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

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

Modeling Workshop, November 10, 2004 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 Mention monitoring what goes on in a de-regulated market…this is where we began Modeling Workshop, November 10, 2004

Modeling Workshop, November 10, 2004 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

Modeling Workshop, November 10, 2004 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

Modeling Workshop, November 10, 2004 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

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

Modeling Workshop, November 10, 2004 Actuary output Modeling Workshop, November 10, 2004

Econometric Model Output Modeling Workshop, November 10, 2004

Modeling Workshop, November 10, 2004 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

Modeling Workshop, November 10, 2004 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