November 2012
Health Strategies of New Hampshire
Lewin contact: Randy Haught
As a result of the June 2012 Supreme Court ruling that the federal government cannot require individual states to expand their Medicaid programs for adults, as under the Affordable Care Act (ACA), The Lewin Group is working with the New Hampshire Department of Health and Human Services (DHHS) to explore the potential financial impacts of expanding or not expanding the state’s Medicaid program. This report provides estimates on Medicaid enrollment and costs under the option of not expanding Medicaid compared to the option of expanding the program under various program design options. We find that if the state does not expand Medicaid, it could reduce state Medicaid spending by $66 to $114 million over the 2014-2020 period. However, expanding Medicaid would (1) reduce the number of uninsured in the state by an additional 22,300 people, (2) provide subsidized coverage for low income adults in the state, who would not have access without the expansion, and (3) increase federal revenues in the state by $1.8 to $2.7 billion over the 2014-2020 period.
In Phase II of the study, to be released in December 2012, Lewin will estimate the secondary effects of expanding versus not expanding Medicaid in the state. This will include the impact of additional federal revenues on the state economy if the state expands Medicaid, the impact on spending for other state programs, the impact on Medicaid Disproportionate Hospital Share (DSH) payments and provider uncompensated care, the financial impact on health care providers, and the potential impact on cost shifting and its effect on commercial premiums.
Client Area: State and Local Governments
Expertise Area: Medicaid and CHIP, Health Reform
October 2011
Lewin contact: John Sheils
This is the Technical Appendix to the report detailing impacts of the Accountable Care Act (ACA) on costs and coverage for major sources of coverage without the Mandate to have coverage. We used the Health Benefits Simulation Model (HBSM), a micro-simulation model of the US health care system designed for simulating policies ranging from narrowly defined insurance market regulations to Medicaid coverage expansions and broad-based reforms involving multiple programs. In this document we explain how the model was used to simulate the impact of the ACA. This includes the methods used to simulate the effect of the ACA without the mandate for people to have health insurance.
You can read the full report on the Health Affairs website at http://content.healthaffairs.org/content/early/2011/10/24/hlthaff.2011.0708
Expertise Area: Health Reform
June 2011
Prepared for The American Association of Retired Persons (AARP), American Hospital Association, American Medical Association, American College of Cardiology, and LeadingAge
Lewin contact: John Sheils
The Lewin Group developed a case study for The American Association of Retired Persons (AARP), American Hospital Association, American Medical Association, American College of Cardiology, and LeadingAge, which analyzes the economic impacts of the “Commitment to American Prosperity Act” (CAP) being considered by Congress to limit the growth in Federal spending. The case study examines the impact that spending reductions would have on people who depend upon federal programs for income and healthcare. Because health care is such a large portion of federal spending, it also presents estimates of the impact that these cuts would have on health care provider revenues and the resulting effects on access to care for Medicare and Medicaid beneficiaries.
Client Area: Associations, Federal Government
Expertise Area: Health Reform
June 2011
Expertise Area: Health Reform, Medicaid and CHIP
December 2010
Lewin contact: John Sheils
In this study, we focus on the impact of The Affordable Care Act of 2010 on state spending for Medicaid and the Children’s Health Insurance Program (CHIP).
Expertise Area: Health Reform, Medicaid and CHIP
October 2010
NYS Health Foundation
This high-level implementation plan is presented as a follow-up to the New York State Health Foundation’s (NYSHealth’s) July 2010 report, “Bending the Health Care Cost Curve in New York State: Options for Saving Money and Improving Care, ” which was designed to inform a State-level discussion of health care savings opportunities in New York. The report outlined the estimated impact of 10 scenarios that could help to contain escalating health care costs in New York State over the next decade while also improving health care quality. With the assistance of a Technical Advisory Panel, four of the modeled scenarios were selected for high-level planning to identify the action steps, timeframes, and resources required for implementation. The scenario presented here deals with rebalancing long-term care: restructuring New York State’s Medicaid programs for long-term care, examining both residential and community-based settings for a large population of beneficiaries with extensive functional and cognitive impairments, and behaviorally and medically complicated needs.
Client Area: Foundations
Expertise Area: Health Reform
October 2010
NYS Health Foundation
This high-level implementation plan is presented as a follow-up to the New York State Health Foundation’s (NYSHealth’s) July 2010 report, “Bending the Health Care Cost Curve in New York State: Options for Saving Money and Improving Care, ” which was designed to inform a State-level discussion of health care savings opportunities in New York. The report outlined the estimated impact of 10 scenarios that could help to contain escalating health care costs in New York State over the next decade while also improving health care quality. With the assistance of a Technical Advisory Panel, four of the modeled scenarios were selected for high-level planning to identify the action steps, timeframes, and resources required for implementation. The scenario presented here deals with adopting bundled payment methods : making prospective payments for entire episodes of care, potentially encompassing inpatient care, physician services while hospitalized, and post-acute care services, including short-term rehabilitation and home health care.
Client Area: Foundations
Expertise Area: Health Reform
October 2010
NYS Health Foundation
This high-level implementation plan is presented as a follow-up to the New York State Health Foundation’s (NYSHealth’s) July 2010 report, “Bending the Health Care Cost Curve in New York State: Options for Saving Money and Improving Care, ” which was designed to inform a State-level discussion of health care savings opportunities in New York. The report outlined the estimated impact of 10 scenarios that could help to contain escalating health care costs in New York State over the next decade while also improving health care quality. With the assistance of a Technical Advisory Panel, four of the modeled scenarios were selected for high-level planning to identify the action steps, timeframes, and resources required for implementation. The scenario presented here deals with integrating care for dual eligibles: enrolling New York’s Medicaid/Medicare dual eligibles into a fully integrated coordinated care setting.
Client Area: Foundations
Expertise Area: Health Reform
October 2010
NYS Health Foundation
This high-level implementation plan is presented as a follow-up to the New York State Health Foundation’s (NYSHealth’s) July 2010 report, “Bending the Health Care Cost Curve in New York State: Options for Saving Money and Improving Care, ” which was designed to inform a State-level discussion of health care savings opportunities in New York. The report outlined the estimated impact of 10 scenarios that could help to contain escalating health care costs in New York State over the next decade while also improving health care quality. With the assistance of a Technical Advisory Panel, four of the modeled scenarios were selected for high-level planning to identify the action steps, timeframes, and resources required for implementation. The scenario presented here deals with expanding palliative care: requiring hospitals to establish a palliative care program to promote better coordinated, higher value care where appropriate.
Client Area: Foundations
Expertise Area: Health Reform
September 2010
Lewin contact: John Sheils
The Health Benefits Simulation Model (HBSM) is a micro-simulation model of the US health care system. HBSM is a fully integrated platform for simulating policies ranging from narrowly defined insurance market regulations to Medicaid coverage expansions and broad-based reforms involving multiple programs. The model has been adapted to simulate the impact of the Affordable Care Act (ACA) and can be used to model other health reform proposals.
Expertise Area: Health Reform
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