Insurance Expansion = Additional Joint Replacement Surgery

This seems like an obvious no-brainer but researchers at Boston Medical Center (BMC) have found that the expansion of insurance coverage in Massachusetts in 2006 resulted in an increase in the number of elective knee and hip replacement procedures by 4.7%. The greatest increases were among Black and Hispanic patients.

“The need for knee and hip replacements is fairly universal among various ethnic groups, ” said Amresh Hanchate, Ph.D. He is associated with the Section of General Internal Medicine at BMC, and the Healthcare Disparities Research Program in the Department of Medicine at Boston University School of Medicine, and is the first author of the study. He said, “Access to care has not been universal. Our findings suggest that there may have been a pent-up demand for these procedures among racial/ethnic minorities, and once these patient populations received insurance, they were able to move forward with the procedures.”

According to the study’s findings, reported by Medical Press, joint replacement procedure use increased 22.4% overall during the 2½-year period following insurance expansion.

According to Medical Press, the increase that was associated with reform was significantly higher among Hispanics (37.9%) and Blacks (11.4%) than Whites (2.8%). However, lower income was not associated with larger increases in procedure use. The share of knee and hip replacement procedures performed in safety-net hospitals in Massachusetts decreased from a pre-reform level of 12.7% by 1%.

“Our findings clearly demonstrate that limited insurance coverage has been a real barrier to receiving some forms of medical care such as joint replacement surgery, among racial/ethnic minorities, ” said Nancy Kressin, Ph.D., of the Section of General Internal Medicine at BMC, and Director of the Healthcare Disparities Research Program in the Department of Medicine at Boston University School of Medicine. She was a senior author of the study and added, “By opening that door, by providing access through insurance, we can help many people receive the care they need to live healthier lives.” According to the study, 18% of the population in the U.S., ages 18-64, do not have health insurance.