AHRQ's Advancing Quality in States Initiative: Quality in Practice Workshop

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Bringing Data to Policy Or.
You can show data to policymakers but you can't make them read the footnotes.

Alan Weil
Executive Director
National Academy for State Health Policy
December 4, 2008
Using Administrative Data to Answer State Policy Questions

AHRQ

Throughout this presentation, the National Academy for State Health Policy logo is centered at the bottom of the slide.

Slide 2

Presentation Outline

• A Tale of Two Programs

• Two Worlds Collide

• Health Policy Needs You!

Slide 3

A Tale of Two Programs

This slide contains two graphs. On the left, the graph depicts Enrollment in SCHIP, which increased from zero to 3950 from 1997 until 2004. And on the right, the graph depicts Children receiving TANF, which decreased from 7077 to 4399 from 1994 until 2000.

Slide 4

Former Recipients' Reasons for Leaving Welfare

This slide contains a horizontal bar graph listing reasons former Welfare recipients left the program (in percentages):

Increased earnings or new job: 69 percent

Administrative/hassle: 10 percent

No need/not interested: 7 percent

Change in family situation: 6 percent

Income from other source: 5 percent

Moved to new county/state: 4 percent

Other: 6 percent

Source: Urban Institute calculations from the National Survey of America's Families, 1997.

Slide 5

Mean Earnings of Single Parent Welfare Leavers

The graph on this slide shows the range and mean earnings of single parents families who left the Welfare program.

First quarter range: $1941 to $3416; mean: $2663

Second quarter range: $2081 to $3439; mean: $2575

Third quarter range: $2163 to $3877; mean: $2695

Fourth quarter range: $2327 to $3934; mean: $2712

Notes: The graph shows the minimum, maximum and median earnings as reported across the studies. The shaded box represents the range in which the middle 50 percent of reported earnings fall. Not all studies provide data for all post-exit quarters. See table III.5 for more information.

Source: "Final Synthesis Report Of Findings From ASPE's 'Leavers' Grants," Gregory Acs and Pamela Loprest, November 27, 2001.

Slide 6

Percent of Single-Parent Welfare Leavers Returning to TANF

The graph on this slide shows the percentage range and mean of single parents families who left the Welfare program and returned to the TANF program.

First quarter range: 3 to 21 percent; mean: 7 percent

Second quarter range: 9 to 24 percent; mean: 15 percent

Third quarter range: 12 to 25 percent; mean: 18 percent

Fourth quarter range: 11 to 25 percent; mean: 19 percent

Ever returned: 17 to 38 percent; mean: 27 percent

Notes: The graph shows the minimum and maximum, and median TANF return rates as reported across the studies. The shaded box represents the range in which the middle 50 percent of reported TANF return rates fall. Not all studies provide data for all post-exit quarters. See table IV.1 for more information.

Source: "Final Synthesis Report Of Findings From ASPE's 'Leavers' Grants," Gregory Acs and Pamela Loprest, November 27, 2001.

Slide 7

Coverage of Recent Enrollees During the 6 Months Before They Enrolled

This slide contains a pie graph depicting the coverage of SCHIP enrollees during the 6 months prior to enrollment.

Uninsured all 6 months before enrolling: 43 percent

Medicaid during 6 months before enrolling: 29 percent

Private insurance during 6 months before enrolling: 28 percent

Other coverage during 6 months before enrolling: less than 1 percent

Source: 2002 congressionally mandated survey of SCHIP enrollees and disenrollees in 10 states and State Enrollment Data Files

Slide 8

Reasons Private Coverage Ended Among Recent Enrollees

This slide contains a table listing reasons (in percentage) of why private insurance ended for SCHIP enrollees and whether it was voluntary.

Involuntary loss of coverage: total of 14 percent

• Employment change or benefit loss at same job: 13 percent

• Loss of parent or family structure change: 1 percent

May be voluntary loss of coverage, dependent on state policy: total of 8 percent

• Affordability: 8 percent

Voluntary loss of coverage: total of 7 percent

• Prefers SCHIP or dislikes other insurance: 2 percent

• Miscellaneous: 5 percent

Source: 2002 congressionally mandated survey of SCHIP enrollees and disenrollees in 10 states

Note: Miscellaneous category includes moved/relocated, wanted child to be insured, enrolled based on provider/agency recommendation, and other reasons with insufficient information to determine whether substitution played a role.

Slide 9

Percent of Children with the Usual Source of Care Before and After Enrolling in State SCHIP Programs

This slide contains a bar graph showing the percent of children with usual source of care before and after enrolling in the state SCHIP programs in 6 states.

Alabama

Pre-SCHIP: 79 percent

Post-SCHIP: 92 percent

Florida

Pre-SCHIP: 81 percent

Post-SCHIP: 95 percent

Iowa

Pre-SCHIP: 86 percent

Post-SCHIP: 86 percent

Missouri

Pre-SCHIP: 62 percent

Post-SCHIP: 91 percent

New Hampshire

Pre-SCHIP: 91 percent

Post-SCHIP: 99 percent

Texas

Pre-SCHIP: 84 percent

Post-SCHIP: 90 percent

Source: State Title XXI annual reports from fiscal years 1999 through 2003

Note: Florida, New Hampshire, and Texas reported data on the percent of SCHIP enrollees with a "usual place," Iowa and Missouri reported on "usual provider," and Alabama did not define the type of usual source of care.

Slide 10

Two Worlds Collide

Slide 11

Maslow's Hierarchy of Needs

This slide contains a 5-level pyramid. From bottom to top, the categories are: Physical, Security, Belonging, Self Esteem, and Self Actualization.

Slide 12

Wolsam's Hierarchy of Needs

This slide contains two 5-level pyramids, modeled on Maslow's hierarchy of needs. The left pyramid represents policymakers' hierarchy of needs; from bottom to top: NOW! Unambiguous, Accessible to all, Values, Net Effects, and Reelection. The right pyramid represents researchers' hierarchy of needs; from bottom to top: Before the grant runs out, Complex, Peer review, Objectivity, Marginal effects, Tenure.