medicaid Beneficiaries in North Carolina: 2016-2018

Fact Sheet: Churn Patterns Among Adult Medicaid Beneficiaries from North Carolina: 2016-2018

Research Article: Medicaid Coverage Disruptions among Children Enrolled in North Carolina Medicaid from 2016 to 2018

Research Article: Postpartum Medicaid enrollment and churn in North Carolina

Behavioral Health Utilization

We used North Carolina Medicaid claims data to document sociodemographic disparities in behavioral health-related service needs among pediatric, adult, and adult dual-enrolled individuals in advance of North Carolina Medicaid transformation. 

Project Team: Gary Maslow, MD; Alexis French, PhD; Kelley Jones, PhD; Nicole Heilbron, PhD; Charlene Wong, MD, MSHP; Rebecca Whitaker, PhD, MSPH; Janet Prvu Bettger, ScD, FAHA; Jessica Beliveau, MPH, PMP

Fact Sheet: Behavioral Health Service Use Among Medicaid-enrolled Adults in North Carolina During 2018 - 2019

Fact Sheet: Behavioral Health Use Among Medicaid-enrolled Youth in North Carolina

New Medicaid Enrollees

We used North Carolina Medicaid enrollment and claims data to provide early evidence and actionable insights for NC DHHS leadership about the influence of COVID-19 on new enrollees in the Medicaid program to inform future state and federal policy responses. 

Project Team: Brad Wright, PhD (UNC-Chapel Hill); Paul Shafer, PhD, MA (Boston University); David Anderson, MS; Charlene Wong, MD, MSHP; Rebecca Whitaker, PhD, MSPH; Janet Prvu Bettger, ScD, FAHA; Jessica Beliveau, MPH, PMP

Publications:

Fact Sheet: How Covid-19 Unemployment and Social Vulnerability Affected Medicaid Enrollment Across North Carolina

Fact Sheet: Comparing Health Care Use and Costs Among New Medicaid Enrollees Before and During COVID-19

Research Article: Association of Unemployment with Medicaid Enrollment by Social Vulnerability in North Carolina during COVID-19

Research Article: Comparing Health Care Use and Costs among New Medicaid Enrollees before and during the COVID-19 Pandemic