This research was based on the latest Insurance Coverage Estimates (ICE) from Truven Health Analytics, released in June 2017.
The ICE release contained two scenarios: ACA reform and ACA repeal. Reform estimates reflected continued support of Medicaid expansion and health exchanges. The repeal scenario assumed a rollback of insurance coverage to pre-2014 levels.
Overall, the Truven Health model assumed that the uninsured population will increase by approximately 20 million by 2020. This is a more conservative scenario than other published estimates. The nonpartisan Congressional Budget Office, for example, projected a 24 million-person growth of the uninsured population by 2026 based on one recent legislative proposal. These Truven Health forecasts were distinct in that they estimated impact at a local ZIP code level, using publicly available enrollment figures for health insurance exchanges and expanded Medicaid, combined with U.S. Census Bureau figures of households in poverty. Truven Health then paired the population estimates with utilization models specific to each payer segment to produce utilization scenarios for changes in insurance coverage.
Inpatient Demand Estimates from Truven Health provided local, annual acute care admissions and patient days by diagnosis-related group (DRG) and three-digit ICD-9 diagnosis code. The estimates were reported by age, sex, and principal payer. Inpatient Demand Estimates were derived from all-payer state discharge data from 24 states and Medicare Provider Analysis and Review (MEDPAR) data. Truven Health Outpatient Procedure Estimates, as accessed through the Truven Health Market Expert® solution, provided local, annual procedure group and visit category estimates and forecasts by age, sex, principal payer, and site of service.
The estimates were derived from Truven Health commercial, Medicare, and Medicaid claims.