This document provides an overview of SHAP (State Health Access Program) evaluations and how they can inform implementation of the Affordable Care Act. It discusses how SHAP grantees are conducting evaluations through administrative data, surveys, focus groups and ROI analyses. Grantees will report benchmarks on enrollment, costs, and qualitative measures. The evaluations can provide best practices on outreach, newly insured characteristics, and models for insurance exchanges. Technical assistance is available from SHADAC to help grantees with data, indicators, methods and a data user workshop.

1. SHAP Evaluations – Looking Toward The Affordable Care Act Elizabeth Lukanen, MPH State Health Access Data Assistance Center University of Minnesota, Minneapolis, MN SHAP Grantee Meeting July 26, 2010 Funded by a grant from the Robert Wood Johnson Foundation

3. SHADAC Technical Assistance2

4. SHAP Evaluation Overview 3

5. 4 SHAP Evaluation - Overview Vary in size and budget 5 year budgets range from $120,000 to >$2,000,000 From <1% to 10% of budgets 8 states contracting out evaluation Primarily local universities and health policy centers Evaluation progress is varied across grantees

6. 5 SHAP Evaluation Overview - Data and Methods All states are utilizing administrative data Cost, enrollment, demographics 9 states are conducting surveys Enrollee, employer, state-wide household 5 states are conducting focus groups or key informant interviews Enrollees, employers, eligibility staff 3 states are conducting Return on Investment (ROI) analysis as they related to multi-shares

7. SHAP Benchmark Reporting 6

8. 7 SHAP Benchmark Reporting Comparable enrollment and cost data Context is crucial for communicating key lessons SHAP can inform the larger framework of Affordable Care Act Benchmark reporting Report by each initiative in your SHAP program and 2 summary questions Report both quantitative and qualitative measures Reporting slightly different for coverage expansion and other initiatives

11. Coverage Expansion Initiatives Benchmark Questions

12. Other SHAP Initiatives Enrollment and call centers, online application development, wellness programs, outreach activities, payment reform, etc. Impact statement Metrics that best measure impact Web hits, call volume, number of referrals, employers in program, media spots, progress, program participation Progress compared to stated goals Cost of initiative: HRSA, State, Other 11

13. Other InitiativesBenchmark Questions

14. Supplemental Enrollment in Health Care Coverage What residual health care coverage enrollment benefits were experienced as a result of the SHAP initiatives? Other ways that your state’s SHAP activities resulted in coverage gains in non-SHAP funded coverage programs Number of individuals screened for public program enrollment and subsequent enrollment (if known) Aspects of your eligibility process that informed non-target household members about public programs 13

16. SummaryBenchmark Questions

17. Reporting Guidance This information will be used by HRSA to show the progress of SHAP HRSA is also looking to SHAP to help collect questions and implementation lessons as they relate to ACA Use the impact statements to sections to contextualize progress toward your goals If progress on an initiative is stalled, please indicate why in the impact statement section If progress on an initiative hasn’t started tell us why or indicate that it is scheduled for a future year SHADAC will provide one-on-one help to complete this reporting 16

18. SHAP and the Affordable Care Act 17

20. 133% Medicaid

21. 200-400 Tax CreditBridge to Reform Today 2010 2014

22. SHAP & Affordable Care Act Many SHAP activities are relevant to health reform: Enrollment, outreach and coverage for low income adultsEnrollment, outreach and coverage for small businesses No wrong door enrollment systems Insurance exchanges Coordinated safety net programs Testing medical home models And more…… 19

23. Using SHAP Evaluation to Inform Implementation of Affordable Care Act Information from the SHAP evaluation can inform implementation of Affordable Care Act: Best practices on enrollment and retention Indentifying outreach strategies to reach low income adults and small businesses Collecting characteristics and service use of newly insured, low income adults Process and models to build insurance exchanges Testing of “benchmark plan” type programs Examining medical home and care coordination models 20

24. Outside SHAP - Data to Consider Important to track impact of Affordable Care Act at the state level Start thinking now about about what you want to know Start collecting baseline indicators for monitoring the impact Build on existing data and indicators 21

25. Baseline Data Potential Indicators Include: Health Insurance Status Employer-based coverage Individual market State public programs Medicare Hospitals Community clinics Physician services Consumers Health plans 22

26. Small Group Discussion 23

27. Small Group Discussion What questions do you have related to the implementation of SHAP and Affordable Care Act? What data and information could help address these questions? How might your SHAP evaluation provide this data and information? Report back: Common questions related to implementation of SHAP and ACA 24

28. SHADAC Technical Assistance 25

29. SHAP Data and Evaluation Technical Assistance Help grantees identify data sources for benchmarks Consult on outcome indicators, data sources, data availability, and evaluation methods Assist with small area estimation Advise on survey development Support development of Return on Investment (ROI) methods 26

30. SHADAC Data User Workshop Friday, October 22, 2010 @ University of Minnesota, Minneapolis One-day workshop for health policy analysts Promote understanding of federal survey data sources available for state-level analysis Hands-on training in computer lab Scholarships available www.shadac.org/2010DataUserWorkshop Application deadline is July 30, 2010 27

31. 28 Contact Information Minnesota SHAP Project Team: Lynn Blewett, Ph.D. Kelli Johnson, MBA Elizabeth Lukanen, MPH * Primary contact – elukanen@umn.edu, 612-626-1537 Website: www.shadac.org/shap State Health Access Data Assistance Center University of Minnesota, Minneapolis, MN www.shadac.org ©2002-2009 Regents of the University of Minnesota. All rights reserved.The University of Minnesota is an Equal Opportunity Employer