Sheila Hoag

Sheila Hoag

Director, Business Development
  • Medicaid and the Children’s Health Insurance Program (CHIP)
  • Access to Care
  • Express Lane Eligibility
  • Health Reform and the Affordable Care Act (ACA)
  • Primary Care Transformation
  • Qualitative Methods
Focus Areas
  • Health
  • Medicaid and CHIP
  • State Health Policy
About Sheila

Sheila Hoag’s expertise lies in insurance coverage for vulnerable populations, with a focus on children’s coverage, access to care, and health reform. She has evaluated Medicaid and CHIP coverage reforms and policies designed to increase coverage into Medicaid and CHIP, including enrollment and renewal simplifications. Since 2017, she has served as the co-chair of the Coverage Learning Collaborative, providing technical assistance to the Centers for Medicare & Medicaid Services (CMS) and states on Medicaid and CHIP coverage topics.

Hoag has directed several notable projects designed to increase children’s coverage, including an evaluation of the KidsWell Campaign, an effort sponsored by the Atlantic Philanthropies to take advantage of policy opportunities presented by the Affordable Care Act to create universal coverage for children. She also evaluated an effort to engage city leaders to conduct outreach and enrollment for children and their families eligible for Medicaid, CHIP or Marketplace coverage, also funded by Atlantic Philanthropies. In the arena of broader health care coverage and care delivery, Hoag led the design and implementation of the process evaluation of Enroll America, an effort sponsored by the Robert Wood Johnson Foundation (RWJF) to increase enrollment under the Affordable Care Act. In 2018, she led another study for RWJF to understand the effects of recent ACA-related policy changes on consumers during the November-December 2017 open enrollment period. From 2011 to 2014, she directed the Children’s Health Insurance Program Reauthorization Act (CHIPRA) Express Lane Eligibility Evaluation, which evaluated approaches to encourage take-up and retention in Medicaid and CHIP; and from 2010 to 2014, was the deputy director of the congressionally mandated evaluation of the CHIPRA 10-State Evaluation.

Since 2013, Hoag has also been working on evaluations examining efforts to transform primary care in the United States. For example, from 2013 to 2017, she was senior advisor and quality assurance reviewer for the Health Care Innovation Awards Primary Care Redesign Evaluation. Currently, she is leading an analysis of access to care for the Comprehensive Primary Care Plus (CPC+) evaluation, a multipayer initative for which CMS is working with 61 public and private partners in an effort to transform thousands of primary care practices throughout the United States.

Hoag is widely published in peer-reviewed journals such as Health Affairs and Foundation Review. She is a reviewer for Health Affairs and the Journal of the American Medical Association, and served on the board of the Eastern Evaluation Research Society from 2012 to 2014. Hoag holds an M.A. in public policy studies from the Irving B. Harris School of Public Policy Studies and a certification in health administration from the Graduate Program in Health Administration and Policy, both at the University of Chicago.

Key Projects
  • Health Insurance graphic
    Enroll America Evaluation

    Enroll America is a nonprofit organization with a mission of maximizing the number of Americans who enroll in and retain coverage through the Affordable Care Act. Year 2 includes qualitative research to understand how Enroll America implements its ACA outreach and enrollment activities in states that...

  • Evaluating Express Lane Eligibility

    Express Lane Eligibility allows a state’s Medicaid and/or CHIP program to rely on another public agency’s eligibility findings to qualify children for public health insurance coverage. Mathematica evaluated ELE in the Medicaid and CHIP programs.

  • CHIPRA 10-State Evaluation

    This study addressed a series of policy questions related to the impact of CHIP, the effective operation of CHIP programs, and the inter-relationship between and among CHIP, Medicaid, and employer-sponsored insurance coverage for low-income children.

Latest News
  • Sheila Hoag
    Lessons on Health Philanthropy

    Mathematica Policy Research’s experts offer lessons learned from evaluations of foundation-funded health projects in three articles published in the most recent issue of The Foundation Review.