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November 16, 2017

Dean Baicker, Whose Medicaid Research Has Been Politicized, Discourages “Cherry-Picking Results"

Harris School Dean Katherine Baicker delivered a presentation Monday discussing the results of a significant study she conducted on the effects of Medicaid expansion in Oregon.

The study, whose key findings were published in 2013, did not find measurable improvements in health outcomes—which Republican Medicaid skeptics have used to support their position—but did find that people with Medicaid say that they receive better care and report less depression.

Baicker talked about the importance of looking at data objectively and picking similar data cohorts for any study. “When conducting statistical analyses, we must make sure we are comparing apples to apples and oranges to oranges,” Baicker said.

Baicker also explained the selection of Oregon as the case study for her project. “In 2008, when Oregon expanded Medicaid to extend coverage to 10,000 more people, we saw it as a great opportunity to study Medicaid,” she said. She was also attracted to the state for her project because it used a random number generator to provide Medicaid insurance coverage, naturally creating a randomized trial setting for the researchers.

During the study, Baicker and her partner Amy Finkelstein, an economics professor at MIT, looked at health outcomes, use of various health services, and financial well-being among low-income adults in Oregon.

Baicker’s study found that an expansion of the state-subsidized health insurance increased the use of primary and preventive health care and state spending on care by 25 to 35 percent. While the expansion did not lead to any significant improvement in health outcomes, people were shown to be 30 percent less likely to experience depression when on Medicaid than when they were not.

Baicker attributed this variation in depression rates to the greater financial security that comes with having medical insurance.

The study, however, showed that expanding coverage also increased hospitalization rates. “Many people were surprised by this outcome, but an economist wouldn’t find this surprising; people who were covered now had access to an expensive service at a zero or minimal price,” Baicker said.

In addition to talking about the impacts of health insurance expansion, Baicker also commented on the reactions to her study. She mentioned that many people view only results that fit their ideologies instead of looking at the study comprehensively.

“Cherry-picking results will give you a distorted version of the truth…. What this study aims to do is present the facts so people and policymakers can make key decisions,” Baicker said.

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Baicker studies health care policy, health care reforms, and health insurance finance as the C. Boyden Gray Professor of Health Economics at Harvard University.

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