This document summarizes findings from a survey of over 4,600 publicly insured adults in Minnesota. It finds that while providing health insurance increases access to care, barriers still result in disparities. Even after controlling for differences, some ethnic groups reported more barriers related to costs, access, and providers not understanding their culture. Reporting bigger problems was linked to higher odds of delayed, forgone, or no preventive care. Suggested solutions focused on improving access to plan information through simplified outreach and help resources.
California higher ed where is comes from and where it goesSally Hamilton
This document contains graphs showing the funding sources and expenditures for the University of California (UC), California Community Colleges (CCC), and California State University (CSU) systems from 1970 to 2010. The graphs show that for all three systems, the largest funding source was the general fund, though its percentage has decreased over time. For expenditures, the largest category for all systems was instruction/teaching.
2012 State of the Vending Industry Report - Automatic Merchandiser - June / J...Steven Duque
The road to recovery has been slow in the recession, for both automatic merchandising and the multiple industries it serves. Fiscal 2011 saw trends from the previous year continue, as the vending industry slowly recovers from the massive fallout of the Great Recession. In 2011, industry sales declined for the fourth consecutive year, although at a progressively slower rate. The 1.5 percentage point sales decline in 2011 was half the rate posted in 2010, indicating vending operators made progress in
stemming the downward trend.
The document provides data on newspaper and magazine advertising in Pakistan in 2011 compared to 2010. It shows that ROP (run of paper) and ordinary ad types declined by around 27% and 19% year-over-year for newspapers and magazines respectively. The top categories, products, brands, and publications are also outlined. Overall, the data indicates a decrease in advertising spending and shifts in the leading brands and categories across both print mediums between 2010 and 2011 in Pakistan.
Este documento describe el proceso de configuración (setup) de una computadora personal después de su ensamblaje. Explica que el BIOS estandariza el uso de los periféricos y que el programa setup almacena la configuración del hardware en la memoria no volátil CMOS. También cubre los diferentes niveles de configuración accesibles a través del setup como el estándar, avanzado y del chipset, y la importancia de actualizar el BIOS.
The document shows the percentage of female and male students in grades 3 through 8 who scored at levels 3 and 4 on the 2008 New York State English Language Arts exam. It displays that in grades 3 and 4, a higher percentage of female students met these achievement levels compared to male students, with the gap being largest in grade 3. Across all grades 3 through 8, the percentage of female students meeting these levels was consistently higher than for male students.
Presentation: Health Reform in Massachusettsmasscare
The document summarizes the Massachusetts Model of Health Reform, including its origins, structure, impacts, challenges, and lessons for national reform. Key points:
- The 2006 reform law expanded insurance coverage through an individual mandate, employer requirements, and subsidizing coverage up to 300% of poverty.
- It reduced the uninsured rate from 10% to around 4-5% but increased costs for employers and individuals. Financial challenges grew for safety-net hospitals.
- While more have coverage, costs continue rising faster than income. If not addressed, the system may not be sustainable long-term. National reform efforts aim to achieve Massachusetts' coverage gains while better controlling health care spending.
Education Equity in Asian Pacific Islander Communities in Oregon_APANO_
The document discusses achievement and opportunity gaps faced by Asian Pacific Islander (API) students in Multnomah County, Oregon. It shows that while API students score higher than average on math tests, there are still significant achievement gaps compared to white students. Additionally, educational attainment rates among APIs vary greatly depending on language and country of origin. The document suggests looking deeper into subgroup data to better understand challenges faced. In 3 sentences or less:
While API students score above average in math, there are still achievement gaps compared to white students. Educational attainment rates among APIs vary greatly depending on language and country of origin. The document argues for examining subgroup data to better understand challenges faced by different API communities.
California higher ed where is comes from and where it goesSally Hamilton
This document contains graphs showing the funding sources and expenditures for the University of California (UC), California Community Colleges (CCC), and California State University (CSU) systems from 1970 to 2010. The graphs show that for all three systems, the largest funding source was the general fund, though its percentage has decreased over time. For expenditures, the largest category for all systems was instruction/teaching.
2012 State of the Vending Industry Report - Automatic Merchandiser - June / J...Steven Duque
The road to recovery has been slow in the recession, for both automatic merchandising and the multiple industries it serves. Fiscal 2011 saw trends from the previous year continue, as the vending industry slowly recovers from the massive fallout of the Great Recession. In 2011, industry sales declined for the fourth consecutive year, although at a progressively slower rate. The 1.5 percentage point sales decline in 2011 was half the rate posted in 2010, indicating vending operators made progress in
stemming the downward trend.
The document provides data on newspaper and magazine advertising in Pakistan in 2011 compared to 2010. It shows that ROP (run of paper) and ordinary ad types declined by around 27% and 19% year-over-year for newspapers and magazines respectively. The top categories, products, brands, and publications are also outlined. Overall, the data indicates a decrease in advertising spending and shifts in the leading brands and categories across both print mediums between 2010 and 2011 in Pakistan.
Este documento describe el proceso de configuración (setup) de una computadora personal después de su ensamblaje. Explica que el BIOS estandariza el uso de los periféricos y que el programa setup almacena la configuración del hardware en la memoria no volátil CMOS. También cubre los diferentes niveles de configuración accesibles a través del setup como el estándar, avanzado y del chipset, y la importancia de actualizar el BIOS.
The document shows the percentage of female and male students in grades 3 through 8 who scored at levels 3 and 4 on the 2008 New York State English Language Arts exam. It displays that in grades 3 and 4, a higher percentage of female students met these achievement levels compared to male students, with the gap being largest in grade 3. Across all grades 3 through 8, the percentage of female students meeting these levels was consistently higher than for male students.
