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The impact of health care reform on hospital and preventive care: Evidence from Massachusetts

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  • Kolstad, Jonathan T.
  • Kowalski, Amanda E.

Abstract

In April 2006, Massachusetts passed legislation aimed at achieving near-universal health insurance coverage. The key features of this legislation were a model for national health reform, passed in March 2010. The reform gives us a novel opportunity to examine the impact of expansion to near-universal coverage state-wide. Among hospital discharges in Massachusetts, we find that the reform decreased uninsurance by 36% relative to its initial level and to other states. Reform affected utilization by decreasing length of stay, and the number of inpatient admissions originating from the emergency room. When we control for patient severity, we find evidence that preventable admissions decreased. At the same time, hospital cost growth did not increase.

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Bibliographic Info

Article provided by Elsevier in its journal Journal of Public Economics.

Volume (Year): 96 (2012)
Issue (Month): 11 ()
Pages: 909-929

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Handle: RePEc:eee:pubeco:v:96:y:2012:i:11:p:909-929

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Web page: http://www.elsevier.com/locate/inca/505578

Related research

Keywords: Health; Health care; Health reform; Insurance; Hospitals; Massachusetts; Preventive care;

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References

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  1. Congressional Budget Office, 2012. "Updated Estimates for the Insurance Coverage Provisions of the Affordable Care Act," Reports 43076, Congressional Budget Office.
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  10. Amanda E. Kowalski, 2009. "Censored Quantile Instrumental Variable Estimates of the Price Elasticity of Expenditure on Medical Care," NBER Working Papers 15085, National Bureau of Economic Research, Inc.
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  14. Mark Duggan, 2000. "Hospital Ownership and Public Medical Spending," NBER Working Papers 7789, National Bureau of Economic Research, Inc.
  15. Kolstad, Jonathan T. & Kowalski, Amanda E., 2012. "The impact of health care reform on hospital and preventive care: Evidence from Massachusetts," Journal of Public Economics, Elsevier, vol. 96(11), pages 909-929.
  16. Sharon K. Long & Karen Stockley & Alshadye Yemane, 2009. "Another Look at the Impacts of Health Reform in Massachusetts: Evidence Using New Data and a Stronger Model," American Economic Review, American Economic Association, vol. 99(2), pages 508-11, May.
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Citations

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Cited by:
  1. Jonathan T. Kolstad & Amanda E. Kowalski, 2012. "Mandate-Based Health Reform and the Labor Market: Evidence from the Massachusetts Reform," NBER Working Papers 17933, National Bureau of Economic Research, Inc.
  2. Manan Roy, 2011. "How Well Does the U.S. Government Provide Health Insurance?," Departmental Working Papers 1102, Southern Methodist University, Department of Economics.
  3. Supon Limwattananon & Sven Neelsen & Owen O'Donnell & Phusit Prakongsai & Viroj Tangcharoensathien & Eddy van Doorslaer & Vuthiphan Vongmongkol, 2013. "Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-Of-Pocket Expenditures in Thailand," CESifo Working Paper Series 4262, CESifo Group Munich.
  4. Nicole Maestas & Kathleen J. Mullen & Alexander Strand, 2013. "Disability Insurance and Healthcare Reform: Evidence from Massachusetts," Working Papers wp289, University of Michigan, Michigan Retirement Research Center.
  5. Martin B. Hackmann & Jonathan T. Kolstad & Amanda E. Kowalski, 2013. "Adverse Selection and an Individual Mandate: When Theory Meets Practice," NBER Working Papers 19149, National Bureau of Economic Research, Inc.
  6. Naoki Aizawa & Hanming Fang, 2013. "Equilibrium Labor Market Search and Health Insurance Reform," PIER Working Paper Archive 13-002, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania.
  7. Abe Dunn & Adam Hale Shapiro, 2013. "The impact of health care reform on physician payments: evidence from Massachusetts," Working Paper Series 2013-36, Federal Reserve Bank of San Francisco.
  8. repec:dgr:uvatin:2013067 is not listed on IDEAS
  9. Kolstad, Jonathan T. & Kowalski, Amanda E., 2012. "The impact of health care reform on hospital and preventive care: Evidence from Massachusetts," Journal of Public Economics, Elsevier, vol. 96(11), pages 909-929.
  10. Pashchenko, Svetlana & Porapakkarm, Ponpoje, 2012. "Quantitative analysis of health insurance reform: separating regulation from redistribution," MPRA Paper 41193, University Library of Munich, Germany.
  11. Hubert P. Janicki, 2011. "Distributional Effects of Public Health Insurance Reform," 2011 Meeting Papers 423, Society for Economic Dynamics.

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