Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Health Reform' Category

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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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The cost of allowing kids to remain dependents up to 26 years

Many of the provisions of the Affordable Care Act include provisions requiring health insurers to do certain things.  Variability of premiums are regulated, certain services are mandated (e.g., free annual check-up) and minimum benefits packages are set on the health insurance exchanges.  One seemingly innocuous provision of the ACA is that children are allowed to remain […]

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ASSA 2016: How do high-deductible health plans affect spending levels?

Are high deductible health plans (HDHP) the holy grail for reducing cost? If so, how do consumers go about reducing cost, by reducing all utilization or shopping around for better prices? This is the research question that Ben Handel presented at 2016 ASSA meetings. He uses data from a large firm with 35,000-60,000 employees and […]

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Economists’ Declaration

In September 2015, 267 economists from 44 countries, led by Lawrence H. Summers of Harvard University, signed the Economists Declaration on Universal Health Coverage, which calls on global policymakers to prioritize a pro-poor pathway to universal health coverage as an essential pillar of sustainable development.  The full text is here.  An excerpt is below: Universal […]

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Reforming Medicare Provider Payment

With the ACA and now MARCA, Congress is moving full steam ahead with payment reform. An article by Paul Ginsburg and Gail Wilensky (2015) consider some of the implications of these reform efforts. This belief – that a set of metrics can be developed or delivery systems specified that could lead to the delivery of […]

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