Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Health Insurance' Category

Avoiding unnecessary care: Does insurance coverage matter?

Consumer Reports‘ “Choosing Wisely” initiative aims to identify high-cost, low-value treatments that can often be avoided.  One question remains is why do providers still offer these services?  Do payer coverage policies or reimbursement rules affect these choices? A paper by Colla et al. (2017) attempts to answer that question.  The authors used commercial payer claims data […]

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Smarter deductibles?

Are high deductible health plans a good thing?  Republicans typically argue yes as they say that increased cost sharing reduces moral hazard.  That is, when people have to pay for medical care out of pocket, they don’t ask for unnecessary care or use care more frugally.  Democrats typically argue that increased cost sharing reduces demand […]

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How do payers use patient reported outcomes?

This is the question asked by a study conducted by Brogen et al. (2017).  To see how payers use patient reported outcomes (PRO) in oncology, the authors conducted a literatures search, and searched the websites of the following health technology assessment bodies: Pharmaceutical Benefits Advisory Committee (PBAC) in Australia, Canadian Agency for Drugs and Technologies […]

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The Changing US Health Insurance Market

An interesting paper by Graves and Nikpay (2017) look at the evoluation of the health insurance market before and after Obamacare.  The authors find We found that the ACA’s unprecedented coverage changes increased transitions to Medicaid and nongroup coverage among the uninsured, while strengthening the existing employer-sponsored insurance system and improving retention of public coverage. […]

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The last Obamacare sign up?

Today is the last day to sign up for Obamacare for 2017.  If President Trump has his way, it could be the last day to sign up for Obamacare ever.  In fact, Marketplace reports that Trump administration decided to pull ads promoting last-minute sign-ups, although it reversed that decision shortly after. The media put forth mixed estimates […]

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Judge blocks Aetna-Humana merger

A judge blocked a potential $37 billion deal for the merger of large U.S. health insurers Aetna and Humana.  The Washington Post provides some explanation behind the judge’s logic: Bates wrote in his opinion that the proposed merger would have decreased competition substantially in the Medicare Advantage market in 364 counties. Aetna and Humana had argued […]

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Dismantling Obamacare: A How to Guide

President Trump today released an Executive Order that asked the secretary of HHS to: “…exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay” parts of the law that would place a fiscal burden on states, individuals or health-care providers. Most of the provisions in the ACA can’t just be […]

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Can we explain the growth in health care spending with growth in pet care spending?

A blog post by Austin Frakt of the Incidental Economist says the answer is yes. In almost every year since the 1960s, health care spending has grown at least as fast as the overall economy, and often much faster. Health economists have long debated why. Strange as it may sound, how we care for our […]

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Good News-Bad News in Covered California

First the good news, it appears that the Covered California marketplace is working.  People are selecting lower cost options and forcing insurers to compete.  Gabel et al. (2017) state that …the average purchased price for all plans was 11.6 percent less than the average offered price in 2014, 13.2 percent less in 2015, and 15.2 percent less in […]

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VBID in TRICARE

Value-based insurance design looks to be expanding. As the American Journal of Managed Care reports: The bill calls for a pilot demonstrating the feasibility of incorporating VBID by “reducing co-payments or cost shares for targeted populations of covered beneficiaries in the receipt of high-value medications and services and the use of high-value providers” no later […]

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