This brief from the SHARE grant program examines a rich source of US hospital administrative data--the Healthcare Cost and Utilization Project (HCUP)--and provides an example of how a SHARE-funded research project led by Dr. Peter Cunningham at Virginia Commonwealth University has used these data to evaluate the impacts of an early ACA Medicaid expansion on utilization-related outcomes at hospitals in California.

Download a PDF of the brief.

The SHADAC newsletter contains updates on SHADAC activities, news from the states, resource updates, and blog highlights.
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SHARE Panel at APPAM Will Consider Early Post-Expansion Utilization Data

Four researchers will present findings from their SHARE-funded studies on a panel at the 2015 Fall Research Conference hosted by the Association for Public Policy Analysis and Management (APPAM) in Miami, Florida. The panel, titled “Early Data on Health Care Utilization after Coverage Expansion,” will take place on Thursday, November 12th, and will feature presentations from Peter Cunningham (Virginia Commonwealth University), Marguerite Burns (University of Wisconsin – Madison), Angela Fertig (Medica Research Institute), and Michael Dworsky (RAND Corporation). Kathy Hempstead, Coverage Team Director at the Robert Wood Johnson Foundation, and Brett Fried, SHADAC Senior Research Fellow, will act as discussants. Learn more.

December 8th Webinar: Analysis of Provider Network Monitoring Practices

Karen Brodsky and Barbara Markham Smith of Health Management Associates (HMA), will discuss their SHARE-funded analysis of trends in provider network monitoring practices by states and health plans during a December 8th webinar hosted by HMA. They will highlight key findings from a survey of health plans and state regulators concerning provider network adequacy compliance and monitoring standards (detailed in an in-depth report here). Based on these findings, they will provide recommendations for states and health plans seeking more effective and efficient ways of ensuring adequate provider access for members. Register for the webinar.

Sarah Gollust Discusses Geographic Variations in Media Messages about Reform 

Dr. Sarah Gollust of the University of Minnesota discussed her SHARE-funded research in a presentation titled, “Media and the Politics of Implementation: Geographic Variation in ACA Coverage,”at the 2015 Annual Meeting of the American Political Science Association (APSA) on September 6th in San Francisco. The presentation focused on an analysis of the geographic variation in the volume and content of televised messages about the ACA from October 2013 through March 2014. The next stage of the project will link patterns of media messaging at the market level to individuals’ attitudes and behavior using national survey data (Kaiser Health Tracking Poll and the National Health Interview Survey). 
 

Angie Fertig Finds Evidence Consistent with Pent-Up Demand among New ACA Enrollees 

A new brief from Dr. Angie Fertig at Medica Research Institute highlights initial findings from a SHARE-funded study  examining pent-up demand after the ACA. In the brief, Dr. Fertig, with co-authors Dr. Caroline Carlin and Dr. Sharon Long, examines administrative and claims data from a Minnesota health insurer to identify early patterns in the first claim for new Medicaid and commercial non-group (including Marketplace) enrollees who signed up for coverage between January and March 2014. The researchers found patterns of utilization that are consistent with pent-up demand among new Medicaid enrollees. However, the evidence of pent-up demand among new enrollees with non-group coverage relative to the comparison group is mixed. 
 

Tal Gross Explains Why Medicaid Expansion Makes Economic Sense 

In a recent video from Columbia University’s Mailman School of Public Health, Dr. Tal Gross summarizes the policy implications of his SHARE-funded analysis of the economic impact of state ACA Medicaid expansion decisions. Dr. Gross and his colleagues at Northwest University found that the amount of money that state governments save from not expanding Medicaid is roughly equal to the amount of money that the hospitals in those states have to spend to care for the uninsured (i.e., their uncompensated care costs). These findings are detailed in Dr. Gross’s recent NBER working paper.
 

V-BID in Connecticut: Early Results Show Beneficial Impact on Utilization 

The research team led by Dr. Richard Hirth at the Center for Value-Based Insurance Design (V-BID Center) at the University of Michigan released a brief highlighting initial findings from their SHARE-funded analysis of Connecticut’s Health Enhancement Plan (HEP) for state employees, which reduces cost-sharing for high-value clinical services and targets patient incentives to eliminate barriers to evidence-based care. The authors found significant improvements among HEP enrollees during the first HEP plan year for a variety of standard preventive measures compared to a control group of state employee health plan enrollees in four different states without a comparable intervention. The findings from this brief are highlighted in the podcast of an August 4th webinar that was co-hosted by SHARE and the V-BID Center.
 

Grantee Spotlight

Sarah Gollust, PhD

Sarah Gollust is the principal investigator on a SHARE-funded project to measure geographic variation in ACA-related media messages and the subsequent relationship of media messages to insurance enrollment from 2013 to 2014. Her broad research interests are in the politics and ethics of health policy, and she is particularly interested in understanding the media’s role in influencing the public’s opinions and perceptions of health policy issues. Learn more.
 

 

SHARE Publications and Presentations

 

Fertig, A. August 2015. "The First Insurance Claim of New ACA Enrollees." Issue Brief. Minneapolis, MN: Medica Research Institute.

Fertig, A. August 4, 2015. "The First Insurance Claim of New ACA Enrollees." Presentation. Minneapolis, MN: Medica Research Institute Seminar.

Gross, T. July 2015. "Why Medicaid Expansion Makes Economic Sense." Video. New York, NY: Mailman School of Public Health, Columbia University.  

Gollust, S. September 6, 2015. “Media and the Politics of Implementation: Geographic Variation in ACA Coverage,” Presentation. San Francisco, CA: 2015 Annual Meeting of the American Political Science Association (APSA).

Hirth, R. August 4, 2015. "Innovative Benefit Design for Connecticut State Employees - Findings from a V-BID Evaluation." Webinar. SHARE and the Center for Value Based Insurance Design at the University of Michigan. 

Hirth, R. March 2015. "Connecticut's Health Enhancement Program for State Employees UPDATE (2015)." Issue Brief. Ann Arbor, MI: Center for Value-Based Insurance Design at the University of Michigan.
 

Fried, B., Kemmick Pintor, J., Graven, P., & Blewett, L.A. 2014. "Implementing Federal Health Reform in the States: Who Is Included and Excluded and What Are Their Characteristics?" Health Affairs. Published online before print. doi: 10.1111/1475-6773.12232