Unbiased Analysis of Today's Healthcare Issues
Which states have implemented the Health Insurance Exchanges included in the Affordable Care Act (a.k.a. Health Reform, a.k.a. ObamaCare)? According to the Kaiser Family Foundation, 16 States have already established a state exchange, 3 are planning for Partnership Exchange, 16 are Studying Options and 9 have had no significant activity on this front. Most strikingly,…
Today, Aetna, the third-largest U.S. health plan, agreed to buy Coventry Health Care for $5.6 billion. Aetna paid a 20 percent premium for Coventry. Why is Coventry such an attractive target? The answer is that President Obama’s Health Reform will greatly expand the number of people eligilbe for Medicaid. Since many states are moving towards…
Today the Supreme Court upheld the large majority of Affordable Care Act (a.k.a., Health Reform, ObamaCare, ACA) including the individual mandate. Why was the individual mandate allowed to remain in the law? According to Justice Ginsburg and others, it is a form of a tax. “Justice Ginsburg makes clear that the vote is 5-4 on…
Today, the Supreme Court is deciding whether to let many of the provisions of the Affordable Care Act (a.k.a. ACA, a.k.a. Health Reform, a.k.a. Obamacare) stand. One of the key provisions is the individual mandate. The individual mandate requires all individuals to purchase health insurance. If you don’t buy health insurance, you must pay a…
Although Health Reform did little to reduce the cost of health care, it did make significant strides to expand access to care. For low-income individuals, the increased access comes along two dimensions: expanded Medicaid eligibility and increased physician fees. Specifically, Health Reform required to Make all individuals with incomes below 138% of the Federal Poverty…
Health reform not only changes the health care market for the demand side (e.g., patients, insurers), but also for the supply side (e.g., hospitals, physicians). In the Medicare setting, a number of initiatives have aimed to pay providers who provide high-quality or low-cost care more money, and pay providers who provide low-quality or high-cost care…
The answer depends on the state. Today, I examine an Urban Institute research paper that looks at this progress in more detail. Dividing States into 3 Group The most advance States fall into Group 1 (CA, CO, CT, DC, HI, IN, MA, MD, NV, OR, RI, UT, VT, WA, WV). These states have either enacted…
One of the provisions in the Patient Protection and Affordable Care Act (a.k.a ACA, a.k.a. Health Reform, a.k.a. Obamacare) is that it limits the profits of health insurance companies. The ACA imposes a minimum medical loss ratio (MLR) on all insurers. The MLR is the amount of money spent on covered person medical care divided…
Medicare’s push to evaluate all types of providers is being extended to Inpatient Rehabilitation Hospitals (IRFs). According to Health Reform bill (specifically, Section 3004 of the Affordable Care Act), CMS is required to start publishing quality measures for IRFs by October 1, 2012. This newly created IRF Quality Reporting Program (QRP) currently has proposed two…
Health Reform’s Accountable Care Act (ACA) mandates the creation of Accountable Care Organizations (ACOs). Dartmouth researcher Elliott Fisher stimulating much of the interest in ACOs by introducing the concept of an “extended hospital medical staff” at a 2006 meeting of the Medicare Payment Advisory Commission (MedPAC). Today, I review an article by Berenson and Burton (2011) describing…