Increased Utilization of Ambulatory Occupational Therapy and Physical Therapy After Medicaid Expansion.

Objective: To determine if Medicaid expansion in 2014 improved utilization of ambulatory physical therapy and occupational therapy.

Design: Secondary data, pre-post analysis study using a difference in differences approach. The study compared utilization rates and likelihood of an ambulatory therapy visit for Medicaid ambulatory therapy patients in the pre-expansion (2012-2013) period and postexpansion (2014-2015) period. A descriptive analysis of utilization and logistic regression with a difference in differences approach of the odds of a therapy visit was conducted.

Setting: Not applicable.

Participants: The 2012-2015 public use data files of the Medical Expenditure Panel Survey- Household Component.

Main Outcome Measures: Descriptive results and the odds ratio of an ambulatory therapy visit were determined.

Results: About 788,233 more Medicaid beneficiaries had an ambulatory therapy visit after Medicaid expansion. By subpopulation, the increases in utilization were greatest for beneficiaries from low-income households and beneficiaries living in the west census region. Policy change increased the odds of a therapy visit for a Medicaid beneficiary by 27%.

Conclusions: Utilization of ambulatory therapy by Medicaid beneficiaries increased after Medicaid expansion.