Unbiased Analysis of Today's Healthcare Issues

Smarter deductibles?

Are high deductible health plans a good thing?  Republicans typically argue yes as they say that increased cost sharing reduces moral hazard.  That is, when people have to pay for medical care out of pocket, they don’t ask for unnecessary care or use care more frugally.  Democrats typically argue that increased cost sharing reduces demand […]

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The problem with step therapy

Step therapy is good in theory, but often not in practice.  In step therapy, patients are required to try one drug first–typically a low cost and/or high-value treatment–before moving on to more expensive alternatives.  In theory, this is a great idea.  The first drug patients should try should be the highest value one. In practice, however, […]

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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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2016 ASSA: Effect of guaranteed issue and community rating on health insurance premiums

How should insurance be regulated? Should insurance plans be able to price premiums based on health conditions? The drawbacks of this approach is that it is not equitable as sicker patients will pay higher premiums. Should all people pay the same cost? Although more equitable, using a single price would incentivize healthy people to avoid […]

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Antidepressant coverage in the Health Insurance Exchange plans

The most common drug class taken among patients aged 18-44 is an antidepressant. Furhter, these relatively young and healthy patients are likely to be the ones who enroll in healht plans within the health insurance exchanges.  The question is, how easily can patients access information about antidepressant coverage? According to a recent RWJ report, the […]

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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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Do quality rankings matter?

There have many policy initiatives to measure and improve quality of care.  For instances, NCQA’s HEDIS measure are the most widely used quality measures among commercial insurers.  Since employers generally choose insurance plans for employees (or at least select the menu of insurance options for employees), one would expect that employers would look for high […]

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Insurance and Receipt of Recommended Care

Insurance doesn’t have much effect on whether patients receive recommended care: Source: Asch SM, Kerr EA, Keesey J, Adams JL, Setodji CM, Malik S, et al. Who Is at Greatest Risk for Receiving Poor-Quality Health Care? New England Journal of Medicine. 2006;354(11):1147-56. PubMed PMID: 16540615. HT: Ashish Jha of The Health Care Blog.

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The Most Important Health Policy Study of Our Generation

Perhaps the most important paper on the effect of health insurance on health, spending, and access to care was released this week. Although randomized controlled trials are rare for measuring the effect of insurance, the design of the Oregon Medicaid program introduced random variation into who received Medicaid coverage.  The authors write: In 2008, Oregon […]

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How does gaining Medicare coverage affect healthcare utlization?

According to an article by Decker, Doshi, Knaup and Polsky (2012), the answer is that Medicare health insurance increases utilization among the uninsured, but the utilization of medical services does not rise to the same level as those who previously had insurance. “Although we do not find statistically significant differences in Medicare expenditures or in […]

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