Hospital Readmissions Increased In Massachusetts After Health Care Reform Interview with:

Karen E Lasser, MD MPH
Associate Professor of Medicine
Boston University School of Medicine, Boston, MA What are the main findings of the study?

Dr. Lasser: After controlling for variables that could affect the risk of readmission, we found that:

  1. There was a slightly increased risk of all-cause readmission in Massachusetts (MA) relative to control states (New York and New Jersey) post-reform.
  2. Racial and ethnic disparities in all-cause readmission rates did not change in MA relative to control states.
  3. However, both blacks and whites in counties with the highest uninsurance rates had a decreased risk of readmission following MA health reform relative to blacks and whites in counties with lower uninsurance rates. Were any of the findings unexpected?

Dr. Lasser: We did not expect readmission rates to go up in MA following health reform. What should clinicians and patients take away from your report?

Dr. Lasser: Clinicians should recognize that there are a host of other factors, beside insurance, that put patients at risk for readmission. These factors include social problems (e.g. homelessness or lack of social support), substance use, mental illness, lack of access to primary care, difficulty affording medications, etc. Similarly, patients should recognize that having health insurance alone will not prevent them from getting readmitted. It is important that patients understand why they were admitted, what changes are being made to their medications, and whom to call if they have questions or concerns once they arrive home.  What recommendations do you have for future research as a result of this study?

Dr. Lasser: I think it would be very interesting and informative to examine this questions in states that expand insurance coverage under the ACA. States which have a higher uninsurance rate than MA may observe an improvement in readmissions.

The effect of Massachusetts health reform on 30 day hospital readmissions: retrospective analysis of hospital episode statistics

Last Updated on April 1, 2014 by Marie Benz MD FAAD