Patients in Mass. faced cost barriers after reform
Patients who gained access to insurance as a result of the healthcare reform law passed in Massachusetts still faced cost barriers in their access to care, according to a study. The study, conducted by researchers at Harvard Medical School, looked at 431 patients ages 18 to 64 who received care at the emergency room in the state’s secondlargest safety net hospital between July 25, 2009, and March 20, 2010. “These findings illustrate that the insurance plans that most previously uninsured patients received in Massachusetts as part of healthcare reform had a mixed effect in terms of access to care,” Dr. Danny McCormick, the study’s lead author and an assistant professor at Harvard Medical School, said in a news release. The patients who were insured by the programs through which most of the uninsured in Massachusetts gained coverage had “similar or higher levels of access to and utilization of outpatient visits compared with the privately insured, as well as similar access to preventive care.” However, a greater number of patients who had Medicaid or Commonwealth Care Type 1—a program with minimal cost-sharing—said they delayed or did not get a medication and delayed or did not get dental care as compared with privately insured patients. Those covered through the Commonwealth Care Type 2 or 3 programs, which involve greater cost-sharing, “reported significantly more cost-related barriers to obtaining care than the privately insured” and to seeing a primary-care physician or a dental provider and obtaining medication, according to the study’s authors.