People More Likely to be Identified with Diabetes Early Through Medicare Expansion

From QuestDiagnostics:

MADISON, N.J.,March 23, 2015/PRNewswire/ People in states that expanded Medicaid under the Affordable Care Act (ACA) are far more likely to be newly identified with diabetes than in states that elected not to expand the public health care program, finds a new study by researchers atQuest Diagnostics(NYSE:DGX). Published online today inDiabetes Care, the official publication of the American Diabetes Association, the study is believed to be one of the first nationally representative analyses of the impact of the ACA in promoting earlier diagnosis of, and potentially better outcomes for, diabetes.

From Diabetes Care Abstract


Newly identified diabetes was defined as an ICD-9 diagnosis code of 250.x (di- abetes) or hemoglobin A1c of >6.4% (46 mmol/mol) within the first 6 months of a calendar year and the absence of both in the preceding calendar year within our data repository.


We identified 215,398 and 218,890 patients who met our definition of newly diagnosed diabetes within the first 6 months of 2013 (control period) and 2014 (study period), respectively (a 1.6% increase). We identified 26,237 Medicaid- enrolled patients with new diabetes in the control period vs. 29,673 in the study period: an increase of 13%. The number of Medicaid-enrolled patients with newly identified diabetes increased by 23% (14,625 vs. 18,020 patients) in the 26 states (and District of Columbia) that expanded Medicaid compared with an increase of 0.4% (11,612 vs. 11,653 patients) in the 24 states that did not expand Medicaid during this period. Similar differences were observed in younger and older adults and for both men and women.


This study suggests that in the states that expanded Medicaid under the ACA, an increased number of Medicaid patients with diabetes are being diagnosed and treated earlier. This could be anticipated to lead to better long-term outcomes.

Diabets Care Editorial

In an accompanying editorial,William T. Cefalu, M.D., editor in chief,Diabetes Care, andWilliam H. Herman, M.D., wrote, Kaufman et al. have again demonstrated that Medicaid expansion increases the number of low-income Americans with newly identified diabetes and will likely improve their outcomes. The data demonstrate the benefits of Medicaid expansion, yet nearly half of our states have chosen not to expand this benefit to their citizens. The real-world benefits and costs of Medicaid expansion merit additional research and civil debate. And perhaps most important, their results should be used to guide health pol- icy to address the growing burden of chronic diseases.