Presentation: Health Reform in Massachusettsmasscare
The document summarizes the Massachusetts Model of Health Reform, including its origins, structure, impacts, challenges, and lessons for national reform. Key points:
- The 2006 reform law expanded insurance coverage through an individual mandate, employer requirements, and subsidizing coverage up to 300% of poverty.
- It reduced the uninsured rate from 10% to around 4-5% but increased costs for employers and individuals. Financial challenges grew for safety-net hospitals.
- While more have coverage, costs continue rising faster than income. If not addressed, the system may not be sustainable long-term. National reform efforts aim to achieve Massachusetts' coverage gains while better controlling health care spending.
Education Equity in Asian Pacific Islander Communities in Oregon_APANO_
The document discusses achievement and opportunity gaps faced by Asian Pacific Islander (API) students in Multnomah County, Oregon. It shows that while API students score higher than average on math tests, there are still significant achievement gaps compared to white students. Additionally, educational attainment rates among APIs vary greatly depending on language and country of origin. The document suggests looking deeper into subgroup data to better understand challenges faced. In 3 sentences or less:
While API students score above average in math, there are still achievement gaps compared to white students. Educational attainment rates among APIs vary greatly depending on language and country of origin. The document argues for examining subgroup data to better understand challenges faced by different API communities.
This document discusses how a collaborative called "Paying More for the American Dream" uses Home Mortgage Disclosure Act (HMDA) data to support advocacy and increase lending in communities. It describes how the group analyzes raw HMDA data to focus on hot issues like subprime lending and produce reports highlighting findings. The collaborative tells its story with data by determining messages, presenting findings visually through charts and maps, and retelling the story in multiple ways to increase understanding. The document lists collaborators from organizations in several states and provides contact information for more details.
AUSL is a non-profit organization that manages 19 schools in Chicago, serving over 10,500 students. It focuses on turning around chronically failing schools through teacher training programs and a disciplined transformation process. AUSL schools have seen significant gains in student achievement compared to previous years and other CPS schools.
85% of Americans use the internet and internet use increases with younger age groups. 66% of Americans have home broadband access which has doubled since 2000. Device ownership has seen a mobile revolution with more people owning smartphones and tablets than desktop computers. 2/3 of online adults use social media with nearly half using it on a typical day.
Presentation charity analytics natuurpunt at bpost media and social day 2013 ...mma
This document summarizes a project to analyze member loyalty and predict churn for a non-profit nature conservation organization. Key findings include:
- Involvement level, having a standing order, recruitment type, and province all impact membership duration. Members who donate or volunteer have longer tenures.
- A predictive model was created to assign each member a "churn score" between 0-1 based on likelihood to stop membership in the next year.
- Recommendations focus on retention efforts like targeted mailings, traffic light risk ratings, and investigating reasons for stopping renewals. Overall, predictive analytics can make churn prevention more actionable.
The document discusses changes in humanitarian action over the last 10 years and trends to expect in the next 10 years. It notes that humanitarian assistance funding has increased while attacks on aid workers have also risen. Three major trends are identified: (1) humanitarian assistance is increasing but trust in humanitarianism is decreasing; (2) respect for universal principles is declining while nationalism and sovereignty are rising; (3) conflict-related crises are declining relatively while natural disasters are increasing. The importance of humanitarian principles is emphasized amid these challenges facing humanitarian action.
Internet Governance Forum – USA
Speech by Lee Rainie
Director, Pew Internet & American Life Project
October 2, 2009
A discussion of the critical uncertainties about the evolution of the internet.
This document provides an overview of health reform and how hospitals are responding to changes. It discusses rising healthcare costs in the US compared to other countries. Key aspects of the reform are outlined, including the creation of Accountable Care Organizations and a shift to paying for outcomes rather than procedures. The document also summarizes some of the main ways hospitals are responding, such as aligning with physicians, focusing on the full care continuum, increasing transparency, emphasizing value over volume, and developing a shared community vision. Employer strategies for incentivizing employees to use high quality, low cost providers are also reviewed.
Director Lee Rainie gave a keynote at the NFAIS annual conference about the way the internet and mobile connectivity have transformed the worlds of networked individuals. He discussed how normal life has changed in the past decade because of three revolutions in technology: 1) the spread of broadband; 2) the rise of mobile connectivity; and 3) the emergence of technological social networks. He will discuss trends and likely future developments in technology that will shape the way people learn, share, and create information.
65% of online adults now use social networking sites, up from 61% one year ago. Women maintain their lead in social networking usage, with 69% of online women using sites compared to 60% of men. While young adults ages 18-29 have always been the most active users of social networking sites, older age groups are adopting them at higher rates, with usage among those ages 50-64 and 65+ increasing over the past year.
65% of online adults now use social networking sites, up from 61% one year ago. This means that half of all adults now use social networking sites. Usage has increased rapidly since 2005, when only 8% of internet users used social networking sites. Women maintain a foothold on social networking site use, with 69% of online women using sites compared to 60% of online men. Younger age groups are more likely to use social networking sites, though usage is growing faster among older age groups. When asked about their experiences, most social networking users describe them in positive terms like "good" and "fun".
"65% of online adults use social networking sites" uso de medios sociales en ...Retelur Marketing
Estudio realizado por The Pew Research Center's Internet & American Life Project en el que se analiza el uso y penetración de las redes sociales en la sociedad americana. (inglés)
This document contains data from quarterly reading comprehension assessments for 5th grade students. It includes two graphs showing the percentage of students scoring at or above the standard for each quarter, ranging from 0% to 100%. It also contains two tables with item analysis data for each question on the assessments for two different reading units, including the percentage of students answering each question correctly. The document provides information on collecting assessment data both online and using paper assessments.
