Using Analytic Models and Communicating Their Findings

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Presentation to the MIDAS Network Meeting
Arlington, Virginia by Linda Bilheimer

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Using Analytic Models and Communicating Their Findings

  1. 1. Congressional Budget Office November 16, 2012 Using Analytic Models and Communicating Their Findings Presentation to the MIDAS Network Meeting Arlington, Virginia Linda T. Bilheimer, Ph.D.Assistant Director for Health, Retirement, and Long-Term Analysis
  2. 2. CBO’s Role ■ Provide objective, nonpartisan, timely analyses to facilitate economic and budgetary decisions by the Congress ■ Make no policy recommendations CONGRESSIONAL BUDGET OFFICE
  3. 3. Types of Projections by CBO ■ Federal spending and revenues under current law ■ Federal spending and revenues under current policy ■ Effects on the federal budget of legislation under consideration ■ Economic and budgetary effects of policy options CONGRESSIONAL BUDGET OFFICE
  4. 4. Time Horizons for Projections ■ 10-year budget window for formal cost estimates (plus an indication of effects on the deficit in subsequent decades) ■ Longer-term projections for some population-based programs: Social Security, health care programs CONGRESSIONAL BUDGET OFFICE
  5. 5. CBO Products in a Typical Year ■ About 100 reports, studies, testimonies, substantive letters, and issue briefs – Shifting to shorter products, where feasible ■ 500–600 formal cost estimates and related mandate estimates ■ Many more informal cost estimates for Congressional staff CONGRESSIONAL BUDGET OFFICE
  6. 6. Topic Areas for Analyses and Cost Estimates ■ Agriculture ■ Homeland Security ■ Climate and Environment ■ Housing ■ Disaster Relief ■ Immigration ■ Education ■ Infrastructure and Transportation ■ Employment and Labor Markets ■ National Security ■ Energy and Natural Resources ■ Poverty and Income Security ■ Finance ■ Retirement ■ Health Care ■ Science and R&D ■ Veterans CONGRESSIONAL BUDGET OFFICE
  7. 7. CBO’s Use of Models ■ Use existing evidence to make future projections ■ Facilitate consistency and replication of methods for estimates over time ■ Enable timely responses to requests for estimates ■ Incorporate behavioral responses (if feasible) – Households – Businesses – Federal agencies – State, local, and foreign governments CONGRESSIONAL BUDGET OFFICE
  8. 8. Types of Models Used in CBO’s Estimates and Analyses ■ Cell-based models using spreadsheets ■ Regression models ■ Microsimulation models – Health Insurance Simulation Model (HISim) – CBO’s Long-Term Model (CBOLT) ■ Combinations of the above CONGRESSIONAL BUDGET OFFICE
  9. 9. Construction and Review of Models Inputs External Consultations ■ Reviews of research ■ Research organizations literature ■ Government agencies ■ Historical data from federal (federal, state, and local) programs and states ■ Private-sector organizations ■ Original research using and associations administrative records and ■ Subject matter experts (in survey data academia, private sector, ■ Analysis by the staff of the and government) Joint Committee on ■ CBO’s Panels of Economic Taxation Advisers and Health ■ Brainstorming Advisers ■ Extensive internal review CONGRESSIONAL BUDGET OFFICE
  10. 10. Considerations in Evaluating Evidence ■ Generalizability of research findings to policy under consideration ■ Potential biases in results ■ Determining the middle of the distribution of possible outcomes – Using weighted average of point estimates – Handling statistically insignificant estimates ■ Characterization of uncertainty – Frequently qualitative because of insufficient evidence – Plausible ranges based on known sources of uncertainty – Indication of the sensitivity of results to variations in those sources • Example: CBO’s analysis of alternative scenarios regarding the likelihood of employers’ offering health insurance under the Affordable Care Act. See http://www.cbo.gov/publication/43082. CONGRESSIONAL BUDGET OFFICE
  11. 11. Dissemination of Modeling Methods ■ Descriptions of underlying logic, including graphics and flowcharts ■ Background papers describing modeling methods – CBO’s Health Insurance Simulation Model: A Technical Description http://www.cbo.gov/publication/19224 – CBO’s Long-Term Model: An Overview http://www.cbo.gov/publication/20807 ■ Methodological presentations at professional meetings – The Patient Protection and Affordable Care Act’s Effects on Employers’ Decisions to Offer Health Insurance http://www.cbo.gov/publication/41643 CONGRESSIONAL BUDGET OFFICE
