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In 2005, 72% of insurance coverage in Massachusetts was private and 11% was Medicaid,25 whereas in 2011, 79% of insurance coverage in Massachusetts was private and 16% was Medicaid.26 Massachusetts therefore provides a unique opportunity to evaluate whether an expansion in coverage can impact 30 day readmissions. In addition, analyzing the effects of healthcare reform in Massachusetts may provide insight into the possible effects of the Affordable Care Act as it is implemented nationwide. Modeled on the Massachusetts experience, the Affordable Care Act similarly requires that most US citizens have health insurance.27 The Federal law also expands Medicaid and enables people who do not qualify for Medicaid to purchase coverage through state based health benefit exchanges.

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