Safety-Net Providers after Health Care Reform: Lessons from Massachusetts

National health reform is designed to reduce the number of uninsured adults. Currently, many uninsured Americans receive care at safety-net health care providers such as community health centers (CHCs) or safety-net hospitals. This project examined data from Massachusetts to assess how the demand for ambulatory and inpatient care and use changed for safety-net providers after the state's health care reform law was enacted in 2006, which dramatically reduced the number of individuals without health insurance coverage, says Leighton Ku of George Washington University and his co-authors.

  • Between calendar years 2005 and 2009, the number of patients receiving care at Massachusetts CHCs increased by 31 per cent, and the share of CHC patients who were uninsured fell from 35.5 per cent to 19.9 per cent.
  • Non-emergency ambulatory care visits to clinics of safety-net hospitals grew twice as fast as visits to non-safety-net hospitals from 2006 to 2009.
  • The number of inpatient admissions was comparable for safety-net and non-safety-net hospitals.
  • Most safety-net patients reported that they used these facilities because they were convenient (79.3 per cent) and affordable (73.8 per cent); only 25.2 per cent reported having had problems getting appointments elsewhere.

    Despite the significant reduction in uninsurance levels in Massachusetts that occurred with health care reform, the demand for care at safety-net facilities continues to rise. Most safety-net patients do not view these facilities as providers of last resort; rather, they prefer the types of care that are offered there.

    Source: Leighton Ku et al., Safety-Net Providers after Health Care Reform: Lessons from Massachusetts, Archives of Internal Medicine, August 2011.

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    First published by the National Center for Policy Analysis, United States

    FMF Policy Bulletin/ 16 August 2011
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