Research by Author & Topic

Publications by Sharon K. Long on Health and Health Care

Massachusetts began an ambitious push toward near universal health insurance coverage in 2006. This policy brief provides an update of the impacts of health reform in Massachusetts on insurance coverage as of Fall 2008 for working-age adults, the primary target population of the reform initiative, along with an update on support for health reform in the state. Findings demonstrate that the state has achieved its goal of near universal health insurance coverage and that state residents continue to show strong support for health reform, even in the face of increasing program costs and the recession that began in December 2007. Given the success of the coverage expansion, Massachusetts policymakers are turning to the next phase of health reform - reigning in health care costs.

Urban Institute researcher Sharon Long answers five questions about Massachusetts's landmark health reform experiment, which aims for near-universal coverage and improved access to affordable health care. In 2006, lawmakers passed a bill that required most adults to get health insurance, expanded Medicaid, provided subsidies for lower-income adults, created a health insurance exchange where residents can buy plans easily, and required employers to offer coverage or pay a fee. Early success has made the state a model for nationwide reform.

Massachusetts continues to move forward on comprehensive health reform, with improvements in coverage, access to care and the affordability of care in the state. This policy brief provides a supplement to a recent Health Affairs article on health reform in Massachusetts, examining geographic and racial/ethnic differences in access to care and affordability of care across the commonwealth in Fall 2008.

The Urban Institute, along with its subcontractor, International Communications Research, conducted the 2008 Massachusetts Health Insurance Survey (HIS) for the Massachusetts Division of Health Care Finance and Policy to obtain information on health insurance coverage and access to and use of health care for the non-institutionalized population in Massachusetts. This report provides information about the methods used to collect and analyze the 2008 HIS data.

The Urban Institute, along with its subcontractor, International Communications Research, conducted the 2008 Massachusetts Health Insurance Survey (HIS) for the Massachusetts Division of Health Care Finance and Policy to obtain information on health insurance coverage and access to and use of health care for the non-institutionalized population in Massachusetts. This report summarizes the results of that new survey, including the finding that more than more than 97 percent of Massachusetts residents have health insurance, with only 2.6 percent of state residents remaining uninsured.

We know that health insurance coverage rose dramatically in the past year in Massachusetts. This study examines what the effect has been on specific populations, finding that the greatest gains in insurance coverage were reported by lower-income adults, younger adults and those in minority groups. Further, the reductions in uninsurance tended to be largest for subgroups that started out with higher levels of uninsurance.

Although health insurance coverage rose dramatically in the past year in Massachusetts, some questioned whether health reforms simply moved people from being uninsured to underinsured. This study explores whether requiring individuals to have health insurance has forced some people, particularly those with modest incomes, into plans that offer little financial protection. The findings suggest, however, that health reform in Massachusetts is both providing new coverage for many of those who were previously uninsured and improving the quality of coverage for those with insurance coverage.

In April 2006, Massachusetts enacted a health care reform bill that seeks to move the state to (almost) universal coverage through a combination of Medicaid expansions, subsidized private health insurance coverage, and insurance reforms. As part of an evaluation of the impacts of the state's reform effort, we conducted surveys of adults aged 18 to 64 years old in Massachusetts in Fall 2006 and Fall 2007. This document provides an overview of the survey approach and the two survey instruments.

In April 2006, Massachusetts enacted a health care reform bill that seeks to move the state to (almost) universal coverage through a combination of Medicaid expansions, subsidized private health insurance coverage, and insurance reforms. As part of an evaluation of the impacts of the state's reform effort, we conducted a baseline survey of 3010 adults aged 18 to 64 years old in Massachusetts. The survey was conducted by ICR/International Communications Research between October 16, 2006, and January 7, 2007, using a Computer Assisted Telephone (CATI) interviewing system. This report provides a detailed overview of the Massachusetts population in Fall 2006.

Medicare has paid skilled nursing facilities (SNFs) using a prospective payment system (PPS) since 1998. This report offers policy options to refine Medicare’s payment of SNF services by developing alternative patient classification models. Three models classify patients according to expected non-therapy ancillary (NTA) costs: two models use data from the SNF to model NTA costs; a third adds data from prior hospital stays. A fourth model predicts rehabilitation therapy costs using patient characteristics. The fifth uses Diagnostic Related Groups to predict total SNF care costs. The report also simulates options for outlier payments for exceptionally high-cost cases.