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The Effects of the Affordable Care Act on Insurance Coverage of the Maxillofacial Trauma Patient
C Francisco Sanchez-Navarro, MD; David Jerkins, MD; R Michael Johnson, MD
Wright State University
2016-02-08
Presenter: C Francisco Sanchez-Navarro
Affidavit:
R Michael Johnson
Director Name: R Michael Johnson
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
BACKGROUND: The maxillofacial trauma patient demographic has been under-insured leading to poor reimbursement rates. The Affordable Care Act (ACA) was passed into law in March 2010. The ACA was fully implemented in January 2014. The purpose of this article is to review the effects of the ACA on insurance coverage of maxillofacial trauma patients.
METHODS: A review of patients treated for maxillofacial trauma at a Level 1 trauma center was undertaken. Insurance status was grouped into Medicare, Medicaid, other government, workers compensation, commercial insurance, and self-pay. Patients treated were categorized based on year of admission date: before the ACA, at the midpoint of the ACA implementation and after full implementation. The data were analyzed with IBM SPSS.
RESULTS: A total of 1220 patients with maxillofacial trauma were included for the years 2008-2014. No difference in the age or ICU length of stay (mean 2.24, p = 0.127) was found. Significant differences were noted in the Injury Severity Score and length of stay (p = 0.0001). In all groups commercial insurance was the most common payer. There was a significant increase in Medicaid and decrease in self-pay patients (p = 0.037).
CONCLUSIONS: following the implementation of the ACA, our hospital saw a statistically significant increase in Medicaid patient coverage with a concomitant decrease in uninsured patients. Though commercial insurance remains the most common payer, a downward trend has been noticed over the study period. This study provides insight into the insurance coverage trends following the passing of the ACA.
