Using Existing Data to Eliminate Gaps in Health Care Coverage

Major life events such as embarking on the adventure of marriage or beginning a new job should be joyous occasions. And yet, these milestones could put people and their families at risk of losing critical health coverage, as they may have to transition between one health program to another.

How can policymakers ensure that people can better move between programs like Medicaid and state health-insurance exchanges without gaps in coverage? In our paper, “Data-Driven Strategies to Improve Transitions Between Medicaid and Exchange Coverage,” we identify ways that policymakers can use existing data to ensure that people experiencing transitions can move from one health program to another seamlessly.
The paper helps states think about how they can adopt strategies to improve the experience of individuals moving between Medicaid and exchanges to make better use of data and gain insights about how people transition – or fail to transition – between the two health coverage programs. States already have a wealth of data that they collect and create about the people they serve.

For example, looking closely at data already collected could reveal that individuals’ frequent income changes lead to churn may result in higher administrative costs, or that in-language outreach may result in fewer gaps in coverage. The paper includes best practices for:

  • Collaborating across agencies
  • Finding patterns in the data
  • Analyzing data over time

Even without significant investment, states can use the data at their disposal to discern gaps, patterns, and inconsistencies to better understand what happens during transitions, why coverage disruptions happen, and what can be done to promote seamless transitions. Analysis of the data can provide insights into the nature of transition challenges, inform approaches to address identified problems, and provide metrics for assessing improvement.

Read the full paper here.