Shap webinar 1 20 2011 lukanen

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  • 1. State Health Access Program (SHAP) – Data and Evaluation
    Elizabeth Lukanen, MPH
    State Health Access Data Assistance Center
    University of Minnesota, Minneapolis, MN
    National Leadership Series
    Improving Operational and Leadership Success
    January 20, 2011
  • 2. Overview
    About SHADAC
    SHADAC’s role as Technical Assistance Provider to SHAP Grantees
    SHAP Evaluations
    SHAP Progress
    SHAP and the Affordable Care Act (ACA)
  • 3. 3
    About SHADAC
    Bridging the Gap Between Research and Policy
  • 4. 4
    What is SHADAC?
    Independent research center located at the University of Minnesota School of Public Health
    Led by an interdisciplinary team of tenured faculty and supported by research fellows and graduate research assistants
    Primary funding from Robert Wood Johnson Foundation
    Additional project-specific funding from CDC, ASPE, CMS, state-specific contracts, etc.
    Funding from HRSA to provide technical assistance to SHAP grantees
  • 5. 5
    SHADAC Objectives
    Support states in their data, survey, policy and evaluation activities
    Help states monitor rates of insurance coverage and understand factors associated with uninsurance
    Provide assistance to states on policy development, program evaluation and assessment
    Provide support to federal agencies related to conducting health insurance surveys
    • Disseminate research findings in a manner that is meaningful to state and national policy-makers
  • 6
    SHADAC’s Core Activities
    Technical Consultation with States
    State survey design and implementation
    Clarify variance between state estimates from different surveys
    Targeted Policy and Evaluation Work
    Evaluation design and implementation
    Policy analysis of coverage options
    Best Practices for Surveys on the Uninsured
    Best way of asking insurance, income, race/ethnicity questions
    Reviewing and improving estimates from national surveys
    Promoting Use of Sound Data and Methods
    Production of issue briefs, webinars, presentations, web content
    Translating research into useful information
  • 6. Participant Poll
    How often do you use data or evaluation results to make programmatic decisions?
    We plan to , but Rarely do
  • 7. SHADAC’s role as Technical Assistance Provider to SHAP Grantees
    Portland, Oregon
  • 8. SHAP Technical Assistance
    Review grantee evaluation plans
    Provide advice on outcome indicators, data sources, data availability, and evaluation methods
    Provide technical assistance to grantees in:
    Selecting appropriate metrics to allow measurement of progress toward objectives
    Identifying the types and sources of available data
    Assisting in the use of longitudinal data where feasible
    Advise on survey development
    Assessing differences between state and federal survey data
    Assist with small area estimation
    Support development of Return on Investment (ROI) methods
  • 9. 10
    SHAP Benchmark Data Collection
    Comparable information collected from all grantees
    Data on direct enrollment and residual enrollment
    Information about barriers, successes and lessons learned
    Used to demonstrate success of SHAP and provide lessons for implementation of Affordable Care Act (ACA)
    Collected bi-annually in concurrence with HRSA reporting
    Context is crucial for communicating key lessons
  • 10. SHAP Evaluation Overview
    Madison, Wisconsin
  • 11. 12
    SHAP Evaluation - Overview
    Vary in size and budget
    5 year budgets range from $120,000 to >$2,000,000
    From <1% to 10% of budgets
    8 states contracting out evaluation
    Primarily local universities and health policy centers
    Evaluation progress is varied across grantees
  • 12. 13
    SHAP Evaluation Overview - Data and Methods
    All states are utilizing administrative data
    Cost, enrollment, demographics
    9 states are conducting surveys
    Enrollee, employer, state-wide household
    5 states are conducting focus groups or key informant interviews
    Enrollees, employers, eligibility staff
    3 states are conducting Return on Investment (ROI) analysis as they related to multi-shares
  • 13. SHAP Progress
    Albany, New York
  • 14. 15
  • 15. Implementation Challenges
    Slow internal processes for hiring, procurement and contract execution
    State budget shortfalls and subsequent hiring freezes, which have impacted state personnel capacity
    Longer than anticipated time needed to engage stakeholders and build partnerships
    Uncertainty and need for programmatic restructuring due to the passage of the ACA
  • 16. Implementation Lessons
    Stakeholder engagement, though time consuming, is crucial to program success
    Program take-up is slow unless accompanied by targeted outreach and messaging
    Coverage expansions must be accompanied by improvements in eligibility and enrollment systems
    The benefit of wellness initiatives may not be realized in the short term
    Lack of data and information hinders strategic planning and decision making
  • 17. Participant Poll
    How much has the passage of the ACA affected your day-to-day work?
    A great deal
    A little bit
    Not very much
    Not at all
  • 18. SHAP and the Affordable Care Act
    Seattle, Washington
  • 19. Medicaid Expansion in Affordable Care Act (ACA)
    New mandatory eligibility group for low-income individuals – 2014 implementation date
    Includes all persons with family incomes up to 133% of the FPL who are not:
    Age 65 and older
    Eligible for Part A Medicare or enrolled in Part B
    Undocumented (i.e. unauthorized) immigrants
    Newly covered include children 6-19, parents of covered children, childless adults
  • 20. 55-64 Reinsurance
    Dependent Care Coverage
    Small Employer Tax Credit
    High Risk Pool
    Early Medicaid
    Bridge to Reform
  • 23. SHAP & Affordable Care Act
    Many SHAP activities are relevant to health reform:
    Enrollment, outreach and coverage for low income adults
    Enrollment, outreach and coverage for small businesses
    No wrong door enrollment systems
    Insurance exchanges
    Coordinated safety net programs
    Testing medical home models
    And more……
  • 24. Using SHAP Evaluation to Inform Implementation of Affordable Care Act
    Information from the SHAP evaluation can inform implementation of Affordable Care Act:
    Best practices on enrollment and retention
    Indentifying outreach strategies to reach low income adults and small businesses
    Collecting characteristics and service use of newly insured, low income adults
    Process and models to build insurance exchanges
    Testing of “benchmark plan” type programs
    Examining medical home and care coordination models
  • 25. 24
    Contact Information
    Minnesota SHAP Project Team:
    Lynn Blewett, Ph.D.
    Kelli Johnson, MBA
    Elizabeth Lukanen, MPH
    * Primary contact –, 612-626-1537
    State Health Access Data Assistance Center
    University of Minnesota, Minneapolis, MN
    ©2002-2009 Regents of the University of Minnesota. All rights reserved.The University of Minnesota is an Equal Opportunity Employer