SHADAC Data Center and RWJF DataHub Chosen as Health Data All-Stars
TheSHADAC Data Centerand theRWJF DataHubwere both selected as “Health Data All-Stars” by theHealth Data Consortium, a health data advocacy group with key members including the Institutes of Medicine, the U.S. Department of Health and Human Services, the Robert Wood Johnson Foundation (RWJF), and the California HealthCare Foundation (CHCF). The 50Health Data All-Starsare “prominent domestic resources for health data at the federal, state, and local levels,” identified as “the health data resources that matter most” by a group of leading health researchers, government officials, entrepreneurs, advocates, and others. The SHADAC Data Center was highlighted because it facilitates easy state comparisons; data can be viewed in readable line graphs, charts, or tables; and image files can be downloaded and shared with social networks. The RWJF DataHub was chosen because it is “user-friendly for non-sophisticated users;” it allows easy state comparisons; and data can be viewed in a bar graph or table.
ASPE Releases SHADAC Review of Data Sources for Evaluating the ACA Medicaid Expansion
The Assistant Secretary of Planning and Evaluation (ASPE) released aSHADAC report describing and assessing existing data sources that could be used to evaluate the impacts of the ACA on Medicaid-eligible populations and health care providers. The report identifies key outcomes of interest for evaluating the impacts of the ACA on these two groups, the available data sources that can be used to assess these outcomes, and the gaps in the available data. In all, the report examines eight national population surveys, seven provider surveys, and four sources of administrative data from providers. For each of these sources, the report indicates how the data are collected and from whom; how complete or representative the data are for the populations of interest; and what level of geography is available for analysis.
Kathleen Call: American Community Survey (ACS) Over-Counts Medicaid
SHADAC Investigator Kathleen Call presented at the American Association for Public Opinion Research (AAPOR) 28thAnnual Conference in Boston, discussing errors in Medicaid reporting across the American Community Survey (ACS), Current Population Survey (CPS), Medical Expenditure Panel Survey (MEPS), and National Health Interview Survey (NHIS). This analysis is the first to consider how Medicaid reporting in the ACS, in particular, compares to other federal surveys, which generally undercount Medicaid. Dr. Call and her colleagues found that the ACS actuallyover-counts Medicaid for the most part, and they note that this is likely due to the structure of the survey question and the inclusion of the institutionalized population in the survey sample. View Dr. Call’s presentation slides.
News from the States
New Jersey: Populations Not Likely to Enroll in Medicaid or Private Subsidized Coverage in 2014
Thenewestin a series of reports from the Rutgers Center for State Health Policy on New Jersey’s uninsured population considers which uninsured New Jersey adults are unlikely to enroll in Medicaid or private subsidized coverage in 2014 and should therefore be targeted for outreach. The analysis uses the2009 New Jersey Family Health Survey(NJFHS) and finds that respondents who were classified as unlikely to enroll in health insurance are more likely to be male, younger, Hispanic, Asian, or non-citizens. Respondents who are single, separated, or divorced; have less education; or are poorer, were also more likely to opt out of coverage.
Medicaid Crowd-Out in Ohio under an ACA Expansion
Areportfrom authors at The Ohio State University College of Public Health and the Ohio Colleges of Medicine Government Resource Center examines the potential for Medicaid crowd-out in Ohio if the state expands the program under the ACA. The analysis uses the 2012 Ohio Medicaid Assessment Survey (OMAS) and the 2004, 2008, and 2010 Ohio Family Health Surveys (OFHS) to estimate the scope of crowd-out among current adult Medicaid enrollees in the state, observing that crowd-out is a modest problem among this population. Based on this finding, the authors estimate that the state can expect similarly low crowd-out among low-income childless adults if the state expands Medicaid. They point out that crowd-out will likely be higher as income thresholds increase to populations with more access to employer-sponsored insurance, but they estimate that crowd-out should still remain low overall.
U.S. Virgin Islands: Medicaid Expansion Analysis
The final reportfrom the U.S. Virgin Islands (USVI) Health Reform Implementation Task Force includes an analysis of Medicaid expansion in the Territory. The analysis is based on an incremental expansion model using population data from the2009 SHADAC Virgin Islands Health Insurance Survey. The analysis finds that, although the ACA significantly increases federal support for Medicaid expansion in the USVI, the amount of USVI funding required to match the federal funds (which are provided to the USVI at an enhanced FMAP rate of only 55 percent, rather than the initial 100 percent match planned for the states), together with the high demands on the current USVI budget, makes it unlikely that the USVI will be able to fully access all the federal funds available through the ACA. To learn more about the impact of health reform in the USVI, see"Health Reform and the U.S. Virgin Islands: High-Need-Limited Impact,"an analysis by SHADAC researchers published in the February 2013 issue of theJournal of Public Health Management and Practice.
