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Measuring Churn at the State Level: Methods & Data

November 25, 2014
November 25, 2014: For years, state policymakers have been concerned about the effects of people cycling between Medicaid and uninsurance due to temporary changes in eligibility. This phenomenon, known as "churning," carries health and financial risks to individuals and families, as well as increased program costs. 
 
Churn under the ACA
 
The ACA is expected to reduce the number of people affected by traditional churn by expanding access to affordable health insurance coverage options. However, people experiencing transitions between health insurance plans still face barriers related to the continuity of care, potentially aggravating health conditions and increasing costs. As a result, measuring and monitoring churn will continue to be an important challenge for states, even as they see overall coverage rates rise.
 
Report: Methods and Data for Measuring Churn at the State Level
 

A new SHADAC report, "ACA Coverage Expansions: Measuring and Monitoring Churn at the State Level,” describes potential methods and data sources for producing state-level churn estimates. The types of analyses outlined in the paper can help states to understand the causes, consequences, and prevalence of churn as the phenomenon evolves under the ACA and to make informed decisions about policy options that could reduce churn or mitigate its effects.

Additional Resources

This paper is one in a four-part series focused on innovative uses of data resources and analytic approaches that states can apply to monitor and evaluate health care reform efforts. The papers in the series were commissioned by HHS’ Office of the Assistant Secretary for Planning and Evaluation with the goal of providing an overview of health reform data sources available to policymakers, such as state-level administrative data, health insurer filings, marketplace enrollment data, and survey data. The series also highlights key analytic questions that states can addressed by these data sources.

Find all four papers in the series here.