Final (For Web) Presentation To Council Of Great City Schools Houstonbiferguson
This document discusses the development and implementation of a new "Fair Student Funding" model for Baltimore City Public Schools. It summarizes the historical challenges facing the district, including declining enrollment and funding shortfalls. It then outlines the goals and principles of the new student-based funding model, which aims to allocate resources in a simple, equitable, and transparent manner so that schools can better meet student needs.
The document discusses trends in the mobile industry in 2011 and projections for 2012. Key points include:
- Smartphone penetration dramatically increased in 2011, reaching 48% and fueling growth in the mobile ecosystem.
- Consumers have led technological shifts to mobile, being around 18 months ahead of businesses. This will drive growth in mobile advertising and point-of-sale applications as businesses catch up.
- In 2012, over 60% of mobile phones will be smartphones as falling prices increase accessibility. Geo-local applications and changes to media and commerce will continue.
- The report focuses on opportunities in content, marketing/advertising, mobile commerce/services, and payments—areas that will drive consumer value
The document contains the results of a questionnaire given to students in Years 3 to 6 at Essex Primary School. It includes two graphs (Graphs A and B) that show the responses of girls and boys to various questions about their eating, drinking, exercise, and screen time habits. Graph A shows that most girls and boys eat 3 meals a day and drink milk at breakfast, though boys are more likely to eat more at dinner or prefer red meat. Graph B indicates that similar percentages of girls and boys like fast food and do sports outside of school, though more boys do sports. Around half of both girls and boys have a TV in their room and watch 1+ hours of TV per day.
Mobile technology has seen rapid adoption globally over the past decade. Smartphone usage in particular has accelerated, with over half of US mobile users projected to have smartphones by 2015. This shift has transformed consumer behavior and led to new forms of mobile commerce and payments. New York has emerged as a major technology hub, with over 300 digital startups founded in recent years. The city has a growing ecosystem of local and outside venture capital firms investing in mobile and digital companies. Entrepreneurs are advised to have a clear strategic plan, network widely, be realistic about valuation expectations, and choose funding partners carefully.
1) Nearly two-thirds of seniors surveyed were very satisfied with their current Medicare coverage, though satisfaction was lower among younger seniors.
2) Seniors were generally satisfied with specific aspects of their Medicare coverage except for prescription drug inclusion. Satisfaction increased with age.
3) Only 39% were very confident their coverage would meet needs if health declined, confidence was lower among younger seniors.
4) While over half planned to keep their current coverage, 44% would consider changes, with younger seniors more open to changes than older seniors.
5) About 18% reported changing their Medicare coverage at least once, similar across age groups.
Highlights from e expectations 2012 s geyer noel-levitzStephaneGeyer
The survey found that high school juniors and seniors rely heavily on guidance counselors, friends, teachers, and family when forming their list of potential colleges to consider. They commonly use school brochures/print mail, web searches, and emails from schools as resources. When researching academics, costs, and scholarships, students prefer details on school websites and printed brochures. They find campus visits and school websites most helpful for learning about a campus location and community. Overall, while print materials remain important, digital resources are increasingly influential in students' college selection processes.
Wake County public schools calendar survey resultsNews 14 Carolina
The Wake County Public School System released the results for its 2010 School Calendar Survey. The school board plans to use the survey results in their decision about the future of mandatory year-round schools. About 30 percent of the county's parents responded.
Trends and Disparities in Children's Health Insurance: New Data and the Impli...soder145
This document summarizes key findings from an analysis of trends in children's health insurance coverage between 2016 and 2017. Some key points:
- The uninsured rate among children in the U.S. increased from 4.7% in 2016 to 5% in 2017, reversing over a decade of decline. This represented nearly 270,000 additional uninsured children.
- The increase was driven by a decline in public coverage, particularly Medicaid. Uninsurance rose across most demographic groups.
- There was considerable variation between states, from a low of 1.4% uninsured in Vermont to a high of 10.7% in Texas.
- States with low uninsurance typically had high rates of employer-sponsored insurance or
Exploring Disparities Using New and Updated MEasures on SHADAC's State Health...soder145
Slides from webinar webinar introducing two new measures of health outcomes and social determinants of health on SHADAC’s State Health Compare—Unhealthy Days and Unaffordable Rents. This presentation, hosted by SHADAC researchers Brett Fried and Robert Hest, examine these new measures and highlight how the estimates can be used to explore disparities between states and among sub-populations.
This document discusses how a collaborative called "Paying More for the American Dream" uses Home Mortgage Disclosure Act (HMDA) data to support advocacy and increase lending in communities. It describes how the group analyzes raw HMDA data to focus on hot issues like subprime lending and produce reports highlighting findings. The collaborative tells its story with data by determining messages, presenting findings visually through charts and maps, and retelling the story in multiple ways to increase understanding. The document lists collaborators from organizations in several states and provides contact information for more details.
AUSL is a non-profit organization that manages 19 schools in Chicago, serving over 10,500 students. It focuses on turning around chronically failing schools through teacher training programs and a disciplined transformation process. AUSL schools have seen significant gains in student achievement compared to previous years and other CPS schools.
85% of Americans use the internet and internet use increases with younger age groups. 66% of Americans have home broadband access which has doubled since 2000. Device ownership has seen a mobile revolution with more people owning smartphones and tablets than desktop computers. 2/3 of online adults use social media with nearly half using it on a typical day.
Presentation charity analytics natuurpunt at bpost media and social day 2013 ...mma
This document summarizes a project to analyze member loyalty and predict churn for a non-profit nature conservation organization. Key findings include:
- Involvement level, having a standing order, recruitment type, and province all impact membership duration. Members who donate or volunteer have longer tenures.
