Annual report on Montana Medicaid shows consistent improvement in health coverage, access to services, health outcomes, and reduction in costs for enrollees

New data finds state general fund spending on Medicaid has remained stable since before Montana expanded Medicaid.

Bozeman, Mont. (April 30, 2024) – The Montana Healthcare Foundation released its fourth annual report on Montana’s Medicaid program. Report findings show that people who enrolled in Medicaid through Medicaid expansion had fewer visits to the ER, health care-related costs declined, and spending patterns progressively shifted toward lower-cost outpatient care each year they had health coverage.

New data also shows that Medicaid has consistently accounted for about 13% of Montana’s state general fund spending since 2015, the year before Medicaid expansion was implemented (pgs. 22-23).

Medicaid coverage allows Montanans to access primary care, mental illness and substance use treatment, emergency and hospital care, and specialty services such as cancer care and surgery. Consistent with national research, this report shows for the third consecutive year that access to these services is contributing to better health outcomes for Montanans, accompanied by decreased emergency and hospital costs.

Dr. Aaron Wernham,
Montana Healthcare Foundation CEO

Key findings with corresponding report pages include:

• Medicaid expansion provides health care coverage to nearly 110,000 adults with low income. Implementing the program led to a reduction in the number of people without health insurance, dropping the state’s uninsured rate by more than 50% since 2013 (pgs. 33-34). (Updated uninsured rate estimates following the conclusion of the Medicaid eligibility redetermination process in 2023 were unavailable.)
• People who have health insurance under Medicaid expansion access preventive services and care for chronic conditions. In 2022 (the most recent year for which complete data were available), 3,800 people started diabetes treatment, 6,100 people got treatment for substance use disorders, and 35,000 people accessed mental health services (pgs. 35-37).
• Medicaid is a critical source of health care coverage for American Indian people, who comprise only 6.5% of the state population but 20% of Medicaid enrollment. In 2022, more than 10,700 American Indian people in Montana received preventive services—an increase of 17% from the year prior (pgs. 10, 38-39).
• Medicaid expansion coverage contributes to fewer visits to the ER. Between their first and third years of having health insurance, the number of Medicaid expansion enrollees needing emergency care decreased by 10.5%, and the number of people going to the ER for preventable dental conditions declined by about 30% (pgs. 40-42).
• Health care costs also shifted from more intensive emergency and inpatient care to outpatient services and pharmacy, suggesting improved health outcomes. Emergency and inpatient costs comprised 28% of expansion member costs during their first year of enrollment, which decreased to 24% by their third year (pg. 43).
• Medicaid expansion also controls health care costs. Implementing Medicaid expansion generated more than $28 million in state budget savings by providing higher match rates for some existing Medicaid populations and replacing state spending with new federal dollars (pg. 45).

2024 Medicaid in Montana: How Medicaid Impacts Montana’s State Budget, Economy, and Health was produced by Manatt Health and commissioned by the Montana Healthcare Foundation.

Manatt Health integrates legal and consulting expertise to better serve the complex needs of clients across the health care system. Combining legal excellence, first-hand experience in shaping public policy, sophisticated strategy insight, and deep analytic capabilities, Manatt Health provides uniquely valuable professional services to the full range of health industry players. Our diverse team of more than 200 attorneys and consultants is passionate about helping our clients advance their business interests, fulfill their missions, and lead health care into the future. For more information, visit Manatt.com/Health.