Inpatient Medicaid Costs Dropped With Increased SNAP Benefits Interview with:

Rajan Anthony Sonik Lurie Institute for Disability Policy Heller School for Social Policy and Management Brandeis University Waltham, MA

Rajan Anthony Sonik

Rajan Anthony Sonik
Lurie Institute for Disability Policy
Heller School for Social Policy and Management
Brandeis University
Waltham, MA

Medical Research: What is the background for this study? What are the main findings?

Response: We know that food insecurity (experiencing hunger, insufficient food, or concerns about having enough food) is associated with a host of health problems, ranging from behavior health conditions to iron deficiencies. However, understanding the relationship between food insecurity and healthcare utilization and cost patterns has been more difficult to assess with available data. Presumably, rises in food insecurity should worsen health, which in turn should increase healthcare utilization and ultimately costs.

To examine this topic, I actually looked at this in the opposite way by asking if a decrease in food insecurity might lead to decrease in costs. The opportunity to do so arose in the form of the April 2009 increase in benefit levels for the Supplemental Nutrition Assistance Program (SNAP; formerly the Food Stamps Program) that were part of the American Recovery and Reinvestment Act (commonly referred to as the “stimulus package”). SNAP has been shown to alleviate food insecurity, and so this increase in benefits created the chance to explore my question. I analyzed Massachusetts data from October 2006 to August 2012 using interrupted time series models and found that inpatient Medicaid cost growth in Massachusetts fell by 73% (p = 0.003) after the increase in SNAP benefits. Moreover I found that decreased admissions were the primary driver of this outcome rather any patterns in health care inflation. In addition, I found that, for people with selected chronic illnesses that create heightened sensitivity to food insecurity, the drop in cost growth was even greater (the diseases studied were sickle cell disease, diabetes, malnutrition/failure to thrive, inflammatory bowel disease, asthma, and cystic fibrosis).

Medical Research: What should clinicians and patients take away from your report?

Response: This study explored one specific social determinant of health—hunger, but it adds to the growing body of literature emphasizing the importance of these factors to the health and wellbeing of patients. Moreover, its findings further indicate the contribution of these factors to growing costs in our healthcare system.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Continued examination of the effect of alleviating social ills such as hunger on health outcomes and costs seems warranted. In particular, this study had limitations in that it was focused only on Massachusetts and the inpatient setting. Future research into other settings could potentially offer important new insights and uncover additional nuances.


Am J Public Health. 2016 Jan 21:e1-e6. [Epub ahead of print]

Massachusetts Inpatient Medicaid Cost Response to Increased Supplemental Nutrition Assistance Program Benefits.

Sonik RA1.

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Rajan Anthony Sonik (2016). Inpatient Medicaid Costs Dropped With Increased SNAP Benefits

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