- A predictive model was created to assign each member a "churn score" between 0-1 based on likelihood to stop membership in the next year.
- Recommendations focus on retention efforts like targeted mailings, traffic light risk ratings, and investigating reasons for stopping renewals. Overall, predictive analytics can make churn prevention more actionable.
The document discusses changes in humanitarian action over the last 10 years and trends to expect in the next 10 years. It notes that humanitarian assistance funding has increased while attacks on aid workers have also risen. Three major trends are identified: (1) humanitarian assistance is increasing but trust in humanitarianism is decreasing; (2) respect for universal principles is declining while nationalism and sovereignty are rising; (3) conflict-related crises are declining relatively while natural disasters are increasing. The importance of humanitarian principles is emphasized amid these challenges facing humanitarian action.
Internet Governance Forum – USA
Speech by Lee Rainie
Director, Pew Internet & American Life Project
October 2, 2009
A discussion of the critical uncertainties about the evolution of the internet.
This document provides an overview of health reform and how hospitals are responding to changes. It discusses rising healthcare costs in the US compared to other countries. Key aspects of the reform are outlined, including the creation of Accountable Care Organizations and a shift to paying for outcomes rather than procedures. The document also summarizes some of the main ways hospitals are responding, such as aligning with physicians, focusing on the full care continuum, increasing transparency, emphasizing value over volume, and developing a shared community vision. Employer strategies for incentivizing employees to use high quality, low cost providers are also reviewed.
Director Lee Rainie gave a keynote at the NFAIS annual conference about the way the internet and mobile connectivity have transformed the worlds of networked individuals. He discussed how normal life has changed in the past decade because of three revolutions in technology: 1) the spread of broadband; 2) the rise of mobile connectivity; and 3) the emergence of technological social networks. He will discuss trends and likely future developments in technology that will shape the way people learn, share, and create information.
65% of online adults now use social networking sites, up from 61% one year ago. Women maintain their lead in social networking usage, with 69% of online women using sites compared to 60% of men. While young adults ages 18-29 have always been the most active users of social networking sites, older age groups are adopting them at higher rates, with usage among those ages 50-64 and 65+ increasing over the past year.
65% of online adults now use social networking sites, up from 61% one year ago. This means that half of all adults now use social networking sites. Usage has increased rapidly since 2005, when only 8% of internet users used social networking sites. Women maintain a foothold on social networking site use, with 69% of online women using sites compared to 60% of online men. Younger age groups are more likely to use social networking sites, though usage is growing faster among older age groups. When asked about their experiences, most social networking users describe them in positive terms like "good" and "fun".
"65% of online adults use social networking sites" uso de medios sociales en ...Retelur Marketing
Estudio realizado por The Pew Research Center's Internet & American Life Project en el que se analiza el uso y penetración de las redes sociales en la sociedad americana. (inglés)
This document contains data from quarterly reading comprehension assessments for 5th grade students. It includes two graphs showing the percentage of students scoring at or above the standard for each quarter, ranging from 0% to 100%. It also contains two tables with item analysis data for each question on the assessments for two different reading units, including the percentage of students answering each question correctly. The document provides information on collecting assessment data both online and using paper assessments.
Final (For Web) Presentation To Council Of Great City Schools Houstonbiferguson
This document discusses the development and implementation of a new "Fair Student Funding" model for Baltimore City Public Schools. It summarizes the historical challenges facing the district, including declining enrollment and funding shortfalls. It then outlines the goals and principles of the new student-based funding model, which aims to allocate resources in a simple, equitable, and transparent manner so that schools can better meet student needs.
The document discusses trends in the mobile industry in 2011 and projections for 2012. Key points include:
- Smartphone penetration dramatically increased in 2011, reaching 48% and fueling growth in the mobile ecosystem.
- Consumers have led technological shifts to mobile, being around 18 months ahead of businesses. This will drive growth in mobile advertising and point-of-sale applications as businesses catch up.
- In 2012, over 60% of mobile phones will be smartphones as falling prices increase accessibility. Geo-local applications and changes to media and commerce will continue.
- The report focuses on opportunities in content, marketing/advertising, mobile commerce/services, and payments—areas that will drive consumer value
The document contains the results of a questionnaire given to students in Years 3 to 6 at Essex Primary School. It includes two graphs (Graphs A and B) that show the responses of girls and boys to various questions about their eating, drinking, exercise, and screen time habits. Graph A shows that most girls and boys eat 3 meals a day and drink milk at breakfast, though boys are more likely to eat more at dinner or prefer red meat. Graph B indicates that similar percentages of girls and boys like fast food and do sports outside of school, though more boys do sports. Around half of both girls and boys have a TV in their room and watch 1+ hours of TV per day.
Mobile technology has seen rapid adoption globally over the past decade. Smartphone usage in particular has accelerated, with over half of US mobile users projected to have smartphones by 2015. This shift has transformed consumer behavior and led to new forms of mobile commerce and payments. New York has emerged as a major technology hub, with over 300 digital startups founded in recent years. The city has a growing ecosystem of local and outside venture capital firms investing in mobile and digital companies. Entrepreneurs are advised to have a clear strategic plan, network widely, be realistic about valuation expectations, and choose funding partners carefully.
1) Nearly two-thirds of seniors surveyed were very satisfied with their current Medicare coverage, though satisfaction was lower among younger seniors.
2) Seniors were generally satisfied with specific aspects of their Medicare coverage except for prescription drug inclusion. Satisfaction increased with age.