State Medicaid Expansion Decisions: Coverage and Fiscal Impacts by State
Ananalysisconducted by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured (KCMU) examines the impact of state Medicaid expansion decisions on coverage, state finances and hospitals. Using the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM)—which relies on data from the Current Population Survey (CPS), the Medical Expenditure Panel Survey’s Household Component (MEPS-HC), and the National Health Expenditure Accounts (NHEA)—the report provides state-level estimates of Medicaid enrollment; uninsurance; total federal expenditures; total state expenditures; state Medicaid and uncompensated care expenditures; and federal and state Medicaid hospital payments, under expansion and non-expansion scenarios. The authors observe that the states that would benefit most from Medicaid expansion are generally the states that have decided against expansion or are still undecided.
NHIS: 2012 Public Use Data Release and Early Release of Selected Estimates
Public use data files from the 2012 National Health Interview Survey (NHIS) arenow available. The 2012 NHIS continued the sample size augmentation that began in 2011 for 32 states and the District of Columbia in order to increase the number of states for which reliable estimates can be made. The 2012 NCHS also transitioned to the population weights derived from 2010 census-based estimates. Each of the 2012 data release files contains ASCII data and sample statements for SAS, SPSS, and Stata. Also available areearly release estimatesfor selected measures from the 2012 NHIS, including health insurance coverage, type of coverage, usual source of care, obtaining needed care, and general health status, among others. The University of Minnesota will have the 2012 NHIS data linked to the Integrated Health Interview Series(IHIS) later this summer.
See SHADAC Issue Brief #34for details about ACA-related changes to the NHIS questionnaire that were first implemented in the 2011 survey and slightly modified in the 2012 survey. The brief provides the instrument item names, questions, survey components, sample universe, and data file for each of the new survey items.
NHIS: 38.2 Percent of U.S. Households Were Wireless-Only in Second Half of 2012
The National Center for Health Statistics (NCHS) issued anEarly Release Reporton wireless substitution estimates from the July through December 2012 National Health Interview Survey (NHIS). NCHS researchers Stephen Blumberg and Julian Luke report that approximately 38.2 percent of American homes were “wireless-only” –i.e., they had wireless phones and no landline—during the second half of 2012, up 2.4 percentage points from the first half of the year. Additionally, an estimated 15.9 percent of households were “wireless-mostly” in the second half of 2012, receiving all or almost all calls on wireless telephones despite also having a landline.
See SHADAC Issue Brief #15 to learn about the survey research issues posed by the growing presence of wireless-only and wireless-mostly households in the U.S. and potential solutions to these challenges.
2012 MEPS-IC Tables Now Available
The 2012 data from the Insurance Component of the Medical Expenditure Panel Survey (MEPS-IC) are now available on the MEPS website. These data are available in state-level tables providing private sector data by firm size, state, industry groupings, ownership type, age of firm, employee characteristics, and average wage quartiles. Data from these tables are also available for individual states instate-specific spreadsheets, which can be downloaded for any State/year combination in either Excel or CSV format.
HHS Survey Enhancements to Monitor Health Reform and Other Health System Changes
The office of the Assistant Secretary of Planning and Evaluation (ASPE) released areportoutlining the steps taken by the U.S. Department of Health and Human Services (HHS) to modify and enhance several of the surveys and major data systems in the HHS portfolio for the purpose of monitoring health reform and other health system changes. For each of the affected surveys, the ASPE report details new questionnaire items; modifications to existing questions; expansions in sample size; changes in sample design; enhancements to modeling and simulation capacities; new efforts to disseminate preliminary data; and reductions in turnaround cycles for estimates.
Report and Webinar: Multi-State Insurance Exchanges
The National Association for State Health Policy (NASHP) released a final report from the West Virginia Regional Exchange Study, which was conducted by NASHP under contract with the West Virginia Offices of the Insurance Commissioner to analyze options for a multi-state health insurance exchange. The report presents results from discussions conducted with a range of experts and state officials in six states regarding a broad spectrum of exchange functions that hold promise for sharing (e.g., consumer assistance; eligibility and enrollment; and IT, etc.). The report outlines identified motivations for sharing; priority functions for sharing; various models for sharing; considerations that could affect the success or likely benefit of a sharing arrangement; and recommended next steps toward realizing the benefits of sharing. NASHP will host a webinar highlighting findings from this study on July 24, 2013, at 2:30 p.m. ET.
SHADAC Welcomes Sam Patnoe
SHADAC is pleased to welcome our newest staff member,Sam Patnoe, who joined us this month as a Research Fellow. Sam comes to SHADAC from Washington, DC, where he obtained his master’s in public health from the George Washington University, majoring in epidemiology. While in Washington, Sam helped assess the system-wide mandatory influenza vaccination program at the Johns Hopkins Hospital and Health System. He also worked in health communications promoting the National Diabetes Education Program (NDEP) as an NDEP Fellow at Hager Sharp, a public relations firm in the District. We are very happy to have Sam--yet another graduate of St. John's University (Go Johnnies!)--on staff. Welcome Sam!
The State Health Access Data Assistance Center (SHADAC) is a program of the Robert Wood Johnson Foundation and a part of the Health Policy and Management Division of the School of Public Health at the University of Minnesota.