Health Topics

Health Projects

Health Policy Research

Elderly woman with nurse For more than 40 years, Mathematica staff have been informing health policy debates and addressing decision makers’ information needs regarding longstanding critical issues, such as people who lack health insurance, efficient operation of government health insurance programs, effective care delivery, health care financing, and public health. Today, Mathematica's team of more than 200 researchers continues to provide reliable data and analysis on the effectiveness of health care investments, and helps policymakers assess needs that remain unmet. Using the most current and effective methods, we collect and analyze data, evaluate programs, summarize policy implications, identify solutions, and translate findings into practice. This work is disseminated in more than 100 reports, articles, and other publications that we produce each year, as well as through presentations to professional societies and briefings of decision makers.

Health Reform

The issue of reforming our nation’s health care system is dominating the policy debate. The system produces life-saving marvels every day, yet fails to provide affordable health care for all. While consuming more resources per capita than any other health care system in the world, our system yields outcomes that are often markedly worse than those of other countries. These tensions have led to broad-based public interest in finding ways to improve the quality, efficiency, affordability, equity, and financing of health care. Mathematica has contributed to the base of research and data to help guide the policy debate. Read more.

Medicare

Demographic and cost trends have put Medicare on an unsustainable growth path. As a result, the next few years are likely to see important changes to the program. Mathematica staff are conducting a wide range of research and data collection activities to help inform policy makers about the implications of various options. In particular, we are looking at ways to increase the value of health care purchased under Medicare by identifying ways to increase quality and reduce costs. We are also assessing a range of care delivery options, including new care management options, the Medicare Advantage program, and Part D prescription drug options. To help shed light on how to best meet the needs of vulnerable Medicare beneficiaries also eligible for Medicaid—the so-called “dual eligibles”—we have studied health care delivery and financing issues for these low-income elderly and individuals with disabilities. Read more.

Medicaid and CHIP

The number of Americans who lack health insurance, which may prevent them from accessing needed care, is a pressing policy concern. We have estimated the number of uninsured families, assessed the functioning of their safety net, and looked at the contributions to charity care of private-sector physicians. We have assessed how Medicaid, the Children's Health Insurance Program (CHIP), and county-level programs cover and enroll low-income families and promote access to care. Our staff conducted two national evaluations of CHIP and assessed outreach, enrollment, and retention in CHIP and Medicaid. Moreover, we are assessing how states decide to modify these programs when budgets are tight. We also provide executive education and strategic and technical assistance to Medicaid and CHIP administrators to help them develop, purchase, monitor, and improve their services. Read more.

State Health Policy

Many states have developed initiatives to control costs while ensuring that health care is affordable. We help support these initiatives by identifying options for expanding access and coverage, tailoring our analyses to each state’s unique demographic, economic, and health care environment. We also analyze private insurance market issues to help states deal with staggering increases in premiums. Our staff members assess cost drivers in the marketplace and the affordability, accessibility, and quality of health insurance reform efforts in different states. As states turn to wellness and prevention programs to encourage healthier lifestyles and prevent disease, we have examined the effectiveness of these initiatives. Read more.

Quality and Health System Functioning

As the demand for evidence on the effectiveness of medical treatments has increased, we have helped develop and measure care quality and consumer satisfaction. We have been a leader in studying medical homes, pay for performance, public reporting of quality data, disease management, and the use of health information technology to monitor and improve care—promising strategies available to policymakers and private health care leaders to encourage improvement. Sound measurement is central to these strategies, and we have developed, analyzed, and evaluated quality measures and have designed and evaluated pay-for-performance programs. We have also sought ways to measure disparities accurately and have assessed the composition of the health care workforce and the function of safety net providers. Read more.

Costs and Payment Policies

A key issue in health care is the continued rapid rise in costs. Controlling costs can make it feasible to extend insurance coverage to more Americans, as long as we can maintain or improve quality. We have studied efforts to increase the value delivered by the health care system and measure quality of care so that steps can be taken to reward high quality providers. We have also examined care coordination and other interventions that seek to make care delivery more efficient. We have studied these issues from a range of perspectives, including those of individuals, employers, providers, and government. Read more.

Key Populations

Policymakers often judge the health care system by how well it serves specific groups. Our studies help support these assessments by exploring the use of health care services; underlying social and systemic issues that increase vulnerability; and the effectiveness of programs and services for many groups, including women, infants, children, low-income families, racial and ethnic minorities, people with disabilities, frail elderly people, those with chronic diseases, military families and veterans,and incarcerated individuals. In some cases, social and economic factors, including poverty and lack of access to health services, increase groups' vulnerability to poor health and create health care disparities. In other cases, we have identified system and market features that promote access to care and better health.

Data Development

We are a leader in helping public agencies use their administrative databases to evaluate, monitor, and design programs for vulnerable populations. We create large-scale insurance databases for Medicaid, SCHIP, and Medicare and design systems so they can be used easily for research. We also have extensive experience merging administrative data sets built from Special Supplemental Nutrition Program for Women, Infants and Children (WIC) records, birth certificates, and Medicaid and Social Security data to study important policy concerns while ensuring data security and confidentiality. Our results are summarized in user-friendly chartbooks and tables, and the data files are used extensively by researchers.

Public and Population Health

We have a long history of studying disease prevention and health promotion initiatives. Our staff has assessed programs to prevent childhood obesity and evaluated efforts that have shown promise in slowing the spread of the childhood obesity epidemic. We have identified interventions that promote better nutrition and increased physical activity, and examined efforts to reduce risky behaviors as a means of promoting public health. Our work in evaluating prevention models and interventions in the areas of smoking and substance abuse has produced valuable information to inform public health efforts. In addition, we are assessing pregnancy prevention models and evaluating programs promoting healthy pregnancies and maternal and child health.