Frequent utilization of the emergency departments (ED) for non-emergent conditions can strain health care systems, impacting both hospitals and patients. While Massachusetts has made significant progress to minimize barriers to accessing and affording care, disparities persist among certain sub-populations.
Using data from three consecutive Massachusetts Health Insurance Surveys (2015, 2017, and 2019), this research brief examines race/ethnicity and the potential reliance on the ED.
The Massachusetts Health Insurance Survey (MHIS) provides information on health insurance coverage, health care access and use, and health care affordability for Massachusetts residents as part of CHIA’s Continuing Study on Insurance Coverage, Underinsurance and Uninsurance.
The MHIS is a tool used by CHIA, legislators, policymakers, employers, insurers and other stakeholders to track and monitor the experiences of Massachusetts residents in obtaining timely and affordable health care. While national data sources can help to monitor some aspects of health insurance coverage and health care access, this survey provides the ability to track issues that are specific to Massachusetts.
In response to the COVID-19 pandemic, the 2021 MHIS included new questions to provide data on the impacts of the pandemic on health insurance coverage, health care access and use, and health care affordability, as well as changes in employment, which may affect health insurance coverage, health risk, and ability to pay for health care. The 2021 MHIS was fielded from July through December 2021.
The 2021 uninsurance rate in Massachusetts was 2.4%, compared to the national rate of 9.2%.
Among residents visiting the emergency department (ED) in the past 12 months, over a third (35%) sought care for a non-emergency condition in their most recent ED visit.
Two in five residents (41%) said that they had difficulties accessing health care for reasons related to COVID-19 in the past 12 months.
Two in five residents (41%) said that they and their families experienced health care affordability issues in the past 12 months, including 60% of residents with moderate family income between 139 and 299% of the Federal Poverty Level.
Over one in four residents reported that their families had unmet health care need due to the COVID-19 pandemic, and Hispanic residents were nearly 1.5 times more likely to report that their families experienced this unmet need compared to White residents (37% vs. 26%).
Using CHIA’s 2019 Massachusetts Health Insurance Survey, CHIA reported on gaps in coverage and care by both ethnicity and region. CHIA also released a series of research briefs exploring health care affordability issues that Massachusetts residents face despite high rates of health insurance coverage in the Commonwealth and also looked at unmet health-related social needs.
Using CHIA’s 2017 Massachusetts Health Insurance Survey, four affordability measures were examined including problems paying family medical bills, family medical debt, unmet health care needs due to cost, and high out-of-pocket health care spending. This research brief documents the scope of health care affordability issues among Massachusetts residents with health insurance coverage all year and the rates of affordability issues for population subgroups.
This research brief compares the methodologies used to calculate the Commonwealth's health uninsurance rate using survey data. The Massachusetts uninsurance rates are quite similar despite differences in survey methodologies used across surveys.