Center for Studying Health System Change
$184,981
Family Out-of-Pocket Medical Costs: Recent Trends and Implications for Health Care Access
Previous Fund-supported research has documented the growing burden of out-of-pocket medical expenditures and the resulting difficulties Americans face in accessing care and paying medical bills. This project will analyze Medical Expenditure Panel Survey data to measure the most recent changes in out-of-pocket spending and premium shares and to identify the factors causing these changes. In addition, project staff will analyze household and physician survey data from the Community Tracking Study to document variation in this cost burden across 60 U.S. communities and how it is affecting people's health care experiences. From these analyses, policymakers will learn how rising health care costs and cost-sharing are affecting families' financial stability and local health systems' capacity to care for the most vulnerable patients.
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Peter J. Cunningham
Senior Health Researcher
600 Maryland Avenue S W Suite 550
Washington, DC 20024-5216
(202) 484-4242
pcunningham@hschange.org
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Trustees of Columbia University in the City of New York
$195,362
Examining Health Insurance Issues and Developing Policy Options to Expand and Stabilize Coverage, 2005-06
The Fund's Program on the Future of Health Insurance tracks changes in insurance coverage, documents the consequences of being uninsured or underinsured, and explores new policies to expand coverage for working families. This core grant to University supports these activities by providing the analytical basis for reports authored by the team and for work undertaken by Fund staff, grantees, and the Commission on a High Performance Health System. Over the next year, the team will focus on such research topics as: the impact of health expenditures on people's savings; how sick leave and health benefits combine to affect access to care; new policies to expand coverage for low-wage workers; the latest trends in coverage among minorities and young adults; and components of the Commission's Health System Indicators Scorecard.
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Sherry Glied, Ph.D.
Professor and Chair, Department of Health Policy and Management
Joseph L. Mailman School of Public Health
Department of Health Policy and Management
600 West 168th Street, Room 612
New York, NY 10032
(212) 305-0295
sag1@.edu
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Education & Research Fund of the Employee Benefit Research Institute
$126,157
Tracking the Evolution and Spread of Consumer-Driven Health Care Plans
Consumer-driven health plans (CDHPs), which include high-deductible health plans and tax-preferred savings accounts for medical expenses, have gained currency among employers as a strategy to reduce premiums and promote cost-conscious health care behavior on the part of employees. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 helped stimulate interest in such plans by introducing Health Savings Accounts, which allow people with high-deductible plans to save pretax dollars to cover expenses that their health plans do not. Little, however, is known about the extent to which CDHPs have proliferated or their effect on the health behavior of employees. The Employee Benefit Research Institute (EBRI) proposes to fill this research gap through an annual Consumerism in Health Care Survey.
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Paul Fronstin, Ph.D.
Director, Health Security and Quality Research Program
2121 K Street, N.W., Suite 600
Washington, DC 20037-1896
(202) 775-6352
fronstin@ebri.org
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Regents of the University of Minnesota
$176,991
Uninsured and Underinsured Workers in Small Businesses: Policy Implications
The proportion of U.S. companies offering health insurance coverage has fallen in the last five years, a decline driven primarily by small firms. Among those small firms that still offer coverage, an increasing number are offering plans with higher deductibles. Using national Medical Expenditure Panel Survey (MEPS) data for 1997-2003, this project will analyze differences in the extent and quality of insurance coverage among firms of different sizes, focusing on the relationship of coverage to wages and other benefits, such as pensions, paid sick leave, and paid vacation. The researchers will also develop new estimates of 'underinsurance' based on health status, income, firm size, and comprehensiveness of health coverage. These findings will enable the project team to assess the potential impact of new legislative proposals for covering uninsured workers.
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Jean Abraham, Ph.D.
Assistant Professor
420 Deleware Street, SE
MMC 510
Minneapolis, MN 55455
(612) 625-4375
abrah042@umn.edu
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Analysis and Modeling of the Leading Health Care Reform Bills of the 109th Congress (2005-2006)
Through various bills introduced in 2005-06, members of Congress have tried to address rapidly rising health care costs and insurance premiums, the erosion of comprehensive and affordable coverage, and problems with the safety and quality of care. Yet there has been little systematic analysis of these proposals to gauge their relative potential for success, estimate their costs to the federal budget, and assess their potential for long-term savings. This project will analyze and compare leading congressional bills that are designed to expand health coverage, improve public insurance programs like Medicare and Medicaid, control health care costs and improve efficiency, improve the quality and safety of care, and develop more rational payment policies. The findings will enable policymakers and the public to understand how various proposals will affect health care access, cost, and quality.
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Health Policy R&D
$59,500
Comparisons of Select Health Care Bills
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Katie B. Horton
President
901 New York Avenue, 3rd Floor
Washington, DC 20001
(202) 624-7265
khorton@hprd.net
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The Lewin Group, Inc.
$90,500
Estimating the Cost and Coverage Impacts of Selected Coverage Expansion Proposals
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John F. Sheils
Vice President
3130 Fairview Park Drive, Suite 800
Falls Church, VA 22042
(703) 269-5610
john.sheils@lewin.com
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The Regents of the University of California
$176,698
The Health and Cost Consequences of Interruptions in Medicaid Enrollment
Relatively little is known about how instability in health insurance coverage affects people's health, or what the cost consequences are for public insurance programs and the health system overall. For this project, researchers will examine California hospital discharge data to investigate whether interruptions in Medicaid coverage are associated with a higher rate of hospital admissions, deaths, or costs for medical conditions that could have been prevented with early primary care. The findings will help federal and state policymakers who are currently weighing policy options—including changes in Medicaid enrollment policy and higher premiums—to control the program's escalating costs.
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Andrew Bindman, M.D.
Professor of Medicine/Chief of General Internal Medicine SFGH
SFGH, 1001 Potrero Avenue
Building 10, Ward 13, 1320C
San Francisco, CA 94110
(415) 206-6095
bindman@medsfgh.ucsf.edu
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Small Grants—Program on the Future of Health Insurance
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Altarum Institute
$29,998
Retirees Under Age 65 at Risk of Losing Health Coverage: Scope of the Problem and Implications for the Health Care Sector
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Paul Hughes-Cromwick
Senior Analyst
3520 Green Court, Suite 300
Ann Arbor, MI 48105-1579
(734) 302-4997
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Education & Research Fund of the Employee Benefit Research Institute
$35,500
Sustaining Membership and Support of the EBRI Annual Health Confidence Survey
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Paul Fronstin, Ph.D.
Director, Health Security and Quality Research Program
2121 K Street, N.W., Suite 600
Washington, DC 20037-1896
(202) 775-6352
fronstin@ebri.org
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Virginia Commonwealth University
$33,483
Trade-offs Between Treatment and Work: The Case of Unemployed Women with Breast Cancer
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Cathy J. Bradley, Ph.D.
Professor
1008 E Clay Street
P.O. Box 980203
(804) 828-5217
cjbradley@vcu.edu
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