Massachusetts health insurance mandate: effects on neurosurgical practice

Massachusetts' health insurance mandate and subsidized insurance program, Commonwealth Care, have been active for 2 years.

The financial impact on the neurosurgery division and demographics of the relevant patient groups were assessed. The billing records of neurosurgical patients from January 2007 to September 2008 were collected and analyzed.

Commonwealth Care comprised 2.2% of neurosurgical inpatients, and these patients did not have significantly different acuity or lengths of stay from the average. Length of stay of MassHealth patients was significantly greater, although acuity was significantly lower than the average. Increased free care reimbursement and increased MassHealth/Commonwealth Care enrollment resulted in a net gain in reimbursement of hospital charges.

The increased insurance rates have resulted in increased reimbursement for the neurosurgical division.