3) Only 39% were very confident their coverage would meet needs if health declined, confidence was lower among younger seniors.
4) While over half planned to keep their current coverage, 44% would consider changes, with younger seniors more open to changes than older seniors.
5) About 18% reported changing their Medicare coverage at least once, similar across age groups.
Highlights from e expectations 2012 s geyer noel-levitzStephaneGeyer
The survey found that high school juniors and seniors rely heavily on guidance counselors, friends, teachers, and family when forming their list of potential colleges to consider. They commonly use school brochures/print mail, web searches, and emails from schools as resources. When researching academics, costs, and scholarships, students prefer details on school websites and printed brochures. They find campus visits and school websites most helpful for learning about a campus location and community. Overall, while print materials remain important, digital resources are increasingly influential in students' college selection processes.
Wake County public schools calendar survey resultsNews 14 Carolina
The Wake County Public School System released the results for its 2010 School Calendar Survey. The school board plans to use the survey results in their decision about the future of mandatory year-round schools. About 30 percent of the county's parents responded.
Trends and Disparities in Children's Health Insurance: New Data and the Impli...soder145
This document summarizes key findings from an analysis of trends in children's health insurance coverage between 2016 and 2017. Some key points:
- The uninsured rate among children in the U.S. increased from 4.7% in 2016 to 5% in 2017, reversing over a decade of decline. This represented nearly 270,000 additional uninsured children.
- The increase was driven by a decline in public coverage, particularly Medicaid. Uninsurance rose across most demographic groups.
- There was considerable variation between states, from a low of 1.4% uninsured in Vermont to a high of 10.7% in Texas.
- States with low uninsurance typically had high rates of employer-sponsored insurance or
Exploring Disparities Using New and Updated MEasures on SHADAC's State Health...soder145
Slides from webinar webinar introducing two new measures of health outcomes and social determinants of health on SHADAC’s State Health Compare—Unhealthy Days and Unaffordable Rents. This presentation, hosted by SHADAC researchers Brett Fried and Robert Hest, examine these new measures and highlight how the estimates can be used to explore disparities between states and among sub-populations.
Leveraging 1332 State Innovation Waivers to Stabilize Individual Health Insur...soder145
Presentation by SHADAC Senior Research Fellow Emily Zylla at the 2018 Association for Public Policy Analysis & Management (APPAM) Fall Research Meeting in Washington, DC.
Modeling State-based Reinsurance: One Option for Stabilization of the Individ...soder145
This document summarizes research on modeling state-based reinsurance programs to stabilize individual health insurance markets. Key findings include:
- An estimated $60 billion is spent annually in the individual market, with 2.5% of enrollees accounting for 48.8% of expenditures.
- State reinsurance programs with varying parameters could reduce insurer costs by $6-14 billion nationally per year.
- Estimated reinsurance costs for four states range from $300,000 to $1.8 billion depending on the attachment point and coinsurance rate.
- Federal transitional reinsurance and proposed legislation allocated $10 billion annually, consistent with these estimates.
2017 Health Insurance Coverage Estimates: SHADAC Webinar Featuring U.S. Censu...soder145
Join us for an overview of the 2017 health insurance coverage estimates from two key, large-scale federal data sources: The American Community Survey (ACS) and the Current Population Survey (CPS).
This webinar will examine the new estimates with technical insight from experts at the U.S. Census Bureau, which administers both the ACS and CPS, and from SHADAC researchers.
Attendees will learn about:
The new 2017 national and state coverage estimates
When to use which estimates from which survey
How to access the estimates via Census reports and American FactFinder
How to access state-level estimates from the ACS using SHADAC tables
SHADAC researchers and Census experts will answer questions from attendees after the presentation.
Exploring the New State-Level Opioid Data On SHADAC's State Health Comparesoder145
Between 2000 and 2016, the annual number of drug overdose deaths in the United States more than tripled, from 17,500 to 63,500, and most of these deaths involved opioids. Despite widespread increases in overdose death rates from natural and semi-synthetic opioids, synthetic opioids, and heroin, individual states’ death rates varied widely. For example, in 2016, Nebraska’s rate of 1.2 deaths per 100,000 people was the lowest in the U.S. for natural and semi-synthetic opioids, while West Virginia’s rate (the highest) was more than 15 times larger, at 18.5 deaths. These deaths are the most glaring indication of the growing crisis of opioid abuse and addiction that has been spreading unevenly throughout the country over the past two decades.
On this SHADAC webinar, Research Fellow Colin Planalp will examine the United States opioid epidemic at the state level, analyzing trends in overdose deaths from heroin and other opioids, such as prescription painkillers. Using data available through SHADAC’s State Health Compare, he will look at which states have the highest rates of opioid-related deaths and which have experienced the largest increases in death rates.
Mr. Planalp will be joined by SHADAC Research Fellow Robert Hest, who will discuss the data on opioid-related overdose deaths from the U.S. Centers from Disease Control and Prevention (CDC) that are available on SHADAC’s State Health Compare. He will also discuss State Health Compare data from the U.S. Drug Enforcement Administration (DEA) on sales of common prescription opioid painkillers. Mr. Hest will show users how to access and use the data for state-level analyses.
