The Impact of Medicaid Expansion on Hospitalizations for Chronic Diseases: A Difference-in-Differences Analysis of Discharges for Diabetic Ketoacidosis, Chronic Kidney Disease, and Cardiovascular Diseasetext_resourcesManaging chronic diseases is increasingly important due to the aging population and the rising disease burden in the US. Diabetes, chronic kidney disease (CKD), and heart disease, which are among the five most prevalent chronic diseases in the country, can largely be managed in outpatient settings. However, without proper management, these conditions often lead to acute complications that necessitate hospitalization. This study evaluates the impact of the Medicaid Expansion Act on hospitalizations for diabetic ketoacidosis, CKD, and heart failure. Using a difference-in-differences (DiD) approach, this paper compares discharges billed under these three conditions in states that expanded Medicaid in 2014 and those that had not expanded until after 2019 or still have not expanded. Data from the State Inpatient Databases (SID), published under the Healthcare Cost and Utilization Project was used. The number of discharges between 2011 and 2019 was studied to allow for the assessment of pre and post-expansion outcomes. The analysis reveals that although states in the treatment and control groups experienced an increase in hospitalizations for CKD and Diabetic Ketoacidosis post Medicaid expansion, the treatment group had significantly fewer discharges post-treatment compared to the control group. Specifically, the average number of discharges decreased by 1856.6 (p = 0.043) for diabetic ketoacidosis and by 1970 (p=0.007) for CKD in states that expanded Medicaid in 2014. However, there was no significant difference between the treatment and control groups for patients with heart disease. These findings suggest that expanding Medicaid may improve chronic disease management in outpatient settings for diseases that are highly symptomatic and able to be managed systematically. However, for diseases that are less symptomatic, like heart disease, which is often termed the “silent killer”, simply improving access to medical insurance and healthcare is not sufficient.Khan, UmmaraAuthorSarkar, NeilAuthorBrown University. Alpert Medical School. Scholarly Concentration Program. Health Policyresearch programCardiovascular system--DiseasesDiabetesChronic renal failureMedicaidChronic diseasesEnglish2024Health PolicyAll rights reservedIn CopyrightAll Rights Reserved