Availability and Use of Enrollment Data from the ACA Health Insurance Marketplace
A better understanding of the diverse sources of administrative data avilable from the state and federal health insurance marketplaces is required in order to respond to questions about the performance of exchanges during the first open enrollment period and about the viability of exchanges in the future.
This paper examines enrollment-related data issues faced by states during the first ACA open enrollment period, including variation in data elements collected through marketplace applications as well as variation in state approaches to public reporting on enrollment data. This paper will also look ahead to potential research questions and uses for data already collected and consider new data collection needs.
ACA Coverage Expansions: Measuring and Monitoring Churn at the State Level
Under contract with MACPAC, SHADAC designs and conducts quantitative analysis to explore the magnitude and type of churn occurring in the pre- and post-ACA insurance market at the state levels as well as the characteristics of churners. This analysis uses data from the Survey of Income and Program Participation. SHADAC designs and executes the analysis, which will include construction of state-specific weights, production of descriptive statistics, and regression analysis to measure the impact of different policies and other factors on churn.
Through provisions designed to improve access to affordable health coverage, the ACA is expected to reduce the number of people who cycle between Medicaid coverage and uninsurance — a concept commonly called “churn.” However, people experiencing transitions between health insurance plans still face barriers related to the continuity of care, potentially aggravating health conditions and increasing costs of care. As states look for ways to monitor and project churn, as well as consider policies for reducing the scope or impacts of the phenomenon, this paper describes possible methods and data sources for producing state-level churn estimates.
Using Insurer Filings to Monitor the Private Health Insurance Market
This paper provides states with information on ways in which they can monitor the private health insurance market over time. This information includes key analytic questions of interest; examples and recommendations of state-level analyses of the regulated health insurance market; and a comparison of two data sources states can use for monitoring and reporting purposes. The two data sources that we explore are the data collected by the Center for Consumer Information and Insurance Oversight (CCIIO) for the purposes of regulating privae health insurers' medical loss ratios (MLRs) and the insurer data collected by the National Association of Insurance Commissioner (NAIC). We consider the differences between these two data sources and identify the key analytic questions that can be best answered by each data source.
Making Use of All-Payer Claims Databases for Health Care Reform Evaluation
This paper provides an update on the development of state-operated All-Payer Claims Databases (APCDs), with a focus on potential analytic uses and capabilities. The purpose of of the paper is to highlight key questions that APCD data and analysis can answer on their own and when linked to other data resources. These questions are organized under four broad topics related to health care reform: health care spending; price transparency; health care quality; and payment reform evaluation. Within these four sections, we provide detail on topics of interest to state agencies, policy-makers, and data analysts. Throughout the paper, we provide examples of existing state uses of APCDs, reporting templates, and dashboards to highlight the unique value of this state data resource.
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