Publication

Medicaid Expansion: Comparing State Choices in Alternative Benefit Plan Design

Presentation by Colin Planalp at the 2015 State Health Research and Policy Interest Group meeting on June 13, 2015, in Minneapolis, MN.

View a PDF of the presentation slides.

Files

Planalp_SHRP_IG_2015.pdf

Publication

Measuring and Monitoring Churn at the State Level: Methods and Data Sources

This brief summarizes, “ACA Coverage Expansions: Measuring and Monitoring Churn at the State Level,” one of a series of SHADAC white papers commissioned by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) to explore innovative uses of data resources and analytic approaches that states can apply to monitor and evaluate health care reform efforts. The white paper, by Colin Planalp, Brett Fried, and Julie Sonier, with contributions from Amy Potthoff-Anderson and Jennifer Ricards, is available here.

View of PDF of this brief.

Files

SHADAC_Brief_43_Churning_for_web.pdf

Publication

SHARE Quarterly Update: January - March 2015

The SHARE Quarterly Update includes news, announcements, presentations, publications, and upcoming events related to the SHARE grant program, its grantees, and their funded research.

SHARE Quarterly Update: January - March 2015

Announcements

SHARE at the 2015 AcademyHealth Annual Research Meeting in Minneapolis

The 2015 AcademyHealth Annual Research Meeting (ARM) will take place on June 14th-16th in Minneapolis, with SHADAC Director Lynn Blewett chairing the event.

Jill Rissi (Portland State University), Erin Taylor (RAND), Richard Hirth (University of Michigan), Karin Rhodes (University of Pennsylvania), and Sarah Gollust (University of Minnesota) will be presenting findings from their SHARE-funded research at the ARM.
Karen Brodsky (Health Management Associates), Angie Fertig (Medica Research Institute), Erin Taylor, and Sarah Gollust will be presenting SHARE findings at the State Health Research and Policy Interest Group Meeting preceding the ARM on June 13th.

We will send out full details on the times and locations of these presentations, as well as presentations by SHADAC researchers, as the conference approaches.

SHARE Podcast Available: Governance and Impacts of Oregon's Coordinated Care Organizations

Dr. Jill Rissi and Dr. Neal Wallace, both of Portland State University, presented findings from their SHARE-funded analysis of Oregon’s Coordinated Care Organizations (CCOs) on a February 19th webinar hosted by SHARE. Drs. Rissi and Wallace discussed the organizational structures and operational approaches of Oregon’s CCOs and presented preliminary findings about how CCOs—and the variation among them—impact health care access, use, quality, and costs. The researchers reported extensive variation in CCO organizational configurations and leadership arrangements, and preliminary analyses show mixed impacts on healthcare access, use, and cost by CCO type. A podcast of the event, along with supporting presentation materials, is now available.

SHARE Briefs Examine Fluctuations in Eligibility for ACA Coverage Assistance, the Rural Implications of Medicaid Expansion, and the Prediction of High-Need Medicaid Enrollees

SHARE released three new briefs highlighting findings from SHARE-funded research projects.

"Sub-Annual Income Fluctuations and Eligibility for Coverage Assistance under the ACA"summarizes an article by Lara D. Shore-Sheppard (Williams College) in the December 2014 issue of Health Services Research. The analysis looked at monthly patterns in income dynamics across income categories eligible for coverage assistance under the ACA and then examined the determinants of movement between categories to estimate the impact of income shifts on coverage eligibility. Dr. Shore-Sheppard found that ACA coverage expansion populations experience high levels of income ﬂuctuation. This ﬂuctuation was associated with a variety of factors, with employment changes having a particularly significant impact.

"Rural Implications of Medicaid Expansion under the Affordable Care Act," details research from Dr. Erika Ziller and her co-authors at the Maine Rural Health Research Center (University of Southern Maine). The authors used data from the Medicaid Expenditure Panel Survey (MEPS), linked with state-level Medicaid policy data and county-level primary care data, to examine the ways in which Medicaid expansion will differentially impact rural individuals. They found that low-income rural residents are less likely than their urban counterparts to live in states that are expanding Medicaid, while simultaneously standing benefit more from expansion in terms of coverage, health status, and access to care.

"The Capacity of Self-Reported Health Measures to Predict High-Need Medicaid Enrolles," from Dr. Lindsey Leininger of Mathematica Policy Research, describes an analysis of the capacity of self-reported health measures to predict need for medical care among new enrollees in a Medicaid waiver program for previously ineligible childless adults in Wisconsin. The analysis indicated that a number of self-reported health measures meet established statistical thresholds for predictive modeling tools and can be used to identify high-need Medicaid members for whom a claims history is unavailable.

SHARE Research on Individual Mandate in American Economic Review

Martin Hackman (Yale University), Jonathan Kolstad (University of Pennsylvania), and Amanda Kowalski (Yale University) published findings from their SHARE research in the current issue of the American Economic Review. In the paper, "Adverse Selection and an Individual Mandate: When Theory Meets Practice," the researchers outline a risk selection model that incorporates the individual mandate and uses parameters estimated using data from Massachusetts on enrollment, premiums, and costs (data collected by the National Association of Insurance Commissioners and aggregated by SNL Financial). Using the model, the authors found that premiums and average costs decreased significantly in response to the individual mandate, with an annual total welfare gain of $51.1 million across the state.

