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Higher Costs, Worse Outcomes for Previously Uninsured Medicare Beneficiaries

Research published recently in the New England Journal of Medicine underscores the importance of having health insurance coverage—not only for ensuring access to needed care, but also for controlling overall health care costs and promoting good health outcomes.

The Commonwealth Fund-supported study, Use of Health Services by Previously Uninsured Medicare Beneficiaries, found that among U.S. adults ages 59 to 64 who had been diagnosed with hypertension, diabetes, heart disease, or stroke, those lacking insurance coverage had much higher medical costs—51 percent higher—after becoming eligible for Medicare at age 65, compared to those with insurance coverage.

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Uninsured adults in this age group also reported 13 percent more doctor visits and 20 percent more hospitalizations than their insured counterparts. Higher use of services and higher costs persisted through age 72, the researchers found.

"These findings support the hypothesis that previously uninsured adults used health services more intensively and required costlier care as Medicare beneficiaries than they would have if previously insured," wrote the authors, who include J. Michael McWilliams, M.D., and his colleagues at Harvard Medical School.

The costs of providing health insurance to people earlier in life, they note, may be partly offset by reduced spending on health care after age 65.

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