Blewett, L. A., G. Davidson, M. Brown, and R. Maude-Griffin. 2003. “Hospital Provision of Uncompensated Care and Public Program Enrollment.” Medical Care Research and Review 60 (4): 509-527.

Hospital provision of uncompensated care is partly a function of insurance coverage of state populations. As states expand insurance coverage options and reduce the number of uninsured, hospital provision of uncompensated care should also decrease. Controlling for hospital characteristics and market factors, the authors estimate that increases in MinnesotaCare (a state-subsidized health insurance program for the working poor) enrollment resulted in a 5-year cumulative savings of $58.6 million in hospital uncompensated care costs. Efforts to evaluate access expansions should take into account the costs of the program and the savings associated with reductions in hospital uncompensated care.

McAlpine, D. and K. T. Call. 2004. “Racial and Ethnic Disparities in Utilization of Preventive Services and Barriers to Care among Minnesota Health Care Program Enrollees.” MetroDoctors 6(6): 11.

Blewett, L. A., M. B. Good, K. T. Call, and M. Davern. 2004. “Monitoring the Uninsured: A State Policy Perspective.” Journal of Health Politics, Policy and Law 29(1): 107-145.

Because states have primary responsibility for the implementation of public health insurance programs, states need timely, good quality data to evaluate programs, monitor trends in the number and characteristics of the uninsured, and better understand the dynamics of health insurance coverage. This article provides a synthesis of the data sources available to states for monitoring rates of health insurance coverage. Information was collected through a comprehensive review of state and national health surveys and in-depth interviews with state analysts in all fifty states. Our findings suggest that national surveys do not meet states' needs for data, and in response, states have initiated their own household surveys. We provide information on thirty-six household surveys that are used to estimate state levels of health insurance coverage. We recommend that national and state efforts be better coordinated to facilitate efficient use of resources to achieve good state-level date.

Spencer, D. L., S. Richardson, and M. McCormick. 2007. "Inpatient Hospital Utilization among the Uninsured Near Elderly: Data and Policy Implications for West Virginia." Health Services Research 42(6, part II): 2442-2457.

OBJECTIVE: To inform state policy discussions about the insurance coverage of the near elderly in West Virginia (WV) and the impact of the uninsured near elderly on hospitals in the state. DATA SOURCES: 2003 West Virginia Uniform Bill (UB) hospital discharge data. The data represent all adult inpatient discharges in the state during the year. STUDY DESIGN: We compare the near elderly with other adults and examine differences by insurance status. Key variables include volume of discharges, health insurance coverage, patient characteristics, and charges incurred. FINDINGS: The near elderly constitute the largest group of nonelderly adult inpatient hospital discharges. They are more likely than younger adults to be admitted for emergency conditions; have comorbidities and complications; have longer hospital stays; and incur higher charges on average. Although the near elderly are least likely to be uninsured, they represent the second largest group of uninsured discharges and incur the most in uninsured charges. CONCLUSIONS: The specific needs of the near elderly warrant consideration in WV's (and other states') ongoing development and evaluation of policies aimed at reducing uncompensated care costs, including programs to expand access to health insurance and primary and mental health care among the uninsured.

Call, K. T., and J. Ziegenfuss. 2007. “Health Insurance Coverage and Access to Care Among Rural and Urban Minnesotans.” Rural Minnesota Journal 2(1):11-36.