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State Health Insurance Reform Modeling: Cost Analysis and Challenges

Learn about modeling comprehensive health insurance access in Massachusetts, estimating costs, movements, participation rates, and revenue. Discover data sources, key questions, partner roles, and challenges in health care reform modeling.

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State Health Insurance Reform Modeling: Cost Analysis and Challenges

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  1. Modeling Health Care Reform: What States Need to Know Amy Lischko Assistant Commissioner, DHCFP Massachusetts Modeling Workshop, November 10, 2004

  2. Today’s presentation • Goals/purpose of MA analysis • Questions • Data • Partners • Sample output • Challenges Modeling Workshop, November 10, 2004

  3. Goals of Analysis • To analyze comprehensive models for increasing access to health insurance in Massachusetts by estimating: • Costs • State and Federal • Other • Movements (including crowd-out) • Participation rates • Revenue estimates Modeling Workshop, November 10, 2004

  4. Questions • What options do you want to evaluate? • Comprehensive vs. incremental • What data are available? • State, Federal, other • What output do you require? Who is your audience? • Does the work require outside expertise? • How much can you do yourself? • credibility Modeling Workshop, November 10, 2004

  5. Data • State • Individual Data (age, insurance status, employment, income, family status, health status) • Employer Data (average price of plan, % contribution, offer by size) • Insurance Market (price of various plans in each market, benefit coverage) • Medicaid and other public program cost data Modeling Workshop, November 10, 2004

  6. Data • Federal • CPS (adjusted for missing income data) • MEPS (validated employer data) • Other • Behavioral responses from literature • Massachusetts-specific behavioral responses Modeling Workshop, November 10, 2004

  7. Partners • Other agency staff • Actuaries (Mercer, Lewin) • price alternative health insurance plans • Economist (J. Gruber) • modeling Modeling Workshop, November 10, 2004

  8. Actuary output Modeling Workshop, November 10, 2004

  9. Econometric Model Output Modeling Workshop, November 10, 2004

  10. Challenges • Data • Missing values become very important • Never used data for policy-making purposes per se, gaps in understanding was more apparent • You know your state better than national experts, check carefully and ask lots of questions! • Assumptions • Modeling is an art not a science, make sure you’re involved and know what assumptions are being made. • National responses from the literature may not always be pertinent to your state, again, question assumptions! Modeling Workshop, November 10, 2004

  11. A Few Final Words • We had a lot of our own data so it was easier to manage this process than if you’re using federal data sets that you don’t know very well • Once you have a model, lots of interest to use it • Own your model. We don’t have staff trained to use it, costs more money to manipulate it. Modeling Workshop, November 10, 2004

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