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

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

3. 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

4. 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

5. 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

6. 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

7. 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

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

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

10. 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

11. 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