Increased coverage didn't reduce MA readmissions

Providing health insurance to the uninsured does not reduce 30-day readmission rates, according to research published in the British Medical Journal.

Researchers from the Boston University School of Medicine (BUSM) used all payer inpatient discharge databases to analyze changes in overall admission rates and disparities among patients aged 18 to 64 in Massachusetts hospitals, as compared to control states New York and New Jersey, according to the study.

Adjusting for confounders including age, sex, comorbidity, hospital ownership, teaching hospital status and nurse-to-census ratio, the odds of all-cause readmission in Massachusetts increased slightly after its 2006 healthcare reform law compared with the control states, according to the study.

Racial and ethnic disparities in all-cause readmission rates didn't change in Massachusetts compared with New York and New Jersey. However, black people in counties with the highest uninsured rates saw decreased readmission odds (.91) compared with white people (.96) in counties with lower uninsured rates, according to the study.

Extending health insurance coverage alone was not sufficient to improve readmission rates in Massachusetts, the researchers concluded, and the industry must do more to reduce hospital readmissions and disparities in care.

"Among African-Americans and Hispanics, we found the odds of readmission did not decrease in Massachusetts relative to control states, and there was no change in the magnitude of the white-black and white-Hispanic difference in readmission rates," lead author Karen Lasser, M.D., an associate professor of medicine at BUSM, told

After Massachusetts' healthcare reform, emergency room (ER) visits by uninsured people under the age of 65 fell from 9.5 percent of total visits to 5.7 percent, while visits by those ages 65 and older were consistently around 1 percent, FierceHealthcare previously reported. ER visits rose as much as 1.2 percent between October 1, 2006 and September 30, 2007, after the Bay State passed its healthcare reform law, and increased by 2.2 percent during the period ending Sept. 30, 2009.

To learn more:
- check out the study
- here's the article