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Publications by Sharon K. Long for Health Policy Center

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More about Sharon K. Long's areas of expertise can be found on this Urban Institute expert's page.


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Health Insurance Coverage and Health Care Access and Affordability in Massachusetts: Holding Steady in 2013 (Research Report)
Sharon K. Long, Thomas H. Dimmock

The Massachusetts Health Reform Survey (MHRS) has been conducted since 2006 to monitor and understand the state's health care system. The 2013 MHRS, funded by the Robert Wood Johnson Foundation and the Blue Cross Blue Shield of Massachusetts Foundation, provides an important new baseline against which to compare the results of the implementation of the Affordable Care Act (ACA), whose major provisions began in 2014. Findings highlight the state's ongoing success at maintaining near universal health insurance coverage and high levels of health care use, as well as the continued need to address the burden of health care costs.

Posted: November 25, 2014Availability: HTML

Taking Stock: Health Insurance Coverage for Parents under the ACA in 2014 (Policy Briefs/Health Policy Briefs)
Genevieve M. Kenney, Nathaniel Anderson, Sharon K. Long, Lisa Dubay, Stacey McMorrow, Lisa Clemans-Cope, Michael Karpman, Douglas A. Wissoker

In this brief, we use data from the June 2014 Health Reform Monitoring Survey (HRMS) to examine changes in health insurance coverage for parents since September 2013. The HRMS was designed to provide early feedback on ACA implementation to complement the more robust assessments that will be possible when the federal surveys release their estimates of changes in health insurance coverage later in 2014 and in 2015. We find that the uninsurance rate declined by 14.4 percent for parents nationally between September 2013 and June 2014 and by 33.3 percent for parents in states that expanded Medicaid. As the ACA moves forward, it will be important to assess (1) whether these coverage gains translate into improvements in access to care, health status, and financial well-being for parents and (2) the extent of positive spillover effects on parents' children.

Posted: September 09, 2014Availability: HTML

A First Look at Children's Health Insurance Coverage under the ACA in 2014 (Policy Briefs/Health Policy Briefs)
Genevieve M. Kenney, Joan Alker, Nathaniel Anderson, Stacey McMorrow, Sharon K. Long, Douglas A. Wissoker, Lisa Clemans-Cope, Lisa Dubay, Michael Karpman, Tricia Brooks

Beginning in June 2013, the Urban Institute's Health Reform Monitoring Survey (HRMS), which was designed to provide early feedback on implementation of the Affordable Care Act (ACA), has been tracking changes in health insurance coverage and other outcomes for children under the ACA. In contrast to adults, uninsured rates for children had been declining in the decade before the ACA's passage, largely because of the expansion of public coverage (Medicaid and the Children's Health Insurance Program) which is substantially generous and draws high participation among children. Estimates derived from HRMS children's supplement suggest that uninsured rates for children had not changed by June 2014 from their pre-ACA levels, though there are reasons to expect that children's coverage will grow in future years.

Posted: September 09, 2014Availability: HTML

QuickTake: Nonelderly Workers with ESI Are Satisfied with Nonfinancial Aspects of Their Coverage but Less Satisfied with Financial Aspects (Policy Briefs/In Brief)
Adele Shartzer, Sharon K. Long

The Urban Institute's Health Reform Monitoring Survey has been tracking health insurance coverage, including employer-sponsored insurance coverage (ESI), since the first quarter of 2013. This QuickTake reports on nonelderly (ages 18–64) workers' ESI in June 2014. In June 2014, most workers were insured and, among those who were insured, most had ESI. When asked to assess their ESI, workers were generally satisfied with available health care services, choice of doctors and other providers, and the quality of the care available under their ESI plan. However, satisfaction levels are much lower for the financial aspects of coverage, with workers more concerned about premiums, co-payments, and their potential financial risk from high medical bills.

Posted: September 04, 2014Availability: HTML

Taking Stock at Mid-Year: Health Insurance Coverage under the ACA as of June 2014 (Policy Briefs/Health Policy Briefs)
Sharon K. Long, Genevieve M. Kenney, Stephen Zuckerman, Douglas A. Wissoker, Adele Shartzer, Michael Karpman, Nathaniel Anderson, Katherine Hempstead

The Affordable Care Act (ACA) has brought major changes to the US health insurance system: In January 2014, Medicaid was expanded to nearly all adults with family incomes at or below 138 percent of the federal poverty level in 24 states and the District of Columbia, and enrollment under the new health insurance Marketplaces officially began in all states and the District of Columbia. We use the June 2014 Health Reform Monitoring Survey (HRMS) to examine changes in health insurance coverage since the beginning of the previous year for nonelderly adults. The HRMS was designed to provide early feedback on ACA implementation to complement the more robust assessments that will be possible when the federal surveys release their estimates of changes in health insurance coverage later in 2014 and in 2015.

