Financial Burden of Medical Spending by State and the Implications of the 2014 Medicaid Expansions (Research Report)
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This study is the first to offer a detailed look at medical spending burden levels, defined as total family medical out-of-pocket spending as a proportion of income, for each state. It further investigates which states have greater shares of individuals with high burden levels and no Medicaid coverage, but would be Medicaid eligible under the 2014 rules of the Affordable Care Act should their state choose to participate in the expansion. This work suggests which states have the largest populations likely to benefit, in terms of lowering medical spending burden, from participating in the 2014 adult Medicaid expansions.
The Urban Institute Health Policy Center's Medicaid/CHIP Eligibility Simulation Model (Methodology Report)
|Posted to Web: April 03, 2014||Publication Date: April 03, 2014|
The Urban Institute Health Policy Center's Medicaid/CHIP Eligibility Simulation Model is a microsimulation that uses rules about Medicaid/CHIP eligibility to approximate adults' and children's eligibility for Medicaid and CHIP. It has been used to simulate eligibility in the 50 states and Washington DC for the years 2008-2012 (before the Affordable Care Act [ACA] was implemented) and 2014 (simulating the new coverage provisions of the ACA). It has also been used to simulate eligibility in Puerto Rico in 2011 and enrollment under hypothetical statehood. It relies on the American Community Survey (ACS) and the Puerto Rico Community Survey (PRCS).
The Health Reform Monitoring Survey: Addressing Data Gaps To Provide Timely Insights Into The Affordable Care Act (Article)
|Posted to Web: March 26, 2014||Publication Date: March 26, 2014|
The Health Reform Monitoring Survey (HRMS) was launched in 2013 as a mechanism to obtain timely information on the ACA during the period before federal survey data will be available. The HRMS provides quarterly data on insurance coverage, access to health care, and health care affordability, along with changing topics of relevance to current policy and program issues. For example, data from summer 2013 show that more than 60 percent of those targeted by the health insurance exchanges struggle with understanding key health insurance concepts, raising concerns about their ability to evaluate trade-offs when choosing coverage.
The Feasibility of Using Electronic Health Data for Research on Small Populations (Research Report)
|Posted to Web: February 11, 2014||Publication Date: December 01, 2013|
This report explores the feasibility of using electronic health record (EHR) and other electronic health data for research on small populations. The first part of the report illustrates the challenges and limitations of using existing federal surveys and federal claims databases for studying small populations. The second part explores the potential of the increasingly available EHR and other existing electronic health data to complement federal data sources, as well as potential next steps to demonstrate and improve the feasibility of using EHRs for research on small populations.
The Health of Disconnected Low-Income Men (Research Brief)
|Posted to Web: February 06, 2014||Publication Date: September 01, 2013|
This brief examines the health insurance coverage and health status of disconnected low-income men from 2008 to 2010, focusing primarily on men’s connections to health care providers and systems. Less than half of low-income men age 18–44 in the United States have any insurance coverage; coverage rates vary significantly by state, citizenship, ethnicity, and education. Compared with higher-income men the same age, low-income men also have lower access to routine health care and have worse health outcomes.
Registries as a Knowledge-Development Tool: The Experience of Sweden and England (Research Report)
|Posted to Web: January 08, 2014||Publication Date: January 08, 2014|
Registries of patients with particular conditions or who have received a particular treatment have a long history and are widely used in many countries. This paper focuses on two kinds of registries – for patients with diabetes and for those who have received a joint hip replacement – in Sweden and England. These examples illustrate how registries can serve multiple purposes, including providing quality and safety feedback to providers and purchasers, generating planning data for health systems, evaluating guidelines, and performing outcomes research. While registries are not foreign to the United States, the completeness and accomplishments of Sweden and England’s registry system go well beyond the American experience, and show how more can be done to make use of these valuable tools.
How are States and Evaluators Measuring Medical Homeness in the CHIPRA Quality Demonstration Grant Program? (Research Report)
|Posted to Web: July 12, 2013||Publication Date: July 01, 2013|
Many Medicaid and CHIP programs and private health plans are pursuing medical home initiatives aimed at improving the quality of health care, but varying conceptual definitions and measurement goals have led to the development of a number of different medical home measurement tools. This Evaluation Highlight, funded by the U.S. Department of Health and Human Services, examines the measurement of "medical homeness" in selected CHIPRA Quality Demonstration projects, describes the development of the Medical Home Index-Revised Short Form (an adaptation of the Medical Home Index survey), and presents preliminary statistics on medical homeness for demonstration practices in six States.
|Posted to Web: June 14, 2013||Publication Date: June 14, 2013|