SHADAC Expertise

State and Federal Health Policy and Health Reform Strategies

State and Federal Health Policy and Strategies

Our faculty and staff are nationally recognized experts on collecting and applying sound data to inform public health, health care reform strategies, federal healthcare policy, and health policy decisions at both the state and federal levels. We rely on both qualitative and quantitative data sources to identify and frame policy options and bring long-standing qualifications in tapping federal survey data sources. We provide direct technical assistance to individual states, create forums to support state-to-state peer learning, and more broadly conduct targeted research and policy analysis as well as translate technical information into content that is accessible and informative to decision-makers.

Related SHADAC work:
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State Health & Value Strategies Technical Assistance

SHADAC provides technical assistance as part of the Robert Wood Johnson Foundation’s (RWJF's) State Health & Value Strategies (SHVS), a program that connects state officials with experts in the field to support them in transforming their health care systems to be affordable, equitable, and innovative. SHADAC provides analytic and evaluation support with the goal of helping states use sound data to inform policy decisions on topics such as Medicaid, state health policy, federal healthcare policy, health equity, multi-payer delivery system and payment reform, quality measurement, coverage and access expansions, health insurance exchanges, and population health. Recent work has focused on the unwinding of the Medicaid continuous coverage requirement, where SHADAC has worked closely with several states to model the enrollment impacts of unwinding.  Another ongoing area of support is helping state agencies improve the quality and collection of enrollee demographic data (e.g. race, ethnicity, language, disability, sexual orientation and gender identity) with a goal of improved health equity programming. This is done both by working with states one-on-one, but also through a peer-learning group aimed at discussing specific operational challenges related to data collection, coding and analysis.

State-Based Reinsurance Programs via 1332 State Innovation Waivers

SHADAC maintains a frequently updated resource highlighting state reinsurance policies passed using a 1332 waiver. This information is presented in an interactive map that provides an overview of the different stages of states' 1332 waiver reinsurance applications.

Public Health Implications of Cannabis Policy in Minnesota

SHADAC and the University of Minnesota’s Cannabis Research Center (CRC) have released a brief using data from the National Survey on Drug Use and Health (NSDUH) to understand issues related to public health implications of Minnesota cannabis use prior to its 2023 legalization. Along with providing key background information and context on cannabis policy in the United States, this brief specifically examines three oft cited concerns with cannabis legalization: the prevalence of cannabis use; cannabis abuse and dependence (i.e., addiction); and driving under the influence of cannabis. The data in this brief are intended to serve as starting points for discussions on the public health impacts of Minnesota cannabis policy. Read the brief in full here along with this accompanying blog post.

Minnesota Long-Term Services and Supports: Demographics Report, Future Utilization & Payments, Projection Model

Lynn Blewett, founding Director of SHADAC, worked alongside researchers at Purdue University to author a report on utilization, cost, and demographics of populations that use Long-Term Services and Supports (LTSS) in Minnesota. This was conducted as part of a larger study, Own Your Future 3.0: Planning for Minnesotans’ LTSS Needs, sponsored by Minnesota’s Department of Human Services, Aging and Adult Services Division. SHADAC researchers and collaborators on this project worked towards the objectives of studying current and future use of Long-Term Services and Supports (LTSS) for older Medicaid enrollees and the general older population in Minnesota, describing LTSS service utilization and expenditures for Minnesota’s older population in 2016-2021, and estimating future Medicaid LTSS utilization and expenditures using demographic data, areas of need, and other information. SHADAC has also collaborated with the Minnesota Department of Human Services to develop a model estimating future Medicaid utilization and spending in Minnesota for long-term services and supports (LTSS). The spreadsheet model leveraged data from the American Community Survey (ACS), the state’s Medicaid Management Information System (MMIS), and the state’s Survey of Older Minnesotans to define current Medicaid cohorts and use, calculate projections of future eligibility, and delineate predictors of LTSS service use under different economic and policy assumptions.

Past Work

Leveraging 1332 State Innovation Waivers to Stabilize Individual Health Insurance Markets

Funded by the Robert Wood Johnson Foundation (RWJF), SHADAC researchers documented the strategies and rationale of the first three states to receive federal approval to establish state reinsurance programs with federal funding—Alaska, Minnesota, and Oregon—via Section 1332 State Innovation Waivers in order to address the volatility of their individual health insurance markets. SHADAC identified challenges, facilitators, and lessons learned during the waiver application and implementation processes that could be helpful for states considering similar state health policy action and for federal regulators interested in supporting similar state initiatives.

Strategies to Increase Access to Medications for Opioid Use Disorder during the COVID-19 Pandemic and Beyond

SHADAC researchers, along with Hennepin Healthcare researcher Tyler Winkelman, authored a Milbank Foundation policy brief that examines the federal healthcare policy and state policy changes put in place to improve access to medications for opioid use disorder (MOUD) during the COVID-19 pandemic, during which time MOUD became especially challenging to access because MOUD patients are typically required to have as many as six in-person clinic visits a week. The authors conclude with federal and state policy recommendations based on their analysis.

Assessment of State Health Information Exchange Policy

On behalf of the Connecticut Health Foundation, SHADAC authored a policy brief exploring the launch of a new statewide health information exchange (HIE)—the Health Information Alliance— in Connecticut. In addition to providing context for the state’s new HIE, the brief also offers an overview of the current landscape in Connecticut related to information exchange and describes opportunities and potential obstacles going forward, such as the need for robust provider participation, provision of incentives to ensure participation, and the development of a long-term funding and patient engagement strategy. To inform this work, SHADAC researchers conducted a review of select national and state literature and organized interviews with key stakeholders both in Connecticut and in other states that are further along with statewide HIE efforts, with the goal of helping policymakers and those interested in patient care and population health understand where the state is today, what’s coming, and what to consider for success.