A framework for tracking the impacts of the Affordable Care Act in California
- Contributor(s):
- Sonier, Julie. Lukanen, Elizabeth. State Health Access Data Assistance Center, University of Minnesota. California HealthCare Foundation.
- Publication:
- [Minneapolis, Minn.] : State Health Access Data Assistance Center, Division of Health Policy Management, University of Minnesota, [2011]
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Delivery of Health Care -- legislation & jurisprudence Health Care Costs -- legislation & jurisprudence Health Care Reform -- legislation & jurisprudence Health Services Accessibility -- legislation & jurisprudence Insurance Coverage -- legislation & jurisprudence Insurance, Health -- legislation & jurisprudence Data Collection Delivery of Health Care -- economics Health Care Reform -- economics Health Services Accessibility -- economics Insurance Coverage -- economics Insurance, Health -- economics Humans California United States United States.
- Genre(s):
- Technical Report
- Abstract:
- The federal Patient Protection and Affordable Care Act (the ACA), enacted in March 2010, will have far-reaching impacts on health insurance coverage, health care financing, and health care delivery in the United States. Understanding the state-level impacts of the ACA will contribute to a better understanding of the national impacts of the law and will provide information to shape ongoing state implementation activities. The goal of this project was to recommend how California (and the California HealthCare Foundation) can measure and monitor the impacts of health care reform in three areas: health insurance coverage; affordability and comprehensiveness of health insurance coverage; and access to health care services. Within each of the three focus areas for this project we identified several categories of metrics needed to monitor the impacts of the ACA. We recommend a total of 51 measures that California can use to monitor the impacts of health care reform over time: 19 related to insurance coverage, 15 related to affordability and comprehensiveness of coverage, and 17 related to access to care. The recommended measures are summarized in Figure 1. Next, we reviewed and assessed existing state and national data sources to determine how each data source might be employed to measure the impacts of the ACA in California. The data sources include population surveys and employer surveys, as well as data from health care providers, health plans, and public programs (e.g., Medi-Cal, county programs for indigent care). For each source of data we compiled technical information, such as: how the data are collected and from whom; how complete or representative the data are; whether comparisons can be made to other states and U.S. averages; whether comparisons can be made for regions within California; and whether the data can be used for monitoring trends among specific population groups such as children, people with low incomes, and by race and ethnicity. We reviewed the data collection instruments (e.g., survey questionnaires), technical documentation for the data sources, and publicly available reports that use the data. For data sources that are unique to California we also conducted key informant interviews with experts who are regular users of the data sources or who are responsible for the data collection in order to better understand the strengths and weaknesses of the data. Selecting the "best "data source for each measure involved assessing the availability of the recommended measures from each data source, and weighing the strengths and weaknesses of potential data sources. Figures 2, 3, and 4 present our recommended data sources for each measure, with asterisks showing where there are gaps in existing data to track these measures. To summarize the gaps in existing data, we divided them into two categories. The first category includes measures that could be collected or modified using existing data collection infrastructure; the second includes measures that cannot be collected until full implementation of the ACA's coverage provisions in 2014. Figures 5 and 6 provide an "at a glance" summary of the data gaps we identified and our recommendations for filling them. Finally, we identified different ways to analyze and present the recommended measures to policymakers and the public to inform them about the impact of health reform in California. Key elements of a successful data dissemination strategy will include organizing content in a thoughtful way, allowing users to view data in a variety of different formats, presenting measures in a way that highlights key information, and making technical documentation accessible.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101567359 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101567359