Grantee Spotlight

Angie Fertig, PhD

Dr. Angela Fertig is Principal Investigator on a SHARE-funded project to evaluate the level of pent-up demand for health care among new enrollees in a regional health plan in Minnesota. Dr. Fertig is a Research Investigator for Medica Research Institute in Minnetonka, Minnesota, where her work encompasses topics such as regional variations in health reform implementation and disparities within low-income populations. Learn more.

SHARE Publications and Presentations

Fertig, A. March 3, 2015. "Pent-up Health Care Demand after the Affordable Care Act." Presentation. St. Paul, MN: Minnesota Health Services Research Conference.

Gross, T. March 16, 2015. "The Effect of Public Health Insurance on the Hospital Industry." Presentation. Santa Monica, CA: RAND Health Economics Seminar.

Hackman, M.B., Kolstad, J.T., & Kowalski, A.E. 2015. "Adverse Selection and an Individual Mandate: When Theory Meets Practice." American Economic Review, 105(3): 1030-1066. (Older Version: NBER Working Paper 19149.)

Leininger, L., & Avery, K. 2015. "The Capacity of Self-Reported Health Measures to Predict High-Need Medicaid Enrollees." SHARE Issue Brief. Minneapolis, MN: SHADAC.

Rissi, J., & Wallace, N. 2015. "Oregon's Coordinated Care Organizations: Governance & Impacts."SHARE Webinar. Minneapolis, MN: SHADAC.

SHARE. 2015. "Sub-Annual Income Fluctuations and Eligibility for Coverage Assistance under the ACA." SHARE Issue Brief. Minneapolis, MN: SHADAC.

Ziller, E., Lenardson, J., & Coburn, A., 2015. "Rural Implications of Medicaid Expansion under the Affordable Care Act." SHARE Issue Brief. Minneapolis, MN: SHADAC.

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Publication

Measuring and Monitoring Churn at the State Level

Webinar

Podcast	Presentation Materials
Video for iPod	Click here to access the presentation slides.
Flash8 Video	Click here to access the webinar transcript.
MP3 (128 kbps)
MP3 (64 kbps)

Event Description

This webinar explores churn — i.e., movement between different insurance coverage types or uninsurance — under the Affordable Care Act and approaches to measuring and projecting churn at the state level.

SHADAC researcher Colin Planalp discusses how churn has changed since implementation of the ACA, the potential impacts for individuals and states, and approaches to estimating churn. Policy analyst Oliver Droppers, from the Oregon Office for Health Policy and Research, discusses Oregon’s experiences estimating churn and policy strategies to address it.

Specific topics of discussion include:

Definitions of churn by coverage types and directionality
A framework for monitoring and projecting churn
Examples of approaches to estimating churn within different policy situations

Resources

Colorado Health Institute. 2014. "The Challenge of Churn: Does Coverage Change over the Course of a Year?" Colorado Health Access Survey Two-Pager. Denver, CO: Colorado Health Institute.

Czajka, J. 2013. "Income Eligibility for Assistance under the ACA: The Question of Monthly vs. Annual Income." SHARE Issue Brief. Minneapolis, MN: SHADAC.

Deprez, R., Buterbaugh, C., & Stabler, H. "'Churning' within Health Insurance Plans: Issues and Policy Solutions." Portland, ME: Center for Community and Public Health, University of New England.

Oregon Medicaid Advisory Committee. 2014. "Addressing Churn: Coverage Dynamics in Oregon's Insurance Affordability Programs." Report from Oregon Medicaid Advisory Committee to the Oregon Health Policy Board. Salem, OR: Oregon Health Authority.

Planalp, C., Fried, B., & Sonier, J. 2014. "ACA Coverage Expansions: Measuring and Monitoring Churn at the State Level." SHADAC Report Commissioned by ASPE. Minneapolis, MN: State Health Access Data Assistance Center.

SHARE. 2015. "Sub-Annual Income Fluctuations and Eligbility for Coverage Assistance under the ACA." SHARE Issue Brief. Minnepolis, MN: SHADAC.

Shore-Sheppard, L. 2014. "Income Dynamics and the Affordable Care Act." Health Services Research, 49(S2): 2041-2061.

Files

Publication

Putting out the Welcome Mat - Targeting Outreach Efforts under the Affordable Care Act: Evidence from the Minnesota Community Application Agent Program

Dybdal, K., Blewett, L., Kemmick Pintor, J., & Johnson, K. 2015. "Putting Out the Welcome Mat - Targeting Outreach Efforts Under the Affordable Care Act: Evidence from the Minnesota Community Application Agent Program." Journal of Public Health Management and Practice, 21(1): 51-58. doi: 10.1097/PHH.0000000000000091

Publication

Medicaid Expansion: Comparing State Choices in Alternative Benefit Plan Design

Files

Publication

Measuring and Monitoring Churn at the State Level: Methods and Data Sources

Files

Publication

SHARE Quarterly Update: January - March 2015

SHARE Quarterly Update: January - March 2015

Announcements

SHARE at the 2015 AcademyHealth Annual Research Meeting in Minneapolis

SHARE Podcast Available: Governance and Impacts of Oregon's Coordinated Care Organizations

SHARE Briefs Examine Fluctuations in Eligibility for ACA Coverage Assistance, the Rural Implications of Medicaid Expansion, and the Prediction of High-Need Medicaid Enrollees

SHARE Research on Individual Mandate in American Economic Review

Grantee Spotlight

Angie Fertig, PhD

SHARE Publications and Presentations

Publication

Measuring and Monitoring Churn at the State Level

Files

Publication

Putting out the Welcome Mat - Targeting Outreach Efforts under the Affordable Care Act: Evidence from the Minnesota Community Application Agent Program

Pages

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