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Author: Fabienne Miller Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
In 2006, the Massachusetts legislature passed a landmark health care reform bill (the Reform) that has served as a model for the national health care reform. By aiming to provide “access to affordable, quality, accountable health care,” the goals of this reform were to reduce the number of uninsured Massachusetts residents while containing health care costs and improving the quality of health care services. This bill has been the subject of much controversy at both the national and state level. Although most agree that the Reform has improved the insurance coverage rate of Massachusetts residents, the financial impact of the Reform has been of special concern with critics arguing that the Reform has increased the overall cost of health care. Despite this scrutiny, it is still unclear whether the goals of the Reform have been achieved. We propose to test a subset of the Reform's goals by examining at the hospital level whether the Massachusetts Health Care Reform has achieved its cost containment and quality improvement goals. We use Centers for Medicare & Medicaid Services (CMS) and Hospital Compare (HC) data to investigate this issue and study hospital costs and quality for the period spanning 2003 to 2009. To assess the impact of the Reform on costs and quality, we compare the change in Massachusetts hospital costs and quality pre- and post-Reform to changes in two states that provide a similar level of health care quality for the same period (namely, Connecticut and Wisconsin). Data from acute care hospitals show that there is no evidence that Massachusetts total hospital costs or salaries of departments providing clinical services were adversely affected by the Reform. Moreover, we find that quality of care improved for several quality measures post-Reform to a greater extent in Massachusetts than in our control states. In sum, our evidence is consistent with the claim that Massachusetts hospital costs were contained and quality improved subsequent to the Reform. Thus, this study provides preliminary support for the argument that the Reform achieved some of its financial and quality goals.
Author: Fabienne Miller Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
In 2006, the Massachusetts legislature passed a landmark health care reform bill (the Reform) that has served as a model for the national health care reform. By aiming to provide “access to affordable, quality, accountable health care,” the goals of this reform were to reduce the number of uninsured Massachusetts residents while containing health care costs and improving the quality of health care services. This bill has been the subject of much controversy at both the national and state level. Although most agree that the Reform has improved the insurance coverage rate of Massachusetts residents, the financial impact of the Reform has been of special concern with critics arguing that the Reform has increased the overall cost of health care. Despite this scrutiny, it is still unclear whether the goals of the Reform have been achieved. We propose to test a subset of the Reform's goals by examining at the hospital level whether the Massachusetts Health Care Reform has achieved its cost containment and quality improvement goals. We use Centers for Medicare & Medicaid Services (CMS) and Hospital Compare (HC) data to investigate this issue and study hospital costs and quality for the period spanning 2003 to 2009. To assess the impact of the Reform on costs and quality, we compare the change in Massachusetts hospital costs and quality pre- and post-Reform to changes in two states that provide a similar level of health care quality for the same period (namely, Connecticut and Wisconsin). Data from acute care hospitals show that there is no evidence that Massachusetts total hospital costs or salaries of departments providing clinical services were adversely affected by the Reform. Moreover, we find that quality of care improved for several quality measures post-Reform to a greater extent in Massachusetts than in our control states. In sum, our evidence is consistent with the claim that Massachusetts hospital costs were contained and quality improved subsequent to the Reform. Thus, this study provides preliminary support for the argument that the Reform achieved some of its financial and quality goals.
Author: Jonathan T. Kolstad Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
Abstract: In April 2006, the state of Massachusetts passed legislation aimed at achieving near universal health insurance coverage. A key provision of this legislation, and of the national legislation passed in March 2010, is an individual mandate to obtain health insurance. Although previous researchers have studied the impact of expansions in health insurance coverage among the indigent, children, and the elderly, the Massachusetts reform gives us a novel opportunity to examine the impact of expansion to near-universal health insurance coverage among the entire state population. In this paper, we are the first to use hospital data to examine the impact of this legislation on insurance coverage, utilization patterns, and patient outcomes in Massachusetts. We use a difference-in-difference strategy that compares outcomes in Massachusetts after the reform to outcomes in Massachusetts before the reform and to outcomes in other states. We embed this strategy in an instrumental variable framework to examine the effect of insurance coverage on utilization patterns. Using the Current Population Survey, we find that the reform increased insurance coverage among the general Massachusetts population. Our main source of data is a nationally-representative sample of approximately 20% of hospitals in the United States. Among the population of hospital discharges in Massachusetts, the reform decreased uninsurance by 36% relative to its initial level. We also find that the reform affected utilization patterns by decreasing length of stay and the number of inpatient admissions originating from the emergency room. Using new measures of preventive care, we find some evidence that hospitalizations for preventable conditions were reduced. The reform affected nearly all age, gender, income, and race categories. We also examine costs on the hospital level and find that hospital cost growth did not increase after the reform in Massachusetts relative to other states
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309083435 Category : Medical Languages : en Pages : 213
Book Description
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Author: Paul Heaton Publisher: ISBN: Category : Health care reform Languages : en Pages : 44
Book Description
