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Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
Call nnslhs 2012
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Call nnslhs 2012

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  • 1. Use of Survey Data for Tracking theImpact of the ACA in StatesKathleen Thiede CallNational Network of State and Local Health SurveysAPHA San FranciscoOctober 29, 2012 Support for this work was provided by a grant from the California HealthCare Foundation.
  • 2. Overview• Monitoring health reform: 1. Health insurance coverage 2. Affordability and comprehensiveness of coverage 3. Access to health care services 2
  • 3. Considerations for Selecting Measures• Measures that reflect major goals and provisions of the law• Outcomes rather than implementation process• Relevant/meaningful to policymakers 3
  • 4. Considerations for Recommending Data Sources• Comparability over time• Ability to do in-depth analysis (e.g., by geography, age, income, race/ethnicity)• Population coverage – complete population of interest• Availability of benchmarks/national comparisons• Timeliness of estimates• Accessibility of data• Flexibility to adapt to changing needs 4
  • 5. Measures come from Varied Data Sources• Population surveys• Employer surveys• Health care provider data• Health plan data• State public program data• Today’s focus: review framework discussing measures available through population surveys 5
  • 6. State-specific Household Survey Activityhttp://www.shadac.org/content/state-survey-research-activity 6
  • 7. Priority Measures: Coverage Distribution of Insurance Coverage Uninsured Public Coverage Employer Coverage Point in time Enrollment trend Employers offering Uninsured for a year Participation rate Employees in firms or longer that offer Churning Uninsured at some % Eligible point in past year % Enrolled Health Insurance Reasons for uninsurance Exchange Families with ESI offer Exempt from mandate Nongroup coverage: exchange and as % of All family Paying penalty market members enrolled Employer coverage: Employers paying exchange and as % penalty of market 7
  • 8. Priority Measures: Coverage Distribution of Insurance Coverage Uninsured Public Coverage Employer Coverage Point in time Enrollment trend Employers offering Uninsured for a year Participation rate Employees in firms or longer that offer Churning Uninsured at some % Eligible point in past year % Enrolled Health Insurance Reasons for uninsurance Exchange Families with ESI offer Exempt from mandate Nongroup coverage: exchange and as % of All family Paying penalty market members enrolled Employer coverage: Employers paying exchange and as % penalty of market 8
  • 9. Priority Measures: Coverage Distribution of Insurance Coverage Uninsured Public Coverage Employer Coverage Point in time Enrollment trend Employers offering Uninsured for a year Participation rate Employees in firms or longer that offer Churning Uninsured at some % Eligible point in past year % Enrolled Health Insurance Reasons for uninsurance Exchange Families with ESI offer Exempt from mandate Nongroup coverage: exchange and as % of All family Paying penalty market members enrolled Employer coverage: Employers paying exchange and as % penalty of market 9
  • 10. Priority Measures: Affordability &Comprehensiveness of Coverage Insurance Premiums Comprehensiveness Financial Burden Employer coverage Enrollment by benefit % of families with high level cost burden Total premium Single ESI “Affordable” premium as % of income Family Nongroup Employee share Deductibles Subsidies Single ESI: single, family # receiving premium Family Nongroup: single, and cost sharing family subsidies in exchange Nongroup coverage Average value of Per enrollee subsidies 10
  • 11. Priority Measures: Affordability &Comprehensiveness of Coverage• Insurance Premiums Comprehensiveness Financial Burden Employer coverage Enrollment by benefit % of families with high level cost burden Total premium Single ESI “Affordable” premium as % of income Family Nongroup Employee share Deductibles Subsidies Single ESI: single, family # receiving premium Family Nongroup: single, and cost sharing family subsidies in exchange Nongroup coverage Average value of Per enrollee subsidies 11
  • 12. Priority Measures: Affordability &Comprehensiveness of Coverage• Insurance Premiums Comprehensiveness Financial Burden Employer coverage Enrollment by benefit % of families with high level cost burden Total premium Single ESI “Affordable” premium as % of income Family Nongroup Employee share Deductibles Subsidies Single ESI: single, family # receiving premium Family Nongroup: single, and cost sharing family subsidies in exchange Nongroup coverage Average value of Per enrollee subsidies 12
  • 13. Priority Measures: Access to Care Individuals System Use of services Barriers to care % of physicians Safety net accepting new Has usual Did not get patients, by payer Volume and type of source of care necessary care services provided (& reasons) % of physicians by safety net clinics Type of place participating in for usual source Not able to get public programs Uncompensated of care timely care appointment Ambulatory care County indigent Preventive care sensitive hospital Difficulty finding care volume and visit in past year admissions provider to take cost new patients Emergency room Any doctor visit visit rate in past year Difficulty finding provider that accepts Preventable/ insurance type avoidable ER visits 13
  • 14. Priority Measures: Access to Care Individuals System Use of services Barriers to care % of physicians Safety net accepting new Has usual Did not get patients, by payer Volume and type of source of care necessary care services provided (& reasons) % of physicians by safety net clinics Type of place participating in for usual source Not able to get public programs Uncompensated of care timely care appointment Ambulatory care County indigent Preventive care sensitive hospital Difficulty finding care volume and visit in past year admissions provider to take cost new patients Emergency room Any doctor visit visit rate in past year Difficulty finding provider that accepts Preventable/ insurance type avoidable ER visits 14
  • 15. Concluding comments• State-specific surveys provide data in all three priority areas: coverage, affordability, access• State-specific survey advantage – Wide range of policy relevant questions – Flexibility to alter survey content – Quick turnaround availability• State-specific survey have and will continue to play a role in monitoring health reform 15
  • 16. Complete copy of the Framework report is available at:http://www.shadac.org/publications/framework-tracking-impacts- affordable-care-act-in-california Kathleen Thiede Call callx001@umn.edu Sign up to receive our newsletter and updates at www.shadac.org @shadac

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