How the ACA impacts cardiovascular care for underserved patients

Expanding Medicaid under the Affordable Care Act (ACA) has led to some improvements in cardiovascular care for underserved racial and ethnic patient populations—but there is still plenty of room for improvement.

That’s the message of new findings presented Friday, May 15, at the American Heart Association’s Quality of Care & Outcomes Research (QCOR) Scientific Sessions 2020. The virtual conference continues through Saturday, May 16.

Lead author Khadijah Breathett, MD, MS, and colleagues analyzed data from more than 270,000 patients, exploring how outcomes were different in states where Medicaid was expanded through the ACA by 2014.

The researchers noted, for example, that Hispanic patients from Medicaid expansion states were 146% more likely to be recommended key heart failure medications. Also, Asian patients in those states were 44% more likely to receive a follow-up heart failure appointment.

“Lack of insurance contributes to racial and ethnic health inequities among U.S. heart failure patients,” Breathett, an assistant professor of cardiology at the University of Arizona College of Medicine, said in a statement. “We were pleased to find that ACA Medicaid expansion was associated with increased delivery of cardiovascular care to racial and ethnic minority groups. Heart failure education and follow-up appointments can empower patients, contribute to better medical management and may prevent future hospitalizations.”

Expanding Medicaid, of course, did not wipe out any and all healthcare disparities. “No significant differences” were found when comparing heart failure care for patients in other racial and ethnic patient populations.

“Based on these findings, increased adoption of the ACA Medicaid expansion may reduce racial and ethnic disparities in heart failure treatment and outcomes,” Breathett added. “However, health equity will require substantial changes in policy and additional investigation of interventions that may reduce barriers to care.”

More information about QCOR 2020 is available here.