The Impacts of Medicaid Status on Venous Leg Ulcer Outcomes

Introduction: To quantify race, gender, comorbidities, Medicaid status, and compare health outcomes for Medicare-only versus Medicare/Medicaid dual-enrolees who develop a hard-to-heal venous leg ulcer (VLU).Methods:Medicare Limited Data Standard Analytic Hospital Inpatient and Outpatient Department Files were used to follow VLU episodes from October 1, 2015, through October 2, 2019. Patients diagnosed concurrently with chronic venous insufficiency and a VLU were propensity-matched and cohorts split into patients enrolled in Medicare-only (73%) and those enrolled in Medicare and Medicaid (dual-enrolees, 27%). Episode claims were used to document demographics, comorbidities, and treatments of Medicare enrolees who developed VLUs and outcomes such as time to ulcer closure, rates of complications, and hospital utilization rates. Quality of Life (QoL) metrics, such as pain and time to VLU closure, were compared across the groups.Results:530,220 Medicare beneficiaries evaluated in this analysis were Medicare/Medicaid dual-enrolees. To qualify for Medicaid, their income had to be below 133% of the federal poverty level. Only 3% of Medicare-only patients and 6% of dual-enrolees had an Advantage plan, lower than the general Medicare population. Dual-enrolees, had Charlson Comorbidity Index (CCI) scores 1 point greater (p