Comparison of Inpatient Utilization for Traditional Medicaid and Healthy Michigan Recipients in Detroit

With the launch of the Healthy Michigan expansion of Medicaid eligibility in April 2014, enrollment in Medicaid in the three-county Detroit area increased quickly. By June 2016, area enrollment in Healthy Michigan reached 279,000, most of them single adult males, and most enrolled in a managed care plan. Healthy Michigan enrollees represented one-third of the 884,000 Medicaid beneficiaries in the Detroit area.

Anticipating that these new enrollees would have pent-up needs for care, the state initially set payment rates for their care to be higher than for other Medicaid enrollees. However, this analysis shows that rates of inpatient utilization for those enrolled in the Health Michigan managed care plans were relatively low in 2014, the first year of the program.

In the second year of the program, inpatient utilization rates for the newly enrolled Healthy Michigan population increased steadily, and by the middle of 2015, were similar to the rates for traditional Medicaid enrollees in the managed care plans.

While rates of use became similar, types of care being provided were not. Traditional Medicaid was dominated by pregnancy-related conditions, while septisemia, acute respiratory and cardiac events, kidney failure, and pancreatitis led the list for Healthy Michigan.

The full report is available here.