SMU SOE Seminar Series (April 8, 2026): Covering the Uninsured with Primary Care Networks: Utilization and Spending Implications

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ABSTRACT

This paper examines how limited insurance coverage through Utah’s Primary Care Network (PCN) affects healthcare utilization and spending among previously uninsured individuals. Introduced in 2002, PCN provides coverage for primary and emergency care but excludes inpatient and specialty services to contain costs. We construct a novel person-month administrative dataset covering all hospital-based healthcare utilization among Utah residents from 2001 to 2005. Using event-study models, we compare utilization patterns of previously uninsured individuals who enroll in PCN to those of traditional Medicaid enrollees. Over the 36 months following PCN enrollment, emergency department visits increase by 21%, inpatient admissions decline by 28%, and hospital-based ambulatory visits fall by 42%. Total hospital spending increases modestly—by approximately 6%—driven primarily by mental health–related care.