Michigan’s Medicaid expansion was associated with more people receiving procedures for coronary artery disease without a negative effect on patient outcomes. That’s according to a recent research letter in the Journal of the American College of Cardiology.

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“Relative to the 24 months prior to the April 2014 expansion, patients having coronary revascularization procedures within 24 months afterward did equally as well,” says lead author Donald Likosky, Ph.D., associate professor of cardiac surgery at the University of Michigan.

“Despite the concern among some that Medicaid patients may be sicker than those with Medicare or private insurance and therefore at higher risk of poor outcomes, quality of care for cardiovascular procedures across Michigan was unchanged following Medicaid expansion.”

Few studies have evaluated the impact of Medicaid expansion within the surgical space, researchers behind the letter say.

The team studied two procedure options that improve blood flow to the heart for people with atherosclerosis: an open surgery procedure called coronary artery bypass grafting (CABG) and a minimally invasive treatment called percutaneous coronary intervention (PCI), or angioplasty.

The authors drew from clinically rich information about 7,558 CABG procedures performed at all 33 nonfederal cardiac surgical programs in Michigan, thanks to participation in the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, one of Blue Cross Blue Shield of Michigan’s Collaborative Quality Initiatives.

The PCI data came from 45,183 procedures at 47 Michigan hospitals participating in another physician collaborative: the Blue Cross Blue Shield of Michigan Cardiovascular Consortium.