This document summarizes research on the intersection of structural risk factors and insurance-based discrimination on healthcare access inequities. The study analyzed data on over 3,800 non-elderly adults in Minnesota to examine how experiences of insurance-based discrimination vary across gender, race, income and insurance status, both independently and combined. It also assessed how the synergistic effects of structural risk factors and reported discrimination influence access to a usual source of care and confidence in getting needed healthcare services. The results show that structural factors like race, income and insurance status combine to produce greater reported discrimination, which then interacts with those factors to further reduce healthcare access. The implications are that reducing inequities requires attention to the convergence of these structural barriers
This study analyzed characteristics associated with accurate reports of health insurance coverage in census surveys. It found that reporting of public insurance was most accurate among low-income, less educated individuals who likely needed care. Reporting varied by specific public program, with family characteristics impacting Medicaid accuracy and respondent characteristics impacting MinnesotaCare accuracy. Private insurance reporting in the ACS was more accurate among advantaged groups, while the CPS saw greater accuracy among older respondents with long-term coverage. The results provide insight into survey design, editing, and using survey data for policy analysis by identifying who reports coverage most reliably.
- The document presents preliminary results from the Minnesota Long-Term Services and Supports Projection Model (MN-LPM), which projects LTSS utilization and costs for Minnesota's Medicaid elderly population through 2030.
- In 2015, over 54,000 Minnesotans received LTSS through Medicaid, costing $991 million total. The model projects these numbers will double by 2030, with LTSS costs reaching $1.7 billion as HCBS use grows significantly faster than nursing home use.
- The model uses Minnesota-specific data on the characteristics of elderly residents and current LTSS spending patterns to generate projections. It is intended to help evaluate potential policy changes that could impact future LTSS needs and costs in
Modeling Financial Eligibility for Medicaid Payment of LTSS
1) Medicaid long-term services and expenditures (LTSS) are a large and growing part of state budgets. States may restrict LTSS eligibility rules to control costs.
2) The researchers modeled LTSS eligibility rules to understand their impact and potential consequences of restricting access.
3) The model found that restricting income eligibility rules had a larger impact on reducing the number of eligible individuals than restricting asset rules. This is because income rules are more broadly applied and generous under current policies.
Poster, advancements in care coordination mn simsoder145
The document summarizes findings from an evaluation of Minnesota's State Innovation Model (SIM) Initiative. It finds that Minnesota's SIM investments increased organizations' capacity for coordinated care in several ways:
1) It strengthened relationships and knowledge sharing between organizations.
2) It improved some care coordination processes like assessing social needs and accessing data.
3) It expanded access to health information exchange capabilities needed to coordinate care across settings.
- Structured interviews were conducted with 33 current and former state agency and health plan staff across 4 states to understand challenges implementing Section 1115 Medicaid expansion waiver programs.
- Key challenges included the significant administrative resources and coordination required across entities, educating enrollees, and reconciling complex program rules across systems.
- While waiver programs allowed for innovative policy testing, the administrative complexity was substantial and ongoing. Implementation involved major efforts to develop new IT systems and operational protocols within tight timelines.
1. The document analyzes the potential impact and costs of state-based reinsurance programs using data from 2012-2015.
2. It estimates that reinsurance subsidies could range from $6.4 billion to $16 billion annually depending on the attachment point and coinsurance rate.
3. Reinsurance costs are estimated to range from close to $300,000 in Illinois to $2 billion in California under sample programs with an 80/20 coinsurance split.
Comparing Health Insurance Measurement Error (CHIME) in the ACS & CPSsoder145
This document summarizes a study that compared survey responses about health insurance from the American Community Survey (ACS) and Current Population Survey (CPS) to actual administrative insurance records to assess accuracy. The study found that both surveys produced reasonably accurate aggregated estimates but that some types of coverage, like direct purchase plans, were less accurately reported. Specifically:
- Both surveys had high sensitivity in detecting those with any insurance but the ACS performed better for direct purchase plans.
- The predictive power of reported coverage types varied, with direct purchase again less accurately predicted than employer-sponsored coverage.
- Prevalence estimates based on surveys were generally within a few percentage points of administrative records, though CPS estimates were less accurate for
Who Gets It Right? Characteristics Associated with Accurate Reporting of Heal...soder145
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1. Barriers to care among
publicly insured adults
Kathleen Thiede Call
CHE Health Equity Conference
Earle Brown Heritage Center
April 24, 2012
Funded by a grant from the Robert Wood Johnson Foundation
2. Setting the Stage
• The Patient Protection and Affordable Care Act
(ACA), passed in March 2010, expands public
program eligibility
• Lack of insurance creates disparities in access
