The effect of providing health coverage to poor uninsured pregnant women in Massachusetts
Article Abstract:
Expanding Medicaid coverage to poor pregnant women may not result in increased access to prenatal care or lower rates of birth complications. The federal government in 1990 expanded Medicaid coverage to pregnant women whose incomes are 133% of the poverty level, and permitted states to expand their coverage to those at 185% of the poverty level. Massachusetts had already created Healthy Start in 1985 to extend coverage to women whose incomes were 185% of the poverty level. But the medical records of 57,257 women giving birth in 1984 and 64,346 women giving birth in 1987 show that this extended coverage did not improve the poor women's access to prenatal care. In fact, access to prenatal care declined slightly for all women in Massachusetts between 1984 and 1987, even those with private insurance. However, women who enrolled in Healthy Start got better prenatal care than those who remained uninsured. There may be other factors in addition to cost that prevent pregnant women from receiving prenatal care.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1993
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Case mix and resource utilization by uninsured hospital patients in the Boston metropolitan area
Article Abstract:
The possibility that uninsured patients may receive fewer medical services than insured patients with similar medical problems due to hospitals' cost-containment policies and other competitive reforms was examined. Medical care of insured and uninsured patients was compared in public hospitals, major teaching hospitals and other institutions in the Boston, Massachusetts, area in 1983. Uninsured patients had, on the average, slightly shorter hospital stays (7 percent shorter) and underwent 7 percent fewer medical procedures than Blue Cross-insured patients. The differences varied by type of hospital. Uninsured patients also had shorter stays than Medicare-insured patients, though they underwent a similar number of procedures. The results indicate that uninsured patients may not receive the same hospital care as those who are insured.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
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Early experience with pay-for-performance: From concept to practice
Article Abstract:
A study is conducted to evaluate the impact of a prototypical physician pay-for-performance on quality of care. It is concluded that paying clinicians to reach a common, fixed performance target may produce little gain in quality for the money spent and will largely reward those with higher performance at baseline.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 2005
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