Can Post-Stratification Adjustments Do Enough to Reduce Bias in Telephone Surveys that Do Not Sample Cell Phones? It Depends
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1. A study examined whether post-stratification adjustments can reduce bias in telephone surveys that do not sample cellphone-only households. 2. The study found that adjusting survey weights to account for cellphone-only households significantly reduced bias for key health outcomes like health insurance coverage and access to care. 3. However, the adjustments were less effective for some populations like Hispanics, Blacks, and young adults. Overall bias remained small after adjustments.
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Scope of Practice: Colorado and the Current Debate
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The document analyzes trends in employer-sponsored health insurance (ESI) in the United States and Minnesota after the Affordable Care Act. It finds that while the percentage of U.S. workers offered and eligible for ESI dropped slightly from 2013-2014, Minnesota saw no significant changes. Both saw minimal increases in workers taking up ESI. Individual premiums significantly increased every year in the U.S. and 2013-2014 in Minnesota. Enrollment in high-deductible plans rose each year in the U.S. and 2013-2014 in Minnesota. The concerns over reduced ESI due to the ACA appear overstated while rising individual costs remain a policy issue.
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The Seattle Fire Department developed a model for educating multicultural communities about fire safety using Community Fire Safety Advocates (CFSAs). [1] After a tragic house fire killed five East African immigrants, the Department partnered with the community to create CFSAs, who are community members trained to provide culturally competent fire safety education. [2] The pilot program trained and deployed CFSAs to the East African community, reaching over 4,000 people and establishing positive relationships. [3] Evaluation found the CFSAs improved fire safety knowledge and the Department has since expanded the program to other languages and cultures.
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This document summarizes research contrasting two measures of health insurance literacy and their relationship to health care access. The researchers analyzed data from a 2015 Minnesota health survey. They found that:
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The document summarizes research comparing estimates of Medicaid enrollment in 2013 and 2014 from the American Community Survey (ACS) and Centers for Medicare and Medicaid Services (CMS) administrative data. The research finds that states with the largest increases in Medicaid enrollment according to CMS also tended to have the largest differences between ACS and CMS estimates, with ACS generally reporting lower enrollment. This suggests the ACS may overstate uninsurance rates where Medicaid enrollment increased substantially. However, misreported coverage likely represents shifts between coverage types rather than uninsurance. Future research should analyze additional years of data and link administrative and survey sources to better understand reporting errors.
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Changing Trends in Employer Sponsored Insurance After the Affordable Care Act
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Adding complexity to an already difficult task: Monitoring the impact of the ...
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Physician Participation in Medi-Cal: Is Supply Meeting Demand?
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This document summarizes research examining whether post-stratification adjustments can reduce bias in telephone surveys that do not sample cell phone-only households (CPOH). The study used NHIS data to compare health estimates with and without CPOH. Post-stratification weighting reduced bias on most outcomes, especially for insurance coverage and access. Bias reduction worked best for the overall population but less so for Hispanics, Blacks, and young adults. While post-stratification can help account for omitting CPOH, more work is needed to monitor its effectiveness over time as phone usage changes.
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Sick and Tired
1) Social assistance recipients in Ontario have significantly poorer health outcomes than both the working poor and non-poor across a wide range of health measures, even after controlling for other socioeconomic factors.
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This study analyzed insurance claims data from before and after the implementation of the Federal Mental Health Parity and Addiction Equity Act to examine the effects of parity on substance use disorder treatment. The results showed:
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This document discusses socioeconomic issues in medicine. It summarizes that:
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This study used data from the National Health Interview Survey to evaluate the impacts of health reform efforts in New York and Massachusetts on health insurance coverage, access to care, and health care use. The researchers found:
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This document summarizes key findings from an analysis of trends in children's health insurance coverage between 2016 and 2017. Some key points:
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This document summarizes research on modeling state-based reinsurance programs to stabilize individual health insurance markets. Key findings include:
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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).
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The new 2017 national and state coverage estimates
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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.
Ibd intersectionality
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
Who gets it right
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.
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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 sim
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.
Poster, section 1115 waivers
- 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.
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- 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.
Modeling state based reinsurance
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 & CPS
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...
This document summarizes a study examining factors associated with accurate reporting of health insurance coverage type. The study used survey data matched to enrollment records from a health plan. It found:
1) Reporting accuracy was highest for those with employer-sponsored insurance and lowest for those with direct purchase or Medicaid coverage.
2) Among those with direct purchase insurance, reporting accuracy was higher for those who were white, non-Hispanic, fully employed, and from higher income households.
3) For Medicaid enrollees, reporting accuracy was higher for those who were unemployed, from lower income and education households.
Medicaid vs. Marketplace Coverage for Near-Poor Adults: Impact on Out-of-Pock...
1) The document analyzes the impact of state Medicaid expansion decisions on out-of-pocket health expenses and insurance coverage for low-income adults making 100-138% of the federal poverty level.
2) It finds that Medicaid expansion was associated with lower total out-of-pocket spending (a reduction of $353), lower premium spending (a reduction of $118), and lower medical spending (a reduction of $235) compared to non-expansion states.
3) Medicaid expansion also increased Medicaid coverage by 11.1 percentage points and decreased the uninsured rate by 4.5 percentage points for this low-income group relative to non-expansion states.
The Impact of Medicaid Expansion on Employer Provision of Health Insurance
- The study examines the impact of Medicaid expansion under the ACA on employer-sponsored health insurance (ESI) offers, out-of-pocket premiums, and eligibility using data from 2010-2015.
- The results show Medicaid expansion decreased worker eligibility for ESI offers by 4 percentage points but had no effect on ESI offers or out-of-pocket premiums. There was also no differential effect for low-wage establishments.
- The authors note the short-term effects may differ from long-term effects, and ongoing uncertainty could impact employer behavior and outcomes over time as more states expand Medicaid.
Shadac acs cps-webinar 2016-final_sept21
The document summarizes key information from a webinar about 2015 health insurance coverage estimates from the American Community Survey (ACS) and Current Population Survey (CPS). It provides an overview of the surveys' methodologies, measures of health insurance coverage, changes in insurance rates from 2013 to 2015, and resources for accessing public data from the ACS and CPS. New products for analyzing health insurance coverage from both surveys were also announced.
2014 SAHIE: Overview with Census Experts
The document summarizes a webinar presented by experts from the U.S. Census Bureau on the Small Area Health Insurance Estimates (SAHIE). SAHIE provides county-level estimates of health insurance coverage across various demographic groups. The webinar discussed the 2014 SAHIE release, which incorporated more up-to-date Medicaid data and showed substantial changes in insurance rates from 2013 to 2014. The webinar also reviewed the data sources and methodology used to produce the SAHIE estimates.
The changing demographics of the uninsured in MN and the nation
The document analyzes changes in the demographics of the uninsured in Minnesota and nationally between 2013 and 2014 following coverage expansions under the Affordable Care Act. It finds that uninsured rates declined significantly in both Minnesota and all 50 states. While the characteristics of the uninsured remained largely the same, the uninsured population is now more likely to be Hispanic, non-citizens, and Spanish speakers in both Minnesota and nationally. The uninsured are also less likely to be children in Minnesota and very low income or Asian nationally. Continued outreach efforts are needed to enroll groups with historically high uninsurance rates.
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