Researchers from the Harvard School of Public Health have found that expansion of health coverage in Massachusetts have reduced mortality rates. The study found that fewer people died in Massachusetts since the state passed its mandatory universal health coverage law in 2006. The researchers have dubbed the Massachusetts reform a model for the Affordable Care Act that requires all Americans to have health insurance coverage and improves access to care. As per the study, 320 fewer Massachusetts men and women died in each of the first four years of the state law than would have been expected.
Those who have health coverage are more likely to see a doctor, access services, and feel better, which contributed to their living longer. The major findings of this study are as follows.
- The death rate in Massachusetts dropped by 2.9 percent in the first four years of universal health insurance compared to similar counties outside the state where health coverage was not expanded
- The life expectancy of minorities such as African-Americans, Asians and Latinos have increased significantly, with death rates dropping by 4.6 percent
- The analyses revealed significant gains in coverage, health care access and self-reported health. The number needed to treat was found to be approximately 830 adults receiving health insurance to prevent one death per year
According to the study’s lead author, the most significant decline was in health conditions such as cancer, infections, heart diseases and other serious illness that could be prevented or delayed with improved medical care, though no statistically significant changes were found in the case of other death causes that are less amenable to health care (for example, car crashes, homicide, suicide). A co-author opined that the study findings are really encouraging for the states that are in the early stage of ACA implementation.
In 2009, a study published in the American Journal of Public Health revealed that around 45,000 annual deaths are associated with the lack of health insurance. The lead author of this study stated that though doctors have many new ways to prevent death from hypertension, diabetes and heart diseases, healthcare would be effective only if patients can get to physicians’ offices and afford their medications. The study cites two reasons for the widening gap in the risk of death between insured and uninsured people – the uninsured are more likely to deny needed care than insured and improved quality of care for insured people.
The importance of health coverage in reducing the risk of death is undeniable. For instance, take obesity which is inextricably linked to several serious health conditions including heart disease, stroke, gallbladder disease, respiratory problems and so on. Family practice physicians play a key role in understanding the challenges faced by obese people and provide proper guidance to help individuals manage obesity and weight management issues, and avoid the risk of serious illness. However, physicians were reluctant to provide such kind of advice to their patients earlier due to the lack of reimbursement for obesity screening and counseling. According to one report, a recent study showed that most U.S. health plans would reject a claim for an office visit where the only diagnostic medical coding was for obesity. In 2009, the National Committee for Quality Assurance’s (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) added 2 new measures related to the documentation of a patient’s Body Mass Index (BMI) status. The scenario improved after Medicare began to cover weight loss counseling as a part of their preventive services package. It is expected that the situation will improve even further as the ACA includes obesity screening in its preventive services that come under essential health benefits so that the insurers will cover it without co-payments, co-insurance or deductibles. Moreover, proper insurance verification processes and expert medical billing and coding would help physicians overcome all kinds of reimbursement issues.