AcademyHealth awarded its Health Services Research (HSR) Impact Award to work that used for the first time a randomized, controlled study design to answer questions about how access to public insurance affects health, health care use, and other outcomes. The HSR Impact Award is presented annually to health services research studies that make a clear impact on health policy and practice.
This year's winner, The Oregon Health Insurance Experiment, took advantage of a unique confluence of events—the offering of a "lottery" for Medicaid coverage and a resulting pool of both selected individuals and comparable, but not selected, individuals—to apply the gold standard of research, the randomized controlled trial, to the questions of how having access to insurance affected utilization, financial strain, and self-reported health and well-being. The research was further bolstered by the broad collaboration between academic, non-profit, and public sector researchers, as well as public and private financing.
"This was an unprecedented opportunity to provide the policy community with vital information about Medicaid's effects at a time of major program changes, and the study would not have been possible without the collaboration of a fantastic team of both state policymakers and a team of researchers,” said Katherine Baicker, Ph.D., professor of health economics, Harvard School of Public Health and co-principal investigator of the study. “This close partnership, along with generous funding, allowed us to collect data never before available on a wide range of outcomes."
This study has important implications for the costs and benefits of expanding Medicaid. In the first year after random assignment, results indicate that enrollment in Medicaid substantially increased health care use, reduced financial strain, and improved self-reported health and well-being. The initial results received extensive national and local coverage in print, radio, and television outlets – with stories appearing in The New York Times, The Washington Post, Associated Press, National Public Radio, and in scores of local newspapers, as well as editorial pages from the Oregonian and The New York Times. There has been extensive blog coverage of the findings by think tanks and analysts, and active commentary from policymakers on both sides of the aisle – from the White House blog to senators’ speeches. As a result, decision makers had access to high-quality information to inform Medicaid coverage decisions during the crucial implementation phases of the Affordable Care Act.
“The Oregon Health Insurance Experiment is unique for a number of reasons, but what made it so compelling as an impact example was its ability to provide actionable, timely information to policymakers," said AcademyHealth President and CEO Dr. Lisa Simpson. "This study shows clearly how health services research can provide the evidence necessary to help decision makers evaluate their options and maximize the value of their health care dollar amid increasingly tight budgets."