Posted: July 29, 2014Availability: HTML

Who Are the Remaining Uninsured as of June 2014? (Policy Briefs/Health Policy Briefs)
Adele Shartzer, Genevieve M. Kenney, Sharon K. Long, Katherine Hempstead, Douglas A. Wissoker

It is now widely agreed that the number of nonelderly (age 18–64) uninsured adults has fallen dramatically since the Affordable Care Act’s (ACA’s) Marketplace open enrollment began. According to the June 2014 Health Reform Monitoring Survey (HRMS), the number of uninsured adults fell by an estimated 8 million between September 2013 and June 2014, with proportionately larger coverage gains among low- and middle-income adults and in states that implemented the ACA’s Medicaid expansion. However, 13.9 percent of adults still remain uninsured as of June 2014. In this brief, we use data from the June 2014 wave of the HRMS to assess the characteristics of those who remain uninsured, providing valuable information for ongoing Medicaid outreach and enrollment efforts, as well as preparations for the next open enrollment period in the Marketplaces.

Posted: July 29, 2014Availability: HTML

QuickTake: Number of Uninsured Adults Continues to Fall under the ACA: Down by 8.0 Million in June 2014 (Fact Sheet / Data at a Glance)
Sharon K. Long, Genevieve M. Kenney, Stephen Zuckerman, Douglas A. Wissoker, Adele Shartzer, Michael Karpman, Nathaniel Anderson

The Urban Institute's Health Reform Monitoring Survey (HRMS) has been tracking insurance coverage since the first quarter of 2013. This QuickTake reports on how the uninsurance rate changed through early June 2014. These results track changes in coverage following the Affordable Care Act's first open enrollment period, which ended on March 31, 2014.

Posted: July 10, 2014Availability: HTML

Strategies in 4 Safety-Net Hospitals to Adapt to the ACA (Research Brief)
Teresa A. Coughlin, Sharon K. Long, Rebecca Peters, Additional Authors

Safety-net hospitals have long played an essential role in the US health care system. The Affordable Care Act fundamentally changes the health care landscape and safety-net hospitals need to make major changes to compete. This report examines four safety-net hospitals to learn how they are preparing for health reform. While hospitals were employing strategies with different intensities, we found that the study hospitals had implemented an array of financial strategies focused on tapping Medicaid revenues. They also adopted delivery systems reforms, particularly ones related to developing community-based partners, and implemented changes in hospital leadership and management structure as well as efforts to better align physician incentives with hospitals and altering the culture of patient care to be more responsive to the shifting market.

Posted: June 13, 2014Availability: HTML

Who Are the Newly Insured as of Early March 2014? (Policy Briefs/Health Policy Briefs)
Adele Shartzer, Sharon K. Long, Stephen Zuckerman

In May 2014, the US Department of Health and Human Services announced that enrollment in health plans through the health insurance Marketplaces had exceeded 8 million people. Estimates suggest that another 5 million people purchased Affordable Care Act (ACA)-compliant plans outside the Marketplace. In addition, it is estimated that total Medicaid and CHIP enrollment increased by an estimated 4.8 million people. Knowledge about the characteristics of these newly insured individuals provides an early assessment of how well the different components of the ACA are working at expanding coverage as of early March. Further, information on the health needs and health care experiences of newly insured individuals is important for understanding their likely health care demands as they gain coverage, along with their potential effect on the risk pools in private and public insurance programs.

Posted: June 05, 2014Availability: HTML

Changes in Mortality After Massachusetts Health Care Reform: A Quasi-experimental Study (Article)
Benjamin D. Sommers, Sharon K. Long, Katherine Baicker

The Massachusetts 2006 health care reform has been called a model for the Affordable Care Act. The law attained near-universal insurance coverage and increased access to care. Its effect on population health is less clear. This study compares mortality rates before and after reform in Massachusetts versus a control group with similar demographics and economic conditions. The results show that reform in Massachusetts was associated with a significant decrease in all-cause mortality and mortality for conditions amenable as compared with the control group. Changes were larger in counties with lower household incomes and higher pre-reform uninsured rates.

Posted: May 06, 2014Availability: HTML

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