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State Health Projects

An interactive map shows our state health work at a glance.

Health Care Exchanges

Read about a legislative toolkit that will assist states with the design of health insurance exchanges, a key component of the Affordable Care Act.


State Health Policy

image of US with stethoscope

Mathematica researchers work closely with states to understand their unique circumstances and to answer their most important health policy questions. Currently, our researchers help to ensure that policymakers and stakeholders in nearly 40 states have the knowledge they need to make informed decisions. Key topics include:


Evaluating State Health Insurance Markets and Reform

States have led the way in testing innovative strategies to provide health insurance to their residents and to introduce reforms. Governors, legislatures, and planning commissions charged with designing these strategies need information about how reform options affect coverage, costs, and use of care as well as other key outcomes like employment. Mathematica has provided these clients with evaluations of insurance expansions and reforms as well as studies on the implementation of new policies.

Related publications:
"Selection in Massachusetts' Commonwealth Care Program: Lessons for State Basic Health Plans" (February 2012)
"Association Health Plans and Community-Rated Small Group Health Insurance in Washington State" (September 2011)
"Evaluation of Healthy San Francisco" (August 2011)

More publications on evaluating state health insurance markets and reforms

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Modeling Changes in Health Insurance Regulation

To help states plan for health insurance reforms, Mathematica has developed custom simulation models tailored to each state’s demographic, economic, and health care environment. These models allow us to generate estimates using state-specific data that reflect each state’s unique circumstances and align with other analyses produced by the state.

Related publications:
“Reducing Hospital Readmissions in New York State: A Simulation Analysis of Alternative Payment Incentives" (September 2011)
“Analytic Support For Washington Citizens' Work Group on Health Care: Evaluation of Health Care Reform Proposals” (March 2009)
“Analysis of Reform Models for Extending Health Care Coverage in New Mexico” (March 2008)

More publications on modeling changes in health insurance regulation

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Supporting the Development of State Health Insurance Exchanges

Health insurance exchanges are designed to serve small groups and individuals by facilitating access to coverage, offering choice among insurance products, and improving affordability. Under the Affordable Care Act, insurance exchanges will be established in every state by January 2014, developed and operated either by the state or the federal government. Mathematica has completed studies to support the development of exchanges and is involved in helping states prepare to implement them.

Designing an Exchange: A Toolkit for State Policymakers" (January 2011)
“Considering a Health Insurance Exchange: Lessons from the Rhode Island Experience” (June 2009)
"Minnesota’s Health Insurance Exchange Study" (March 2008)

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Assessing Trends in Health Care Costs

Health care costs are the largest single expense for most states, creating fiscal pressures that are expected to increase and possibly crowd out states’ capacity to address other needs. To help policymakers understand current and future patterns of health care spending, Mathematica has conducted state-level studies to identify cost drivers in health care, examine expenditure patterns across health care sectors, and project future spending. This information is used to assess the affordability, accessibility, and quality of insurance options available to residents and to identify payment options to help control states’ health care costs.
Related publications:

"Massachusetts Health Care Cost Trends: Trends in Health Expenditures" (June 2011)
"Massachusetts Health Care Cost Trends: Price Variation in Health Care Services" (May 2011, revised June 2011)
"Projected Health Care Spending in Minnesota" (July 2010)

More publications on assessing trends in health care costs

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Evaluating State Health Care Programs for Children

Ensuring access to health care for children is a priority for federal, state, and local governments. In many states, making this goal a reality will require new coverage opportunities as well as removal of the enrollment and retention barriers in current programs. Mathematica has conducted evaluations of landmark initiatives to expand coverage, such as the Children’s Health Insurance Program (CHIP) and Covering Kids and Families, and has helped states and local jurisdictions assess the effect of outreach strategies and administrative procedures on coverage among eligible children.

Related publications:

"State-Based Advocacy as a Tool for Expanding Children's Coverage: Lessons from Site Visits to Six IAC Grantee States" (July 2010)
"Synthesis of 10 Case Studies: Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice"(April 2009)
"SCHIP Children: How Long Do They Stay, and Where Do They Go?" (January 2009)

More publications on evaluating state health care coverage for children

Researching Ways to Meet the Needs of Special Populations

States are on the front lines of ensuring access to health care for special populations, including people with unique health care needs, those who are dually eligible for Medicare and Medicaid, and those with limited proficiency in English. Mathematica conducts analyses that address care management approaches, program improvements, and performance monitoring for these populations.

Related publications:
"Managing the Care of Dual Eligible Beneficiaries: A Review of Selected State Programs and Special Needs Plans" (June 2011)
"Effects of a Discharge Planning Program on Medicaid Coverage of State Prisoners with Serious Mental Illness" (January 2011)
"Examining Effectiveness of Medical Interpreters in Emergency Departments for Spanish-Speaking Patients with Limited English Proficiency: Results of a Randomized Controlled Trial" (August 2010)

More publications on researching ways to meet the needs of special populations

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Analyzing State Public Health Initiatives

More states are turning to wellness and prevention programs to encourage healthier lifestyles and to prevent disease. Mathematica examines the effectiveness of such initiatives and also helps policymakers understand disparities in public health outcomes, enabling states to make informed decisions about future health care investments.

Related publications:

Successful Strategies for Educating Hard-to-Reach Populations: Lessons Learned from Massachusetts' Train-the-Trainer Project Using the Helping You Take Care of Yourself Curriculum" (March 2011)
"Healthy People (HP) 2010 Disparity Elimination Goals: Case Studies of State Efforts" (June 2009)

More publications on analyzing state public health initiatives

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