  12. 12. Dissemination of Findings ■ Formal reports and cost estimates, with summaries of key findings ■ Working papers ■ Peer-reviewed articles ■ Illustrative graphics, including infographics ■ Web landing pages, highlighting findings and likely questions ■ Director’s blog, with updates on new CBO products ■ Meetings with Congressional staff, federal agency staff, media representatives ■ Presentations at professional meetings ■ Invited presentations ■ Combinations of the above CONGRESSIONAL BUDGET OFFICE
  13. 13. Recent Examples of Dissemination Strategies CONGRESSIONAL BUDGET OFFICE
  14. 14. Evaluation of the Medicare Care Coordination Demonstrations Distribution of Outcomes Effects of 34 disease management and care coordination programs on hospital admissions (percentage change) Note: Lighter bars represent less precise estimates CONGRESSIONAL BUDGET OFFICE
  15. 15. Analyzing Prevention Policy Effects: The Interdisciplinary Challenge Logic Model for Analysis of Prevention Policies CONGRESSIONAL BUDGET OFFICE
  16. 16. 50-Cent Increase in the Excise Tax on Cigarettes: Effects on Federal Outlays Study Conclusions (1)(Percentage of GDP) 0.0025 0.0020 Total 0.0015 0.0010 Social Security Medicare 0.0005 Other 0 Medicaid and - 0.0005 Subsidies Through Health Insurance Exchanges - 0.0010 2013 2015 2017 2019 2021 2023 2025 2027 2029 2031 2033 2035 CONGRESSIONAL BUDGET OFFICE
  17. 17. 50-Cent Increase in the Excise Tax on Cigarettes: Health-Related Effects on Federal Revenues Study Conclusions (2)(Percentage of GDP) 0.012 0.010 Total Effects on Revenues from Improvements in Health 0.008 0.006 Effects of Changes in Labor Earnings per Capita 0.004 Effects of Increased Longevity 0.002 0 Effects of Lower Health Insurance Premiums and Related Factors - 0.002 2013 2019 2025 2031 2037 2043 2049 2055 2061 2067 2073 2079 2085 CONGRESSIONAL BUDGET OFFICE
  18. 18. 50-Cent Increase in the Excise Tax on Cigarettes: Health-Related Effects on Revenues, Outlays, and the Deficit Study Conclusions (3)(Percentage of GDP) 0.014 Total Effects on Outlays 0.012 Total Effects on Revenues from 0.010 Improvements in Health 0.008 0.006 0.004 0.002 0- 0.002 Net Effects on the Deficit from- 0.004 Improvements in Health- 0.006 2013 2019 2025 2031 2037 2043 2049 2055 2061 2067 2073 2079 2085 CONGRESSIONAL BUDGET OFFICE
  19. 19. Long-Term Budget Outlook, 2012One-Page Infographic to Accompany Report CONGRESSIONAL BUDGET OFFICE
  20. 20. Revised Estimates of the Effects of the Affordable Care Act, Following the Supreme Court Decision Anticipated Questions Addressed on the Web Landing Page■ What is the net budgetary impact of the coverage provisions, taking into account the Supreme Court’s decision?■ How will states respond to the Supreme Court’s decision regarding the Medicaid expansion?■ How does insurance coverage change after the Supreme Court’s decision?■ Why are the projected Medicaid and CHIP savings stemming from the Supreme Court’s decision greater than the projected additional costs of subsidies provided through the exchanges? CONGRESSIONAL BUDGET OFFICE
  21. 21. Report on the Supplemental Nutrition Assistance Program Serial Infographic to Accompany Report (1) CONGRESSIONAL BUDGET OFFICE
  22. 22. Report on the Supplemental Nutrition Assistance Program Serial Infographic to Accompany Report (2) CONGRESSIONAL BUDGET OFFICE
  23. 23. Report on the Supplemental Nutrition Assistance Program Serial Infographic to Accompany Report (3) CONGRESSIONAL BUDGET OFFICE
  24. 24. Report on the Supplemental Nutrition Assistance Program Serial Infographic to Accompany Report (4) CONGRESSIONAL BUDGET OFFICE
  25. 25. Report on the Supplemental Nutrition Assistance Program Serial Infographic to Accompany Report (5) CONGRESSIONAL BUDGET OFFICE
  26. 26. Report on the Supplemental Nutrition Assistance Program Serial Infographic to Accompany Report (6) CONGRESSIONAL BUDGET OFFICE
  27. 27. Conclusions on Dissemination ■ Different approaches are effective with different audiences, requiring multiple products for each analysis ■ Peer-reviewed literature reaches academics and researchers more than other audiences ■ Brevity and simplicity are essential for policymakers and others; time is their scarcest commodity ■ Well-designed graphics are important dissemination aids CONGRESSIONAL BUDGET OFFICE

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