to health care
• Providing health insurance may not do enough
eliminate access disparities
• Project aims:
– Describe barriers to care among a diverse insured
population and
– Explore the impact of barriers on access to care
2
4. Acknowledgements:
• Funded by a grant from the Minnesota
Department of Human Services
• Contributors
– The Disparities Team
– Wilder Research
• Karen Soderberg @ SHADAC
4
5. Definitions
• Minnesota Health Care Programs
– Medicaid/Medical Assistance
– MinnesotaCare
– General Assistance Medical Care
• No copayments for preventive services
5
6. Methods
• Sampled 2008 enrolled population stratified
by ethnicity
– African American, American Indian, Hispanic/Latino,
Hmong and Somali enrollees with European American as
contrast
– Adult and child enrollees, parent as proxy
• Mixed mode survey
– English only for mail version; translated for telephone
follow-up (English, Hmong, Somali and Spanish)
– 4,626 surveys (RR = 44%); Adult surveys: 2,194
• Focus groups & community forum informed
recommendations 6
7. Survey Content:
• Self-rated health and disability
• Use of medical services
• Barriers to health care – today’s focus
• Trust and confidence in doctors
• Perceived discriminatory attitudes
• Interpreter availability and quality
7
8. Presentation Overview
• Examine how even those with insurance
report experiences that hinder access to care
– Describe the impact of ethnicity on variation in
experiencing barriers to services
– Explore whether ethnic differences hold once
background characteristics associated with
access are controlled
– Examine the impact of barriers on access to and
use of health care services
8
9. Demographic and Health Status
Characteristics, Adults
European American African Hispanic/
Hmong Somali
American Indian American Latino
Unweighted sample size 347 276 199 321 369 219
Weighted population size 162,909 18,206 24,207 11,730 6,481 6,784
Female 65.0% 79.5% 69.5% 71.7% 49.8% 64.9%
Average age 42.7 39.7 41.6 37.6 41.0 38.1
Married 42.2% 29.0% 22.1% 54.1% 44.6% 48.6%
High school graduate 83.2% 74.9% 68.7% 60.8% 30.2% 37.4%
Employed 43.7% 28.1% 23.7% 32.7% 21.3% 31.1%
Resides in Metro area 58.2% 61.6% 94.6% 63.8% 98.3% 92.6%
Born in U.S. 97.6% 99.2% 100.0% 45.6% 21.9% 0.0%
Non-English language
0.0% 0.1% 0.0% 37.0% 31.9% 64.1%
spoken at home
Reports excellent, very
good, or good health 76.9% 63.5% 65.4% 75.1% 74.7% 81.4%
status
Red bolded items are significantly different than European American (p< .05)
9
10. Barriers to Care Domains
100%
85.4%
81.5% 80.9%
80% 75.5% 76.8% 77.1%
73.2%
70.6% 70.9%
67.9%
63.3% 64.5%
59.3%
60% 55.3%
48.1%
43.2%
40%
34.1%
European American
European American
African American
African American
African American
American Indian
American Indian
American Indian
23.0%
Hispanic/Latino
Hispanic/Latino
Hispanic/Latino
20%
Euro Amer
Hmong
Hmong
Hmong
Somali
Somali
Somali
0%
Any cost and coverage barrier Any Access Barrier Any provider-related barriers
Circled items are significantly different than European American
10
11. Prevalence of Barriers to Care (%)
European American African Hispanic/
American Indian American Latino Hmong Somali
Cost and coverage barriers:
Worry insurance won't cover care 40.5 47.3 41.3 53.7 71.4 49.4
Worry will have to pay more than expect 38.7 45.2 49.1 57.6 61.7 42.5
Worry pay more than can afford 50.3 54.4 46.2 61.2 64.8 53.2
Worry medications will cost too much 34.8 38.2 39.1 42.0 60.4 42.5
Not sure if you will be dropped from
MHCP 40.2 44.5 46.8 47.7 66.2 48.3
Don't know what plan covers 41.7 49.2 47.4 44.2 65.3 49.4
Don't know where to go with questions 27.9 39.3 36.4 32.3 60.6 48.5
Any cost and coverage barrier 70.6 75.5 73.2 81.5 85.4 76.8
Access barriers:
Can't get appointment as soon as needed 36.0 41.4 40.7 40.6 52.1 28.6
Transportation problems 23.4 45.7 40.3 32.7 40.4 30.8
Can't see preferred doctor 23.8 28.7 21.5 18.8 44.8 31.4
Office not open when you can go 12.4 24.4 14.7 19.0 41.0 19.6
Don't know where to go 11.3 18.5 15.8 17.7 41.6 20.7
Work or family responsibilities 26.9 31.0 22.0 23.8 59.6 27.0
Availability of childcare 12.7 22.8 15.7 14.3 47.0 26.0
Any Access Barrier 59.3 77.1 67.9 63.3 80.9 64.5
Provider-related barriers:
Doctors don't speak your language 8.3 18.9 11.9 32.8 51.0 29.7
Doctor's don't understand your culture 2.1 15.8 10.2 16.8 50.9 28.0
Doctors don't respect your religious
beliefs 1.1 11.3 3.4 1.8 27.7 15.6
Doctors are not trustworthy 15.0 23.0 21.2 24.1 48.8 25.8
Place of care is not welcoming 8.6 15.4 16.0 10.2 41.1 22.7
Yellow highlights indicate top five
Any provider-related barriers 23.0 43.2 34.1 48.1 70.9 55.3
barriers
Bolded red indicates significant difference from European American
(p < .05) 11
12. Prevalence of Barriers After Adjustment
American African Hispanic/
Indian American Latino Hmong Somali
Cost and coverage barriers:
Worry insurance won't cover care 47.3 41.3 53.7 71.4 49.4
Worry will have to pay more than expect 45.2 49.1 57.6 61.7 42.5
Worry pay more than can afford 54.4 46.2 61.2 64.8 53.2
Worry medications will cost too much 38.2 39.1 42.0 60.4 42.5
Not sure if you will be dropped from
MHCP 44.5 46.8 47.7 66.2 48.3
Don't know what plan covers 49.2 47.4 44.2 65.3 49.4
Don't know where to go with questions 39.3 36.4 32.3 60.6 48.5
Any cost and coverage barrier 75.5 73.2 81.5 85.4 76.8
Access barriers:
Can't get appointment as soon as needed 41.4 40.7 40.6 52.1 28.6
Transportation problems 45.7 40.3 32.7 40.4 30.8
Can't see preferred doctor 28.7 21.5 18.8 44.8 31.4
Office not open when you can go 24.4 14.7 19.0 41.0 19.6
Don't know where to go 18.5 15.8 17.7 41.6 20.7
Work or family responsibilities 31.0 22.0 23.8 59.6 27.0
Availability of childcare 22.8 15.7 14.3 47.0 26.0
Any Access Barrier 77.1 67.9 63.3 80.9 64.5
Provider-related barriers:
Doctors don't speak your language 18.9 11.9 32.8 51.0 29.7
Doctor's don't understand your culture 15.8 10.2 16.8 50.9 28.0
Doctors don't respect your religious
beliefs 11.3 3.4 1.8 27.7 15.6
