Table 1.

Overview of Literature on Prevalence of Non-communicable Chronic Diseases or Medical Costs Among Medicaid Beneficiaries, 2000–2016 (n=29)

Author (year)	Title	Study population	Data source
Bagchi (2007)12	Utilization of, and adherence to, drug therapy among Medicaid beneficiaries with congestive heart failure	Medicaid beneficiaries of any age in Arkansas, California, Indiana, and New Jersey continuously enrolled during the study period and diagnosed with CHF	1998 State Medicaid Research Files and 1999 Medicaid Analytic eXtract for Arkansas, California, Indiana, and New Jersey (n=45,572)
Buescher (2010)13	Medical care costs for diabetes associated with health disparities among adult Medicaid enrollees in North Carolina	North Carolina Medicaid enrollees aged ≥18 years	North Carolina Medicaid claims data, 2007–2008 (n=812,717)
Chang (2013)14	Potential adult Medicaid beneficiaries under the Patient Protection and Affordable Care Act compared with current adult Medicaid beneficiaries	U.S. adults aged 19–64 years enrolled in Medicaid	NHANES, 2007–2010 (n=991)
Cheung (2012)15	National study of barriers to timely primary care and emergency department utilization among Medicaid beneficiaries	U.S. adults aged ≥18 years enrolled in Medicaid	NHIS, 1999–2009 (n=24,986)
Christopher (2016)16	Access to care and chronic disease outcomes among Medicaid-insured persons versus the uninsured	U.S. Medicaid beneficiaries aged 18–64 years with a household income of <138% the federal poverty level	NHANES, 1999–2012 (n=1,485)
Clemans-Cope (2013)17	The expansion of Medicaid coverage under the ACA: implications for healthcare access, use, and spending for vulnerable low-income adults	U.S. adults aged 19–64 years enrolled in Medicaid, excluding dual eligibles and pregnant women, with household income of <138% the federal poverty level and with one or more chronic conditions (including mental illnesses)	MEPS, 2003–2009 (n=3,261)
Decker (2013)18	Health status, risk factors, and medical conditions among persons enrolled in Medicaid versus uninsured low-income adults potentially eligible for Medicaid under the Affordable Care Act	U.S. adults aged 19–64 years enrolled in Medicaid (excluding dual eligibles) with household income <138% the federal poverty level	NHANES, 2007–2010 (n=471)
Downie (2011)19	Racial disparities in blood pressure control and treatment differences in a Medicaid population, North Carolina, 2005–2006	North Carolina Medicaid enrollees aged ≥21 years who identified as “black” or “white” race who were enrolled for at least 11 months and diagnosed with hypertension, excluding those with claims for cardiologist or endocrinologist office visits or on dialysis for end-stage renal disease	North Carolina Medicaid administrative data, 2005–2006 (n=3,514)
D’Souza (2014)20	Clinical and economic burden of COPD in a Medicaid population	U.S. adults aged ≥40 years continuously enrolled in Medicaid FFS and diagnosed with COPD, including dual eligibles and excluding those with comorbid cystic fibrosis, bronchiectasis, respiratory cancer, pulmonary fibrosis, pneumoconiosis, sarcoidosis, or pulmonary tuberculosis	MarketScan, 2003–2007 (n=10,221)
Epstein (2008)21	Cost of care for early- and late-stage oral and pharyngeal cancer in the California Medicaid population	California Medicaid FFS beneficiaries aged 18–100 years diagnosed with oral or pharyngeal cancer with 1 year of continuous enrollment after diagnosis	California Medicaid claims data, 1995–2003 (n=229)
Esposito (2009)22	Medicaid beneficiaries with congestive heart failure: association of medication adherence with healthcare use and costs	Medicaid beneficiaries of any age in Arkansas, California, Indiana, or New Jersey continuously enrolled in FFS, diagnosed with CHF in 1998 (defined as at least one hospitalization or at least two ambulatory visits with CHF diagnosis) and at least one CHF drug claim	1998 State Medicaid Research Files, 1999 Medicaid Analytic eXtract, and 1999 Medicare Standard Analytic File for Arkansas, California, Indiana, and New Jersey (n=37,408)
Garis (2002)23	Examining costs of chronic conditions in a Medicaid population	Kentucky Medicaid beneficiaries of any age with at least one claim for one of the studied diseases	Oklahoma Medicaid claims data, 1995 (n=41,159)
Gilmer (2004)24	Adherence to treatment with antipsychotic medication and healthcare costs among Medicaid beneficiaries with schizophrenia	San Diego Medicaid beneficiaries of any age diagnosed with schizophrenia and continuously enrolled in FFS for 12 months, excluding dual eligibles	San Diego County Adult Mental Health Services data linked with California Medicaid claims data, 1998–2000 (n=2,801 person-years)
Guo (2007)25	Treatment costs related to bipolar disorder and comorbid conditions among Medicaid patients with bipolar disorder	U.S. Medicaid beneficiaries aged <65 years diagnosed with bipolar disorder, excluding those diagnosed with schizophrenia	PHARMetrics, 1998–2002 (n=13,471)
Hankin (2011)26	Patients with obsessive compulsive disorder versus depression have comparable healthcare costs: a retrospective claims analysis of Florida Medicaid enrollees	Florida Medicaid beneficiaries aged ≥18 years diagnosed with pure OCD (OCD without depression or other major mental disorders) or pure depression	Florida Medicaid claims data, 1997–2006