Although it is widely recognized that health care reform has the potential to affect the volume and cost of medical care received through the workers0́9 compensation (WC) system, to date there is little empirical evidence of this effect. This study used the experience of Massachusetts, which implemented a health care reform package with several provisions similar to those in the Patient Protection and Affordable Care Act of 2010, to empirically estimate how health reform impacts WC hospital care. It was found that WC billing frequency for both emergency room visits and inpatient hospitalizations fell by 5 to 10 percent as a result of reform, but that billed charges and treatment volume were not measurably affected. These impacts were observable among patients with more costly injuries and persisted even after various approaches were used to account for the effects of the economic downturn that began at the end of 2007. While many outstanding questions about the impacts of health reform on WC remain, this early quantitative, empirical evidence suggests that reform may reduce medical costs borne by the WC system.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 030946921X Category : Medical Languages : en Pages : 161
Book Description
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Author: Dana Gelb Safran Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
As part of his Council on Economic Growth and Technology, Governor William F. Weld has commissioned a Task Force on the Health Care Industry to address issues surrounding the present the future role of that industry in the maintenance and growth of the Massachusetts economy. In addition to its role advising the Governor, it is expected that the task force will, from time to time, make its positions known to the congressional delegation. The task force will be jointly chaired by Ferdinand Colloredo-Mansfield, Chairman of the Board of Massachusetts General Hospital and Jerome H. Grossman, M.D., President of New England Medical Center. The task force will include representatives from the health care industry, Massachusetts businesses and the academic research community, whose combined expertise will inform its work on the following three objectives: First, the task force will address issues pertaining to the present and future role of the health care industry as a vital element of the Massachusetts economy. Economic and political pressures nationally and locally continue to require adaptation and realignment of the health care delivery sector. The task force will recommend to the Governor strategies by which to foster the appropriate restructuring and development of the Massachusetts health care sector while maintaining and advancing its position as a national and international leader in health care delivery and research. Second, the task force will address key concerns regarding the relationship between the health care sector and other elements of the Massachusetts economy. With representation from the Massachusetts business community along with the health care delivery and research communities, the task force will be well positioned to identify the impact of health acre costs on state businesses' competitive position and to recommend strategies through with to address these pressures. Lastly, the task force will monitor national health care reform legislation and evaluate its impact on the Massachusetts health care industry and the economy at large. In this capacity, the task force will propose strategies by which to implement any nationally mandated reforms within a framework that supports and fosters all sectors of the economy and maintains the Commonwealth's position as a global leader in health care delivery and research.
Author: Publisher: ISBN: Category : Languages : en Pages : 34
Book Description
The Massachusetts health care system is a critical component of the state's economy. Health care is the state's top industry, the largest employer of Massachusetts residents, and accounts for over 13 percent of its $365 billion Gross State Product (GSP). The Commonwealth Fund ranks Massachusetts first in terms of access to care and seventh overall among states on its State Scorecard, which measures health system performance. Massachusetts hospitals are often cited as among the best in the nation in terms of the quality of health care services provided, scoring higher than national average on treatment of major conditions. Furthermore, Massachusetts health insurers are consistently rated among the top ten best plans in each category nationwide. At the same time, Massachusetts is grappling with escalating health care costs, which are consuming a greater portion of the economy and lowering real wage growth. Some of the cost growth is driven by system-wide challenges, such as an aging population and the greater use and availability of increasingly complex levels of medical care, much of which can be uncoordinated. To that point, Massachusetts ranks in the lowest quartile of states for avoidable hospital use and costs on the Commonwealth Fund State Scorecard. However, some challenges, such as those that stem from the structure of the health care market place, are unique to Massachusetts and must be considered when identifying strategies to mitigate health care cost growth. This report examines the factors that contribute to high health care costs in Massachusetts, including the structure of the health care system and the payment methods currently used by Massachusetts health insurers. Understanding these factors will better prepare the Commonwealth to evaluate and develop reforms that have the potential to simultaneously contain cost growth and improve quality. Data describing the Massachusetts health care system are drawn from various published sources. Data on payment methods are based on the results of a 2009 questionnaire administered for the Division of Health Care Finance and Policy, in which Massachusetts insurers documented the ways in which they pay hospitals, physicians, and intermediary organizations (medical groups, Independent Practice Associations [IPAs] and physician-hospital organizations [PHOs]).
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309100070 Category : Medical Languages : en Pages : 383
Book Description
Performance Measurement is the first in a new series of an ongoing effort by the Institute of Medicine (IOM) to improve health care quality. Performance Measurement offers a comprehensive review of available measures and introduces a new framework to examine these measures against the six aims of the health care system: health care should be safe, effective, patient-centered, timely, efficient, and equitable. This new book also addresses the gaps in performance measurement and introduces the need for measures that are longitudinal, comprehensive, population-based, and patient-centered. This book is directed toward all concerned with improving the quality and performance of the nation's health care system in its multiple dimensions and in both the public and private sectors.
Author: Fabienne Miller
Author: Fabienne Miller
Author: Jonathan T. Kolstad
Author: Institute of Medicine
Author: Paul Heaton
Author: National Academies of Sciences, Engineering, and Medicine
Author: Massachusetts. Health Planning and Policy Committee
Author: Dana Gelb Safran
Author: 
Author: Institute of Medicine
Author: