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Publications by Karen Stockley for Health Policy Center

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Coverage, Access, and Affordability under Health Reform: Learning from the Massachusetts Model (Research Report)
Sharon K. Long, Karen Stockley, Kate Nordahl

While the impacts of the Affordable Care Act will vary across the states given their different circumstances, Massachusetts' 2006 reform initiative, the template for national reform, provides a preview of the potential gains in insurance coverage, access to and use of care, and health care affordability for the rest of the nation. Under reform, uninsurance in Massachusetts dropped by more than 50%, due, in part, to an increase in employer-sponsored coverage. Gains in health care access and affordability were widespread, including a 28% decline in unmet need for doctor care and a 38% decline in high out-of-pocket costs.

Posted: February 26, 2013Availability: HTML

National Findings on Access to Health Care and Service Use for Non-elderly Adults Enrolled in Medicaid (Research Report)
Sharon K. Long, Karen Stockley, Elaine Grimm, Christine Coyer

This report to the Medicaid and CHIP Payment and Access Commission (MAPCAC) was prepared to support MACPAC’s June 2012 Report to the Congress on Medicaid and CHIP. The report presents national findings on access to care for non-elderly Medicaid adults using measures from two national household surveys—the National Health Interview Survey (NHIS) and the Household Component of the Medical Expenditure Panel Survey (MEPS). These estimates give a national picture of how access to care for non-elderly adults enrolled in Medicaid compares to that of adults with ESI and uninsured adults, building on prior reports and analyses.

Posted: June 22, 2012Availability: HTML

American Primary Care Physicians' Decisions to Leave Their Practice: Evidence From the 2009 Commonwealth Fund Survey of Primary Care Doctors (Research Report)
Bradford H. Gray, Karen Stockley, Stephen Zuckerman

This study analyzes data from a 2009 Commonwealth Fund survey of American physicians in internal medicine, family or general practice, or pediatrics to identify predictors of their having plans to retire or leave their practice for other reasons in the next 5 years. Just over half (53%) of physicians age 50 or older and 30% of physicians between age 35 and 49 have such plans. The strongest of the multiple predictors involved was time they spent coordinating care for patients. Factors that predict plans to retire differ from those associated with plans to leave practices for other reasons.

Posted: March 15, 2012Availability: HTML

Massachusetts Health Reforms: Uninsurance Remains Low, Self- Reported Health Status Improves As State Prepares To Tackle Costs (Research Report)
Sharon K. Long, Karen Stockley, Heather Dahlen

Massachusetts is in its sixth year of a reform initiative that provided the template for the federal Affordable Care Act of 2010. This Health Affairs article reports on the status of health reform in Massachusetts as of 2010, providing an early indication of potential gains and challenges under national reform.

Posted: January 27, 2012Availability: HTML

Health Reform in Massachusetts as of Fall 2010: Getting Ready for the Affordable Care Act & Addressing Affordability (Research Report)
Sharon K. Long, Karen Stockley, Heather Dahlen

Five years after the enactment of Massachusetts health reform initiative, gains in insurance coverage and access to care have been sustained. This report provides an update on trends in the Bay State since fall 2006, just prior to the implementation of the state's health reform initiative, along with a more in-depth overview of the circumstances of working-age adults in 2010, as the state begins implementation of the Affordable Care Act.

Posted: January 27, 2012Availability: HTML | PDF

Containing the Growth of Spending in the U.S. Health System: Methods Appendix (Research Report)
John Holahan, Linda J. Blumberg, Stacey McMorrow, Stephen Zuckerman, Timothy Waidmann, Karen Stockley

The growth in U.S. health care spending has become a focal point in debates over federal and state health care reform. While the problem is easy to quantify, strategies for slowing rising expenditures are controversial, and evidence of their effectiveness is often elusive. Our full report provides background that describes the problem and reviews the cost containment provisions of the Affordable Care Act (ACA). It also presents estimates of cost savings from several policies that go beyond those included in the ACA. In this appendix, we provide more detail on the methods used to generate these cost savings estimates.

Posted: December 19, 2011Availability: HTML | PDF

Containing the Growth of Spending in the U.S. Health System (Occasional Paper)
John Holahan, Linda J. Blumberg, Stacey McMorrow, Stephen Zuckerman, Timothy Waidmann, Karen Stockley

In this paper we review data on health care spending growth and the reasons for the persistent high rates of growth. We discuss the cost containment provisions that are incorporated into the Affordable Care Act. A number of options that are not included in the ACA are then analyzed. We use a consistent analytic framework for making estimates relying on an extensive body of research evidence. We make estimates of the savings from eliminating tax exclusion, malpractice reform, chronic care management, prevention and various approaches to setting rates for providers. We conclude that no one option could provide substantial savings by themselves and that a combination of several policies is necessary to reduce the rate of growth.

Posted: October 05, 2011Availability: HTML | PDF

Health Reform in Massachusetts: An Update as of Fall 2009 (Research Report)
Sharon K. Long, Karen Stockley

This report provides a comprehensive update on the status of health reform in Massachusetts as of fall 2009. The report examines the overall impact of reform on non-elderly adults; the impacts on vulnerable population subgroups of adults; impacts on racial/ethnic disparities; the status of the remaining uninsured adults in the state; an assessment of the adequacy of coverage under health reform; and support for reform over time. The authors find that Massachusetts has made significant progress in accomplishing the goals of the legislation, although some challenges with respect to the cost of health care remain. A chartbook of key findings was also released as a supplement to the full report.

Posted: June 23, 2010Availability: HTML

The Impacts of Health Reform on Health Insurance Coverage and Health Care Access, Use, and Affordability for Women in Massachusetts (Research Report)
Sharon K. Long, Karen Stockley, Lauren Birchfield, Shanna Shulman

This policy brief examines the progress women have made in under health reform in Massachusetts. The authors find that women achieved significant gains in coverage, access, use, and affordability under health reform, although gains in affordability were more limited. Gains were particularly strong for vulnerable subgroups of women, including lower-income women and racial/ethnic minority women.

Posted: June 23, 2010Availability: HTML

Sustaining Health Reform in a Recession: An Update on Massachusetts as of Fall 2009 (Research Report)
Sharon K. Long, Karen Stockley

This Health Affairs article provides an update on the progress of health reform in Massachusetts as of fall 2009 using data from surveys of working-aged adults. Massachusetts continues to sustain record high levels of insurance coverage in the midst of the economic recession, with uninsurance at 4.8 percent for non-elderly adults in fall 2009. In addition, the authors find that the gains in access and affordability reported in Massachusetts under the initial years of health reform persisted into fall 2009. However, some barriers to accessing care persist and problems affording care continue to be an issue for some residents.

Posted: June 23, 2010Availability: HTML

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