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Emergency Surgeries Drop with Insurance Expansion in MA

Cheryl Clark, for HealthLeaders Media, July 7, 2014

In Massachusetts, rates of discretionary surgical procedures rose, while rates of non-discretionary or emergency procedures declined in the years following the state's insurance expansion, researchers found.

As the insured population grows, hospital surgery centers should expect to perform more elective and discretionary surgical procedures, but fewer non-discretionary operations performed on an emergency basis.

That's what researchers have concluded after looking at what happened in Massachusetts in the years before and after the state's 2006 insurance expansion. Researchers compared the Massachusetts experience with concurrent surgical utilization in New Jersey and New York, states that were not undergoing coverage expansion at that time.

"Most people are saying that by 2019, when we expect 25 million more people with insurance, we'll see a huge influx of patients, and thus a huge influx of surgery," says Chandy Ellimoottil, MD, urology surgeon at the University of Michigan, Ann Arbor, and first author of a report in JAMA Surgery. "But what we find is that it doesn't affect all surgical procedures uniformly."

"This has implications for anyone looking at workforce shortages, and whether they should increase staffing," in order to meet future demand from Medicaid expansion and health insurance exchange coverage, Ellimoottil says.

In Massachusetts, rates of discretionary procedures rose, while rates of non-discretionary procedures declined compared to trends in the two other states.

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