%0 Journal Article
%T Effects of Medicaid Accountable Care Organizations on children's access to and utilization of health services.
%A Constantin J
%A Wehby GL
%J Health Serv Res
%V 59
%N 5
%D 2024 Oct 8
%M 39118199
%F 3.734
%R 10.1111/1475-6773.14370
%X <B>OBJECTIVE: </B>To evaluate the effects of Medicaid Accountable Care Organizations (ACOs) on children's access to and utilization of health services.<BR><B>METHODS: </B>This study employs difference-in-differences models comparing ACO and non-ACO states from 2018 through 2021. Access measures are indicators for preventive and sick care sources, unmet healthcare needs, and having a personal doctor or nurse. Utilization measures are preventive and dental care, mental healthcare, specialist visits, emergency department visits, and hospital admissions.<BR><B>UNASSIGNED: </B>Secondary, de-identified data come from the 2016-2021 National Survey of Children's Health. The sample includes children with public insurance and ranges between 21,452 and 37,177 depending on the outcome.<BR><B>RESULTS: </B>Medicaid ACO implementation was associated with an increase in children's likelihood of having a personal doctor or nurse by about 4 percentage-points concentrated among states that implemented ACOs in 2018. Medicaid ACOs were also associated with an increase in specialist care use and decline in emergency visits by about 5 percentage-points (the latter being concentrated among states that implemented ACOs in 2020). There were no discernable or robust associations with other pediatric outcomes.<BR><B>CONCLUSIONS: </B>There is mixed evidence on the associations of Medicaid ACOs with pediatric access and utilization outcomes. Examining effects over longer periods post-ACO implementation is important.