Blog & News
Six Measures on SHADAC’s State Health Compare Now Updated to Include Pandemic-era Data for Health Behaviors and Outcomes
March 18, 2022:As part of our commitment to releasing relevant and timely state-level data, estimates for six measures on SHADAC’s State Health Compare web tool have recently been updated with data from the first years of the COVID-19 pandemic, 2020 and 2021. Data for each of these measures is drawn from a variety of different data sources, which are detailed in the notes below.
Measures that have been updated include:
- Alcohol-Involved Deaths (2020)
Alcohol-Involved Deaths is a newer measure that was added to State Health Compare last year. Estimates for this measure provide state-level rates of deaths that were determined to be “alcohol-induced,” as defined by the Centers for Disease Control (CDC), including deaths from conditions such as alcohol poisoning and alcoholic liver disease that CDC considers to be entirely alcohol-attributable (a full listing of which is available on the data measure homepage). Data are available for years 1999 through 2020.
- Opioid-Related Deaths (2020)
Opioid-related Drug Poisoning Deaths is a measure that encompasses all age-adjusted rates of deaths caused by drug poisoning (i.e., overdose) per 100,000 people. Users can select national and state-level estimates for this measure for comparison by individual drug types, including legal (natural and semi-synthetic opioids; synthetic opioids [non-methadone]) and illegal (heroin) opioids, cocaine, and psychostimulants, as well as high-level “all opioids” and “all drugs” categories. Estimates are available from 1999 through 2020.
- Suicide Deaths (2020)
Suicide Deaths provides a measure of age-adjusted deaths from suicide per 100,000 people. Estimates can be viewed across categories that include age, sex, race/ethnicity, firearm or non-firearm method, and metropolitan status. Data are available for years 1999 through 2020.
- Premature Death (2020)
Premature Death measures the average number of years of potential life lost prior to age 75 per 100,000 persons. In addition to viewing this measure for the entire state population, data users can compare rates of premature death by race and ethnicity. Data are available for this measure for years 2000 through 2020.
- Adverse Childhood Experiences (2019-2020)
Adverse Childhood Experiences measures the percent of children (age 0–17) residing in households who had experienced no, one, or two or more adverse childhood experiences (ACEs) out of a possible nine ACEs ([1] hard to cover basics on family's income; [2] parent or guardian divorced or separated; [3] parent or guardian died; [4] parent or guardian served time in jail; [5] saw or heard parents or adults slap, hit, kick, punch one another in the home; [6] was a victim of violence or witnessed violence in neighborhood; [7] lived with anyone who was mentally ill, suicidal, or severely depressed; [8] lived with anyone who had a problem with alcohol or drugs; and [9] treated or judged unfairly due to race/ethnicity). Data users can make national and state-level comparisons of ACEs rates of by age, health insurance coverage type, parental education, poverty level, and race/ethnicity. Data are available for the two-year pooled periods 2016–2017, 2017–2018, 2018–2019, and 2019-2020.
- Unemployment Rate (2021)
Unemployment Rate measures the average annual percent of the civilian labor force (age 16 and older) that was unemployed. Individuals are defined as unemployed if they do not have a job, have actively looked for work in the prior four weeks, and are currently available for work. Users are able to compare data estimates for years 2000 through 2020 for national and state total population; however, only 2000-2020 data is available for viewing by race/ethnicity categories, as 2021 data is still forthcoming.
Notes
Data for Alcohol-involved Deaths, Opioid-related Deaths, and Suicide Deaths come from the CDC WONDER system. Data for Premature Death come from the CDC WISQARS system. Estimates for Adverse Childhood Experiences are produced using microdata from the National Survey of Children’s Health. Data for Unemployment Rate come from the U.S. Bureau of Labor Statistics’ Local Area Unemployment Statistics program.
Publication
New SHADAC Brief Summarizes Study of Effects of Medicaid Expansion on Physician Participation
With the Affordable Care Act's (ACA) expansion of Medicaid, approximately 15 million people were able to enroll in the program - many of whom were previously uninsured. However, researchers have long worried that an expansion of insurance coverage would not translate to an equal expansion in access to care. A particular point of concern is the worry that these newly eligible and enrolled individuals would not be able to find enough physicians who participate in Medicaid to treat them.
Existing research has traditionally relied on physician survey data to study trends in physician acceptance of Medicaid and the factors associated with participation in the Medicaid program. For example, under contract with the Medicaid and CHIP Payment and Access Commission (MACPAC), SHADAC researchers used data from the National Electronic Health Records Survey (NEHRS) to create state-level estimates of physician participation in Medicaid before and after expansion and to study the physician- and practice-level characteristics associated with participation.
However, a new study led by Dr. Hannah Neprash is the first to provide direct answers about how clinicians responded to the Medicaid expansion. In their paper, "The effect of Medicaid expansion on Medicaid participation, payer mix, and labor supply in primary care” published in the December 2021 issue of the Journal of Health Economics, Dr. Neprash and her co-authors use all-payer claims and practice management data from 2012 through 2017 to examine how clinicians changed their labor supply and payer mix in response to Medicaid expansion.
This brief summarizes key findings from this study, including the effect of expansion on the number of Medicaid appointments and number of Medicaid patients seen by primary care clinicians (i.e., Medicaid participation), the total number of appointments provided (i.e., their labor supply) and the share of those appointments paid for by Medicaid versus private coverage or other payers (i.e., payer mix). The study also compares the relative change in participation in states subject to the Medicaid expansion compared to the change in states not subject to the expansion, estimating a causal effect of expansion on clinician participation in Medicaid.
Click on the image to the upper right to access and download a PDF of the full brief.
Related Resources
Physician Acceptance of New Medicaid Patients: Findings from the National Electronic Health Records Survey (MACPAC Fact Sheet)
Explore Physician Acceptance of New Medicaid Patients through Two New Measures on SHADAC’s State Health Compare and in a New MACPAC Factsheet (SHADAC Blog)
Physicians who accept new Medicaid patients (State Health Compare Data Measure)