Unbiased Analysis of Today's Healthcare Issues

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.  

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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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ACA decreased the number of uninsured Americans

This is according to a Urban Institute study by Karpman, Long and  Zuckerman (2016).  They look at changes in the uninsurance rate and in the rate of full-year insurance coverage for nonelderly adults (ages 18 to 64) overall and by state Medicaid expansion status.  They found that: The uninsurance rate for nonelderly adults fell from 17.6 percent in […]

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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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Who is participating in BPCI?

In 2013, Medicare launched the Bundled Payments for Care Improvement (BPCI) initiative.  There were 4 models included in the program: Model 1 (least comprehensive): includes Part A services for the index hospitalization alone, and thus most closely resembles current fee-for-service payment. Model 2 (most comprehensive): encompasses Part A and Part B services for the index hospitalization, readmissions, and all other post […]

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ACA driving up health care spending?

That is the conclusion reached by John Holahan and Stacey McMorrow in a RWJ Issue Brief. They claim that “recent reports suggest such growth has returned to a more typical level of approximately 5.6 percent in 2014, considerably faster than increases in gross domestic product (GDP).” Positive excess cost growth–defined as the difference between the […]

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“Affordable” Care Act

Is the Affordable Care Act making health insurance more affordable?  Generally, the answer is yes.  More individuals are insured due to Medicaid coverage expansions in some but not all states and the implementation of health insurance exchanges.  However, there is one worrying trend in affordability: increasing patient cost sharing. A paper by Hempstead et al. (2015), […]

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ACA and narrow networks

One way for insurers to reduce health care costs is to restrict patient access to only lower cost providers.  This phenomenon is known as narrow networks.  On the one hand, narrow networks can promote efficiency by driving down provider price and directing patients to the highest value physicians.  Alternatively, if insurers use narrow networks to direct patients […]

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Covered California and Adverse Selection

The Affordable Care Act requires all individuals to be offered the same premium regardless of health status. Although there are some ratings bands based on age and smoking status, most people who purchase insurance on health insurance exchanges receive the same premium for any given insurance product from any given insurance company. The insurance products […]

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Medicaid Expansion and States’ bottom line

A recent RWJF Issue Brief notes that states that expanded Medicaid received more revenue from the federal government and had less state-level spending on programs that support the uninsured. In examining Medicaid expansion across eight states—Arkansas, Colorado, Kentucky, Michigan, New Mexico, Oregon, Washington and West Virginia—it is clear that states are realizing savings and revenue […]

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