Massachusetts health reforms: Uninsurance remains low, self-reported health status improves as state prepares to tackle costs

Health Affairs

Volumn 31, Issue 2, 2012, Pages 444-451

  Long, Sharon K ^a   Stockley, Karen ^b   Dahlen, Heather ^c  

^a UNIVERSITY OF MINNESOTA   (United States)

^b HARVARD UNIVERSITY   (United States)

^c UNIVERSITY OF MINNESOTA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; HEALTH CARE ACCESS; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH STATUS; HUMAN; SELF REPORT; UNITED STATES;

ADULT; COST CONTROL; DELIVERY OF HEALTH CARE; EMERGENCY SERVICE, HOSPITAL; HEALTH CARE REFORM; HEALTH SERVICES ACCESSIBILITY; HEALTH STATUS; HUMANS; MASSACHUSETTS; MEDICALLY UNINSURED; MIDDLE AGED; SELF REPORT; YOUNG ADULT;

EID: 84858597649     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2011.0653     Document Type: Article

References (20)

1. For a detailed summary of the legislation, see Blue Cross Blue Shield of Massachusetts Foundation. Massachusetts health care reform bill summary [Internet]. Boston (MA): The Foundation; 2006 [cited 2012 Jan 13]. Available from: http://www.bcbsmafoundation.org/foundationroot/en_US/documents/MassHCReformLawSummary.pdf
2. Although the Affordable Care Act draws on Massachusetts's reform initiative, there are important differences. See Seifert RW, Cohen AP (University of Massachusetts Medical School, Charlestown, MA). Re-forming reform: what the Patient Protection and Affordable Care Act means for Massachusetts [Internet]. Boston (MA): Blue Cross Blue Shield of Massachusetts Foundation; 2010 [cited 2012 Jan 13]. Available from: http://masshealthpolicyforum.brandeis.edu/forums/Documents/IssueBrief_ReportFINAL.pdf
3. See, for example, Long SK, Stockley K. Sustaining health reform in a recession: an update on Massachusetts as of fall 2009. Health Aff (Millwood). 2010;29(6):1234-41.
4. Cook A, Holahan J. Health insurance coverage and the uninsured in Massachusetts: an update based on 2005 Current Population Survey data [Internet]. Washington (DC): Urban Institute; 2007 Aug [cited 2012 Jan 13]. Available from: http://bluecrossfoundation.org/~/media/Files/Publications/Policy%20Publications/070800HealthInsCovAndUninsInMassAnUpdateCook.pdf
5. Early rounds of the Massachusetts Health Reform Survey included eighteen-year-olds. That was changed in 2010 to make the definition of adult consistent with that used by the Massachusetts Division of Health Care Finance and Policy in the Massachusetts Health Insurance Survey.
6. The survey is limited to nonelderly adults residing in the community. The sample size in 2008 was somewhat larger-3,868-to support oversamples based on geography and race or ethnicity in that year.
7. Long SK, Stockley K, Dahlen H. Health reform in Massachusetts as of fall 2010: getting ready for the Affordable Care Act and addressing affordability. Boston (MA): Blue Cross Blue Shield of Massachusetts Foundation; 2012.
8. The fall 2006 survey was fielded as Commonwealth Care, the statesponsored health insurance program for uninsured adults who meet income and other eligibility requirements, was beginning; however, enrollment started slowly
9. To access the Appendix, click on the Appendix link in the box to the right of the article online
10. Authors' tabulations based on the 2010 American Community Survey. See King M, Ruggles S, Alexander J, Flood S, Genadek K, Schroeder M, et al. Integrated public use microdata series, American Community Survey [machine-readable database]. Minneapolis (MN): University of Minnesota; 2010.
11. Cohen RA, Ward BW, Schiller JS. Health insurance coverage: early release of estimates from the National Health Interview Survey, 2010 [Internet]. Hyattsville (MD): National Center for Health Statistics; 2011 Jun [cited 2012 Jan 13]. Available from: http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201106.pdf
12. Massachusetts Division of Health Care Finance and Policy. Health insurance coverage in Massachusetts: results from the 2008-2010 Massachusetts Health Insurance Surveys [Internet]. Boston (MA): The Division; 2010 Dec [cited 2012 Jan 13]. Available from: http://www.mass.gov/eohhs/docs/dhcfp/r/pubs/10/mhis-report-12-2010.pdf
13. In addition to the 2006 reform initiatives, Massachusetts has invested in strategies directly designed to reduce emergency department use, such as an emergency department diversion program supported by a $4.5 million grant from the Centers for Medicare and Medicaid Services.
14. Eccleston S. Challenges in coordination of health care services [Internet]. Boston (MA): Massachusetts Division of Health Care Finance and Policy; 2011 Jun 30 [cited 2012 Jan 13]. Available from: http://www.mass.gov/eohhs/docs/dhcfp/cost-trend-docs/cost-trends-docs-2011/eccleston-stacey-june-30.pdf
15. Authors' tabulations based on the 2006-10 National Health Interview Surveys. See Minnesota Population Center and State Health Access Data Assistance Center. Integrated Health Interview Series: version 4.0 [machine-readable database]. Minneapolis (MN): University of Minnesota; 2011.
16. Data were obtained using the following selection criteria: (1) Premiums and Contributions of Plans of Employees Enrolled at Private-Sector Establishments; (2) Single, Employee-plus-one, and Family Plans Separately; (3) All Provider Types Combined; (4) Average Total Employee Contribution; (5) Specific States; (7) Massachusetts; and (8) All Firms. Information obtained from: Agency for Healthcare Re-search and Quality. Medical Expenditure Panel Survey/Insurance Component data tables. In: MEPSnet/IC Trend Query system [Internet]. Rockville (MD): AHRQ; [last updated 2011 Jul 13; cited 2012 Jan 20]. Available from: http://meps.ahrq.gov/mepsweb/data_stats/MEPSnetIC.jsp
17. Massachusetts Division of Health Care Finance and Policy. Massachusetts health care cost trends: trends in health expenditures [Internet]. Boston (MA): The Division; 2011 Jun [cited 2012 Jan 13]. Available from: http://www.mass.gov/eohhs/docs/dhcfp/cost-trend-docs/cost-trendsdocs-2011/health-expendituresreport.pdf
18. Patrick DL. An Act Improving the Quality of Health Care and Controlling Costs by Reforming Health Systems and Payments: text of filing letter [Internet]. Boston (MA): Office of the Governor; 2011 Feb 17 [cited 2012 Jan 13]. Available from: http://www.mass.gov/governor/legislationeexecorder/legislation/health-care-system-and-paymentreform.html
19. Chernew M, Mechanic R, Landon B, Safran D. Private-payer innovation in Massachusetts: the "Alternative Quality Contract." Health Aff (Millwood). 2011;30(1):51-61.
20. See, for example, Kaiser Family Foundation. Kaiser health tracking poll-December 2011 [Internet]. Menlo Park (CA): KFF; [cited 2012 Jan 13]. Available from:http://www.kff.org/kaiserpolls/8265.cfm