Health System: Broader Health Insurance Linked to Better Care

12/13/2013
Photo: Waiting room

Compared with other New England states, health status and preventive care improved in Massachusetts in the last five years, especially for poor and near-poor; © panthermedia.net/Cathy Yeulet

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

A new study shows the health of residents in that state improved measurably 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.

The study's authors note that they cannot 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.

"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 John Z. Ayanian, director of the University of Michigan Institute for Healthcare Policy and Innovation. "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.

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.

MEDICA.de; Source: University of Michigan