Does episode-based payment reduce cost?

That is the question that Carroll and co-authors try to answer in their latest NBER working paper (WP #23926).  They examine the Arkansas Health Care Payment Improvement Initiative (APII), which is a state-wide, multi-payer episode-based program.  Unlike most episode-based payment (EBP) models, provider participation  in the program was mandatory (as of 2013).  NBER summarizes the program…

Medicaid and paperwork

When you buy a typical product, the vendor does its best to make the purchasing process as easy as possible.  There is a reason for this, clearly; they want your business.  State and federal governments, however, have no such incentive.  In fact, oftentimes reducing the number of people using government services saves money. Thus, it…

How did the Affordable Care Act affect the U.S. labor supply?

The Affordable Care Act (ACA) aimed to increase health insurance coverage largely through two pathways: (i) raising the income limits for individuals to qualify for Medicaid, (ii) creating new health insurance exchanges and health insurance subsidies to encourage the purchase of private health insurance among individuals that were not eligible for Medicaid.  Other provisions, such…

What happens to CHIP?

The Children’s Health Insurance Program (CHIP) is a federal program that provides matching funds to states in order for them to provide health insurance to children.  The program was designed to cover uninsured children in families with incomes that are modest but too high to qualify for Medicaid. Currently, however, the program is in jeopardy.  In fact, federal funding for…

The Big Five

UnitedHealthcare, Anthem, Aetna, Cigna and Humana are the five largest health insurers in America. To learn more about them, check out a recent paper by Schoen and Collins (2017) in Health Affairs. The five largest US commercial health insurance companies together enroll 125 million members, or 43 percent of the country’s insured population…In 2016 Medicare and Medicaid…

Progress on Obamacare Sign-ups

According to the N.Y. Times: Despite the Trump administration’s efforts to scale back the health law, about 300,000 more people have signed up for health insurance in the Affordable Care Act marketplaces in the first weeks of this enrollment period than last year. This is about a 25% increase from last year at this time.  However,…

Why shopping for health insurance is hard

The premise is simple.  Create markets, let consumers choose the products that fit them best, and the competition will lead to higher quality and lower prices.  That is the premise behind the Affordable Care Act’s health insurance exchanges.  A necessary condition for this to work, however, is that patients have visibility into the quality and…