Hill (2014)27	Adults in the income range for the Affordable Care Act’s Medicaid expansion are healthier than pre-ACA enrollees	U.S. adults aged 19–64 years enrolled in Medicaid, excluding dual eligibles, those enrolled because of disability, those with limited benefits, and pregnant women	MEPS, 2005–2010 (n=6,005)
Khoury (2013)28	The association between chronic disease and physical disability among female Medicaid beneficiaries aged 18–64 years	Female Florida Medicaid enrollees aged 18–64 years continuously enrolled during the study period, excluding dual eligibles or those with limited benefits	Florida Medicaid eligibility and claims data, 2001–2005 (n=74,851)
Lin (2010)29	Economic implications of comorbid conditions among Medicaid beneficiaries with COPD	Maryland Medicaid enrollees aged 40–64 years diagnosed with COPD and continuously enrolled 12 months before and after first claims for diagnosed COPD	Maryland Medicaid claims data, 2001–2003 (n=1,388)
McCombs (2000)30	The use of conventional antipsychotic medications for patients with schizophrenia in a Medicaid population: therapeutic and cost outcomes over 2 years	California Medicaid beneficiaries aged 14–100 years diagnosed with schizophrenia and continuously enrolled for 2 years following initiation of treatment	California Medicaid claims data, 1987–1996 (n=2,467)
Mullins (2004)31	Economic disparities in treatment costs among ambulatory Medicaid cancer patients	Maryland Medicaid beneficiaries aged ≥18 years diagnosed with breast, colorectal, or prostate cancer	Maryland Medicaid administrative claims data, 1999–2000
Piecoro (2001)32	Asthma prevalence, cost, and adherence with expert guidelines on the utilization of healthcare services and costs in a state Medicaid population	Kentucky Medicaid enrollees of any age (n=530,000); cost estimates for those diagnosed with asthma, excluding those diagnosed with COPD (n=24,365)	Kentucky Medicaid administrative data, 1996
Priest (2011)33	Quality of care associated with common chronic diseases in a nine-state Medicaid population utilizing claims data: an evaluation of medication and healthcare use and costs	Medicaid FFS beneficiaries aged <65 years enrolled at least 6 months, excluding dual eligibles	MarketScan, 2007 (n=2,812,849)
Shaya (2009)34	Burden of COPD, asthma, and concomitant COPD and asthma among adults: racial disparities in a Medicaid population	Maryland Medicaid beneficiaries aged 40–60 years diagnosed with asthma, COPD, or both, excluding dual eligibles	Maryland Medicaid Managed Care patient encounter data, 2001–2003 (n=9,131)
Subramanian (2011)35	Impact of Medicaid copayments on patients with cancer: lessons for Medicaid expansion under health reform	Georgia, South Carolina, and Texas Medicaid beneficiaries aged 21–64 years, diagnosed with cancer, and continuously enrolled in FFS for at least 6 months after diagnosis, excluding pregnant women	Georgia, South Carolina, and Texas Medicaid administrative data linked with cancer registry data, 1999–2004 (n=10,241)
Subramanian (2013)36	Impact of chronic conditions on the cost of cancer care for Medicaid beneficiaries	Georgia, Maine, and Illinois Medicaid beneficiaries aged 21–64 years diagnosed with cancer and continuously enrolled for 3 months prior and 6 months following diagnosis, excluding dual-eligibles	Georgia, Maine, and Illinois Medicaid administrative data linked with cancer registry data, 2000–2003 (n=6,212)
Svarstad (2001)37	Using drug claims data to assess the relationship of medication adherence with hospitalization and costs	Wisconsin Medicaid beneficiaries aged ≥18 years continuously enrolled for 12 months and diagnosed with severe mental illness	Wisconsin Medicaid claims data and data from a prior study (system and medical records and a client assessment questionnaire), 1989–1990 (n=619)
Widmer (2015)38	The association between office-based provider visits and emergency department utilization among Medicaid beneficiaries	U.S. adults aged 18–64 years enrolled for a full year in Medicaid, excluding pregnant women and dual eligibles or others with additional insurance coverage	MEPS, 2009 (n=1,497)
Wu (2011)39	Medical utilization and costs associated with statin adherence in Medicaid enrollees with type 2 diabetes	Medicaid beneficiaries aged ≥18 years diagnosed with diabetes and hyperlipidemia and continuously enrolled 1 year pre-index date and 1 year post-index, excluding dual eligibles	MarketScan, 2004–2006 (n=1,705)
Yang (2016)40	Association of antihypertensive medication adherence with healthcare use and Medicaid expenditures for acute cardiovascular events	Medicaid beneficiaries aged 18–62 years enrolled in Medicaid FFS beginning January 1, 2007, and continuously enrolled for at least 36 months, diagnosed with hypertension and taking antihypertensive medication; excludes dual eligibles and patients with diagnoses for cancer or end-stage renal disease	MarketScan, 2007–2012 (n=59,037)

ACA, Affordable Care Act; CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease; FFS, fee-for-service; MEPS, Medical Expenditure Panel Survey; NHANES, National Health and Nutrition Examination Survey; NHIS, National Health Interview Survey; OCD, obsessive compulsive disorder.