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Tip Sheets

Datasets: Reform by the Numbers

From the Robert Wood Johnson Foundation

As part of the Robert Wood Johnson Foundation’s efforts to monitor the impact of the Affordable Care Act (ACA) on coverage, utilization and affordability, the organization is working with a number of organizations to acquire and analyze timely and unique data. They have developed a website, Reform by the Numbers, which will house downloadable data, tables and graphs, in addition to policy briefs, blogs and other content that highlights key findings. The datasets and resources housed on the website are described below:

Enrollment and Carrier Data

The National Association of Insurance Commissioners (NAIC) maintains an insurance database compiled from annual and quarterly financial statements of approximately 5,000 insurance companies. NAIC is providing quarterly data of carrier reports that describe size and characteristics of group and individual markets. The annual version of the data will provide state breakdowns by quarter by carrier. Data will include, in part, information on the number of policies, federal and state taxes, health premiums, and incurred claims.

Hospital ACA Monitoring Project

The New Jersey Hospital Association and Premier, Inc. are managing collaborations of over 20 state hospital associations where each association will be providing quarterly discharge data. Data from other states is being submitted by Premier Inc. These data include total inpatient admissions and emergency department visits by payer, as well as a number of select diagnoses and procedures likely to be sensitive to insurance.

Health Reform Monitoring Survey

The Urban Institute has launched the Health Reform Monitoring Survey (HRMS), a quarterly survey of non-elderly adults that examine health insurance coverage, health care access and affordability, and health status. Starting with the second quarter of 2013, each round of the HRMS will include supplemental questions on particular coverage-related issues.

HIX 2.0

The Health Insurance Exchange Research Group at The Leonard Davis Institute of Health Economics at The Wharton School of the University of Pennsylvania, along with collaborators at other institutions, has developed data detailing variation in governance and structure of ACA implementation across the 50 states. The data sets provide information in analytical formats on each state’s key implementation decisions regarding Health Insurance Marketplaces and Medicaid expansion, among other topics.

HIX Compare

Breakaway Policy Strategies has compiled a dataset that details benefit design and cost sharing information for health plans offered in all 50 states and the District of Columbia. This dataset will include information on premiums, network composition, deductibles, out-of-pocket limits, and copayment and coinsurance amounts.

ACA View

athenahealth, which provides billing and claims processing software to more than 45,000 outpatient practices and collects real time data on financial, operational, and clinical characteristics of patient encounter, has developed 35 metrics that monitor trends in appointment wait time, physician schedule density, health status of new patients, patient balances due, claims processing, and provider reimbursement. athenahealth will provide these metrics to the foundation on a monthly basis.