Landmark Study Analyzes Cost Of Medical Care For Uninsured

BOSTON — The Blue Cross Blue Shield of Massachusetts (BCBSMA) Foundation recently released a new report by the Urban Institute that, for the first time, analyzes all of the medical care provided to uninsured patients by hospitals, community health centers and physicians in Massachusetts. 

The report, which was released at a health care summit at the JFK Library, is the first product of the BCBSMA Foundation’s Roadmap to Coverage, a new initiative to inform the public about how to provide health coverage for the uninsured in Massachusetts and generate a practical roadmap for achieving this goal.

Rising health care costs and cutbacks in public programs and employer-sponsored coverage, among other factors, are contributing to the growing problem of the uninsured in the Commonwealth. More than 450,000 Massachusetts residents are uninsured, a 25{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} increase from 2000, according to a recent state survey. U.S. Census Bureau estimates put the number of uninsured in the state even higher, at more than 650,000 in 2003.

Key findings of the study include the following:

• Hospitals, community health centers, and physicians provided $1.1 billion in medical care to uninsured patients in Massachusetts in fiscal year 2004. This figure was verified against the amount of medical care reported in surveys of people who do not have health insurance.
• If the uninsured in Massachusetts had health coverage, the annual cost of the additional medical care they would receive would be between $374 million and $539 million, which would increase the share of the state’s economy devoted to health care by less than one-third of one percentage point.
• Expanding coverage to the uninsured in Massachusetts could result in as much as $1.2 to $1.7 billion in economic and social benefits from improved health.

These benefits, the authors noted, “could exceed the incremental medical costs of expanded coverage by a ratio of 3:1.”

In a separate finding, the report calculated that federal, state and local government funding, together with assessments on hospitals and health plans, total $1.9 billion to support an array of “safety net” institutions, programs and services, many of which are targeted to people without health insurance in Massachusetts.

The report estimates that $1 billion of that spending could potentially be reallocated to support expanded coverage for the uninsured. The remaining funding, the report concluded, would need to be retained to support safety net and public health programs even if most Massachusetts residents had health insurance.

“Massachusetts is in a unique position to attempt a coverage expansion,” said Holahan. “Although the number of uninsured in the state is growing, Mass-achusetts still has a relatively low percentage of its population without coverage and a series of well-funded safety net programs.”

The report is available online athttp://www.bcbsmafoundation.org/foundationroot/en_US/documents/roadmapReport.pdf

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