Doctors are not trustworthy 23.0 21.2 24.1 48.8 25.8
Place of care is not welcoming 15.4 16.0 10.2 41.1 22.7
Any provider-related barriers 43.2 34.1
Controls: Employment, health status, sex, metro, marital & education 48.1 70.9 55.3
status, age, survey language
12
13. Barriers and Access to Health Care
• Move from 3 to 5 barrier domains:
1) Coverage
2) Financial
3) Access
4) Family/work
5) Provider-related
Interested in magnitude: big, small or no
problem
Hypothesis: those reporting big problems
accessing healthcare will be more likely to
report unmet medical needs within the last 13
14. Indicators of Unmet Need
(Precede barriers questions in survey)
1) Forgone needed care
“Was there anytime during the past year when you needed
medical care but did not get it?” (yes/no)
2) Delayed needed care
“Was there anytime during the past year that you delayed getting
medical care that you felt you needed?” (yes/no)
3) No preventive care received in past year
“About how long has it been since you went to a doctor or clinic for
regular or routine care? By regular or routine care, we mean
things like physical checkups, blood pressure or cholesterol
checks, mammograms, pap smears, or other types of preventive
care.” (within past year/more than1 year but less than 3 years/3 to
5 years/more than 5 years)
14
15. Odds of Unmet Need by Level of Perceived Barriers
to Care: Adult MHCP Enrollees
8
7.13
Coverage barriers
6.22
6 Financial barriers
4.81
Access barriers
3.79
3.56
3.53
3.45
3.28
4
3.00
2.87
2.64
2.62
2.58
2.30
2.25
2.21
2.05
1.95
1.75
1.64
1.62
1.54
1.34
1.31
1.22
2
1.02
0.95
0.93
0.88
0.7
0
Some Big Some Big Some Big
Delayed care Foregone care No preventive care
Red bolded items are significantly different than those reporting no problems in the barrier domain.
Controls: Race/ethnicity, age, sex, employment, health
status, metro, marital & education status, survey language
15
16. Summary of Results
• No ethnic group is sheltered from problems
seeking care
• Disparities exist even after controlling for health
status and demographics differences
• The pattern of disparities in barriers runs
opposite their prevalence
– Cost and coverage barriers primary obstacles for all cultural
groups; fewer disparities
– Access barriers second most prominent; more disparities
– Provider-related barriers are less prominent; greatest
disparities
• Barriers impact reports of unmet need but not
reports of preventive care use
– Preventive care use measure has limitations
16
17. Community Endorsed Solutions to Cost
and Coverage Barriers
• Develop more accessible (community-based)
and effective information
– Succinct and simplified mailings
– Help lines and navigators
– Outreach initiatives
• Keep copayments low and stables
• Publicize dual function of the Helpline and
Ombudsman
– for answering questions and recording enrollees concerns and
suggestions
– DHS should continue to compile and code the nature of calls and
develop a mechanism to report back
17
18. Community Endorsed Solutions to
Access Barriers
• Develop one-pager outlining enrollee
rights and responsibilities (e.g.,
transportation benefits)
• Allow a modest portion (for example 10%)
of Minnesota's Child Care Assistance
Program to be used to cover health care
appointments
• Expand clinic hours and days
18
19. Community Endorsed Solutions to
Provider-related Barriers
• Remind enrollees that the Helpline and
Ombudsman are venues for airing consumer
praise and complaints
– Need to have reciprocal communication about the
steps DHS or providers have taken to address
enrollee concerns
• DHS should require a mechanism for tallying
complaints against clinic staff, interpreters and
providers, along with stated consequences for
those receiving an inordinate numbers of
complaints
• Increase evaluation and enforcement of CLAS 19
20. Conclusions/Implications
• Enrollment in health insurance does not
guarantee easy access to health care
• Although no cultural group is spared
experiences of barriers, minority enrollees
are significantly more likely to report
problems
• Barriers impact reports of unmet need for
services
• Results foreshadow challenges on the
ACA horizon 20
21. Questions?
Disparities and Barriers to Utilization among
Minnesota Health Care Program Enrollees, 2009
Report available at:
http://www.shadac.org/publications/
21
22. Sign up to receive our
newsletter and updates at
www.shadac.org
@shada
c
23. Defining Community
• Community is characterized by “…a
sense of identification and emotional
connection to other members…shared
values and norms…common interests,
and commitment to meeting shared
needs.”
– - Israel, Schulz, Parker, Becker, Allan, Guzman 2008
• May be geographical or group with a sense of common
identity and shared fate
• CBPR attempts to identify existing communities and
strengthen this sense of community through collective
engagement
23
23
24. Definitions
• Health disparities:
– “A health disparity should be viewed as a chain of
events signified by a difference in: (1) environment,
(2) access to, utilization of, and quality of care, (3)
health status, or (4) a particular health outcome that
deserves scrutiny. Such a difference should be
evaluated in terms of both inequality and inequity,
since what is unequal is not necessarily inequitable.”
(Carter-Pokras, Baquet 2002, p 426)
24
25. Definitions
• Race/ethnicity
– “Racial/ethnic categories are at best
approximations of societally defined
groupings to which individuals are assigned
based largely on skin color, country of origin
or ancestry, and language or dialect spoken”
(Kaplan, Bennett. Use of race and ethnicity in biomedical
publication. JAMA 2003 pp 2709-10)
25
Editor's Notes
This study identifies barriers among at-risk groups and provides an opportunity to understand how even good health insurance may fail to benefit recipients. We describe the extent to which MHCP enrollees report a range of experiences that hinder use of health care and how these barriers vary by ethnicityWe explore ….