Unbiased Analysis of Today's Healthcare Issues

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 »

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 […]

Read the rest of this entry »

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 […]

Read the rest of this entry »

The demise of PPOs in Health Insurance Exchange

A Robert Wood Johnson commentary by Katherine Hempstead provides insight into the evaluation of PPO offerings in health insurance exchange. Since last year there has been a significant reduction in the number of PPOs offered in the Affordable Care Act (ACA) marketplaces. A prior analysis showed that of the 131 carriers offering silver PPO products […]

Read the rest of this entry »

Share of Small Employers Offering Health Insurance

Although the ACA certainly expanded health insurance coverage, mostly through subsidies, creation of insurance exchanges, and Medicaid, small businesses generally did not expand coverage.  A RWJ report from Lucia et al. (2015) used MEPS-IC data to track insurance offering among businesses with fewer than 50 workers. Part of the reason is the rise of health insurance […]

Read the rest of this entry »

Narrow Networks in your state

The Affordable Care Act aimed to increase patient access to care.  Although it has certainly improved the share of patients who are insured, it is not clear whether it has actually improved “access.”  Many health insurance exchange plans are able to offer low premiums by limiting the number or type of doctors you are able to […]

Read the rest of this entry »

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 […]

Read the rest of this entry »

“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), […]

Read the rest of this entry »

Rate hikes in 2016

The Affordable Care Act may turn out to be not so affordable.  From the New York Times: Health insurance companies around the country are seeking rate increases of 20 percent to 40 percent or more, saying their new customers under the Affordable Care Act turned out to be sicker than expected. Federal officials say they […]

Read the rest of this entry »

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 […]

Read the rest of this entry »