The Medicaid for Employed People with Disabilities (MEPD) program allows individuals with disabilities to continue receiving Medicaid while they go back to work. Enrollees who take advantage of MEPD are allowed to make up to 250% of the federal poverty level, while retaining some assets. The goal of this program is to enable people with disabilities to work for income without losing health care coverage. Nationally and locally, comparisons of costs for people with disabilities who work with those who do not indicate that working people have lower health care costs. These preliminary findings suggest that working increases productivity while decreasing costs.
This study is designed to determine whether participation in the MEPD reduces health care costs. Though previous studies suggest health care costs savings, no study has modeled the relationship between MEPD enrollment and cost. Lack of sophisticated methods to control for selection bias and account for treatment effects on the untreated may provide overstated results that are not generalizable to the population.
Aim 1: Recreate previous findings indicating that health care costs are lower for people with disabilities enrolled in MEPD than those not enrolled in MEPD.
Aim 2: Determine the differences between people who enroll in MEPD and those who do not enroll in MEPD. Comparisons will include, but not be limited to, age, gender, race, length of time in Medicaid, waiver program participation, previous use of services, diagnosis types and number.
Aim 3: Assess whether changes in health care costs are related to specific groups of people with disabilities who enroll in MEPD. This analysis is primarily designed to determine if there are target groups who benefit more from MEPD enrollment.
Aim 4: Construct a regression model predicting health care costs using participation in the MEPD program as an independent variable. In addition we will calculate a propensity score to control for bias in program enrollment and construct instrumental variables to help determine what changes in cost may be anticipated if additional people are enrolled in MEPD.