View Research by Author - Karen Stockley

Citation URL: http://www.urban.org/KarenStockley

Massachusetts residents are frequent users of emergency department (ED) care, with high levels of use continuing despite significant improvements in access to care as a result of the state’s 2006 health reform initiative. In an effort to better understand ED use in Massachusetts, this policy brief looks at ED use among working-age adults, focusing on reported reasons for using the ED and barriers to obtaining needed health care among ED users. Findings show adult ED users in Massachusetts are a sicker, more disabled, and more chronically ill population and report more difficulties obtaining care in the community and more unmet need for care than other adults in the state. Potential strategies for addressing preventable ED use include efforts targeted to specific care settings and particular population groups.

The Urban Institute, along with its subcontractor, Social Science Research Solutions, conduct the 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 the survey for health insurance coverage in 2008 and 2009, including the finding that more than 97 percent of Massachusetts residents have health insurance in 2009, despite the economic recession.

The national health reform debate continues to draw on Massachusetts' 2006 reform initiative, with a focus on sustaining employer-sponsored insurance. This study provides an update on employers' responses under health reform in fall 2008, using data from surveys of working-age adults. Results show that concerns about employers' dropping coverage or scaling back benefits under health reform have not been realized. Access to employer coverage has increased, as has the scope and quality of their coverage as assessed by workers. However, premiums and out-of-pocket costs have become more of an issue for employees in small firms.

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.

Medicaid physician fees increased 15.1 percent, on average, between 2003 and 2008. This was below the general rate of inflation, resulting in a reduction in real fees. Only primary care fees grew at the rate of inflation--20 percent between 2003 and 2008. However, because of slow growth in Medicare fees, Medicaid fees closed a small portion of their ongoing gap relative to Medicare--growing from 69 percent to 72 percent of Medicare. The increase in Medicaid fees relative to Medicare fees resulted from relative increases for primary care and obstetrical services, but not for other services.

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.

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