Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

A rising tide lifts all boats: Study links broader health insurance in Massachusetts with better health and care

11.12.2013
Compared with other New England states, health status and preventive care improved in Massachusetts after reform -- especially for poor and near-poor

In 2006, Massachusetts was on the same brink that the entire nation is on today: the brink of expanding health insurance to cover far more people than before, through government-driven, market-based reform.

Now, a new study shows the health of residents in that one trailblazing state improved measurably, especially among the poor and near-poor, in just the first five years -- compared with the health of residents in neighboring states. So did the use of some preventive care, specifically two tests designed to spot colon and cervical cancers early, and cholesterol tests to gauge heart disease risk.

Meanwhile, over those same five years, Massachusetts residents were increasingly likely to say they had health insurance and access to a personal doctor, and less likely to say that costs stood in the way of getting care, than other New Englanders. The changes occurred at similar rates for black, white and Hispanic residents.

Writing in the new issue of The Milbank Quarterly, the study's authors note that they can't be certain that all the population-wide differences between Massachusetts and its neighbors came directly from the expansion of insurance coverage. Other reforms likely had an impact, too. But their detailed statistical analysis, supported by the Commonwealth Fund, points firmly to a positive impact, especially among residents with the lowest incomes.

"Everyone has been looking over the past few years at Massachusetts, which was the first state to show the rest of the U.S. that near-universal coverage could be achieved," says first author Philip Van der Wees, Ph.D., a Dutch researcher who was at Harvard University when the study was conducted. "We found that people have gained in general, mental, and physical health, and that some preventive measures improved. We would hope that this would be a blueprint for the rest of the U.S., though Massachusetts is not the average state, because it began from a higher level of insurance," among the state's residents than the current U.S. average.

Van der Wees worked on the study with John Z. Ayanian, M.D., MPP, formerly of Harvard Medical School and now director of the University of Michigan Institute for Healthcare Policy and Innovation, and with Harvard health care statistics expert Alan Zaslavsky, Ph.D. Van der Wees at the time was a Commonwealth Fund Dutch Harkness Fellow in Health Care Policy and Practice; he is now at Radboud University Nijmegen Medical Center in the Netherlands.

"Our results demonstrate the potential benefits of health care reform in Massachusetts that may also be achieved through the implementation of the federal Affordable Care Act," says Ayanian.

"And, just as with the ACA, the impact of broader health insurance coverage in Massachusetts is intertwined with the effects of numerous efforts in the public and private sector to improve health care quality and contain costs," he adds.

Statewide surveys reveal changes

The data for the study came from annual random telephone surveys during 2001 through 2011 that asked 345,211 New Englanders questions about their general, physical and mental health, and their use of and access to health care services including cholesterol testing and screening for cancers of the breast, colon and cervix. The data were gathered by state health departments in conjunction with the federal Centers for Disease Control and Prevention.

The researchers used advanced statistical approaches to study the data collected between 2001 and 2011 as part of the CDC's Behavioral Risk Factor Surveillance System. This allowed them to detect subtle differences in health status and behaviors, and to analyze these differences further by income and race/ethnicity.

While the research didn't show huge jumps in any particular area of health, care, or access, the overall pattern is consistent with a positive impact from increased health insurance and other reforms, compared with states that didn't embark on major reform efforts. Even when the researchers excluded data from Vermont and Maine, which launched smaller-scale reform efforts, Massachusetts showed greater improvements.

The authors note that the "rising tide" effect in Massachusetts compared with other states was greater among those whose incomes were within 300 percent of the federal poverty level. These poor and near-poor residents had a faster rise in measures related to health care access and health status. The rate of changes in health status, access and care were similar among white, black and Hispanic residents, which means that deeply entrenched disparities in health likely persisted.

By studying access to care and health outcomes for five years after health reform took effect in Massachusetts, the authors also were able to distinguish how access to care and health outcomes changed over time. Whereas improvements in insurance coverage and reduced cost barriers to care were seen within one year after health reform, access to personal doctors improved after two years and gains in health status became evident after four years.

These statewide findings counter prior anecdotal perceptions that access to primary care worsened in Massachusetts after more residents gained insurance coverage.

The editor of the Milbank Quarterly, U-M Medical School professor Howard Markel, M.D., Ph.D., calls the study an important contribution to understanding of the potential implications of the federal Affordable Care Act.

"In an era of demagoguery and exaggeration posing as "facts" it is essential to collect and analyze solid evidence on our nation's health care policies," says Markel, the George E. Wantz Distinguished Professor of the History of Medicine and Director of the Center for the History of Medicine at U-M. "Indeed, it is the only way I know to approach the Sisyphean task of reforming and improving health care access for all Americans. Publishing and disseminating articles like this one is a solid start in that direction."

At the time of the study, Ayanian was at the Harvard Medical School and School of Public Health, and the Brigham and Women's Hospital. Now as director of U-M's IHPI, he leads a group of more than 400 researchers – many of them focused on evaluating the impact of the Affordable Care Act and other changes in health care policy and practice.

Kara Gavin | EurekAlert!
Further information:
http://www.umich.edu

More articles from Studies and Analyses:

nachricht Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland

nachricht Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

When Air is in Short Supply - Shedding light on plant stress reactions when oxygen runs short

23.03.2017 | Life Sciences

Researchers use light to remotely control curvature of plastics

23.03.2017 | Power and Electrical Engineering

Sea ice extent sinks to record lows at both poles

23.03.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>