This report projects health care spending in Minnesota from 2008 to 2018, updating Mathematica’s earlier projections completed in 2009. Changes to the input data are documented, as are changes to the methodology to account for the recession’s spending impacts and health care reform.

Medical homes are part of our nation’s overall efforts to reform the health care system. For decades, medical homes have been a model for coordinating health care for children, particularly those with special health care needs.The sixth brief in a new series from Mathematica looks at federal and state efforts to establish medical homes and notes considerations for policymakers seeking to improve access to services and the quality of care.

This article identifies continuing issues and barriers for many consumers seeking health coverage in high-risk insurance pools under the new Patient Protection and Affordable Care Act. The article notes how the new federal program is intended to serve only the currently uninsured—leaving in place until 2014 the states’ existing high-risk pools for many denied private coverage.

This brief summarizes evidence on the benefits and cost-effectiveness of preventive health services, noting that health reform brings significant new opportunities to improve access to preventive care.

Disease management programs seek to control health care costs by focusing on two major drivers: high-cost chronic illness and inpatient hospitalizations for acute conditions. The fourth brief in a new series from Mathematica looks at the research evidence on the effectiveness of disease management programs and the role of disease management in health care reform.

Show them the money. Health reform will emphasize financial incentives for providers and consumers to promote the use of effective health services and discourage use of marginally effective or inappropriate services. The fifth brief in a new series from Mathematica looks at evidence on the impacts of these financial incentives and draws lessons for policymakers.

This brief synthesizes the compelling research evidence linking health insurance coverage to good health outcomes for both adults and children.

The Massachusetts Special Commission met from January to July 2009 to investigate reforming and restructuring the state’s health care system to provide incentives for efficient and effective patient-centered care and reduce variations in the quality and cost of care. This report details the principles that guided the Special Commission, reports input from key stakeholders, assesses alternative payment approaches, and reports the Special Commission’s recommendations for payment policy and implementation.

A health insurance exchange transforms the way health insurance is packaged, subsidized (for low-income individuals and families), and purchased. This brief describes the process followed in Rhode Island to explore establishing a health insurance exchange-like organization, HealthHub RI, based on the Massachusetts model. The RI experience demonstrated the importance of clearly defining the goals of an exchange, as well as understanding that exchanges may do little to constrain the growth of health care costs. States considering an exchange might want to consider an affordability-based mandate, requiring all state residents to have health insurance coverage that meets an exchange-specified standard, as long as it is deemed affordable.

Mathematica evaluated five health care reform proposals for the state of Washington in 2008. The proposals featured, respectively: reduced regulation in the current market; Massachusetts-style insurance reforms with a health insurance connector; a health partnership program similar to the current state employee health plan; a state-operated single payer plan; and a program that would guarantee catastrophic coverage for all residents. This report provides estimates of the changes in coverage and health care expenditures that would result from implementation of these proposals, as well as impacts on hospital charity care, the scope of coverage and consumer choice, and economic activity in Washington.

Responding to concerns about the high and growing number of New Mexicans without health coverage, the state contracted with Mathematica to develop estimates of costs for alternative reform models. This report updates estimates for three of the models to 2010 and provides estimates for a fourth reform model. The estimates rely on a microsimulation model developed expressly for estimating health insurance coverage costs in New Mexico.

In 2007, the state of Minnesota considered establishing a Health Insurance Exchange to serve small groups and individuals, facilitating access to coverage, choice among insurance products, portability of coverage, and affordability. Mathematica studied the coverage, cost, and fiscal impacts of a series of health reforms that might occur coincident with the implementation of the exchange—guaranteed issue and community rating of both small group and individual products, a mandate requiring all residents to obtain coverage, and a requirement that all employers with 11 or more employees offer a Section 125 or “cafeteria” plan. This report estimates the impacts of the reforms alone and in combination. In addition, it explores the range of implementation and legal issues that policymakers in Minnesota would need to address in order to develop an exchange.

Community health initiatives—locally crafted responses to health care access problems—have been steadfast in their efforts to connect uninsured and medically indigent people to health care services and health insurance. These programs assist in outreach, coordinate and integrate care, and help clients use limited resources efficiently. This report offers five case studies of community health initiatives that seek to improve access and coverage for those most likely to be uninsured: low-income, nonelderly adults.

Mathematica estimated the cost of the current health care system in New Mexico and the relative cost of three alternative strategies to ensure that all New Mexicans become and remain insured. This report discusses the strategies in depth and raises issues for further consideration.