Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Health Reform' Category

Republican plans to replace Obamacare

From Aaron Carroll at the Incidental Economist:

Read the rest of this entry »

The Healthcare Economist on NPR

Check out my interview on NPR with Here & Now’s Jeremy Hobson about what recent changes in health insurance premiums changes mean for the future of the Affordable Care Act.  

Read the rest of this entry »

Obamacare Death Spiral?

Health insurance premiums are projected to increase an astronomical 25% for plans in the health insurance exchanges. Some pundits claim that these increases represent that Obamacare is crumbling or in a death spiral. As premiums rise, healthy people flee the market. This leaves insurers with only more sick individuals which leads to premium increases. More […]

Read the rest of this entry »

Bad news for Obamacare?

Premiums are rising.  HHS Secretary Sylvia Burwell stated: Building a new market is never easy,” she told the group at HHS headquarters. “We expect this to be a transition period for the marketplace. Issuers are adjusting their prices, bringing them in line with actual data on costs.” Burwell’s comments foreshadow the higher premiums expected when […]

Read the rest of this entry »

Do narrow networks reduce cost?

Many health plans in the Obamacare health insurance exchanges aim to keep premiums down by limiting patients to a select group of providers (e.g., hospitals, physicians). The thought is, by limiting patients to a “narrow network” of providers, patients are in essence restricted to see the most efficient providers.  Some may claim that “efficient” means high quality […]

Read the rest of this entry »

Health reform and health insurance churn

The Affordable Care Act provides a lifeline for individuals previously “too rich” for Medicaid, but who did not have access to employer-provided insurance.  First, making Medicaid eligibility rules more generous lead to more people just above the poverty line getting access to health insurance.  Second, the “Obamacare” health insurance exchanges offered community-rated, income-subsidized health insurance coverage for people […]

Read the rest of this entry »

Did BPCI work?

BPCI is Medicare’s Bundled Payments for Care Improvement initiative.  For selected conditions, hospitals receive bundled payments that can include concurrent physician payments, post acute-care or other arrangements. The question is, does this payment approach improve quality and reduce cost? A study by Dummit et al. (2016) looked at lower extremity joint replacement at a BPCI-participating hospital.  They found the […]

Read the rest of this entry »

The End of the Obamacare Exchanges

Princeton economist Uwe Reinhardt things so.  In an interview with Vox he states: The natural business model of a private commercial insurer is to price on health status and have the flexibility to raise prices year after year. What we’ve tried to do, instead, is do community rating [where insurers can’t price on how sick […]

Read the rest of this entry »

Physician Access in California Obamacare Plans

Health plans in the health insurance marketplaces have been competing to keep prices low, while still offering all the services mandated under the Affordable Care Act. One way to do this is to restrict provider networks to lower cost providers.   For patients, restricting provider networks may be a good deal if (i) the quality of […]

Read the rest of this entry »

Is Obamacare working?

The answer is yes and no. According to a study Holahan, Karpman, and Zuckerman (2016), the health insurance exchange plans are good at insuring individuals against financial losses, but not everyone is happy with the care they are receiving. Low- and moderate-income adults with Marketplace coverage are no more likely to report problems paying medical […]

Read the rest of this entry »