The end of Obamacare?

As reported in NPR: A federal judge in Texas issued a ruling Friday declaring the Affordable Care Act unconstitutional, apparently setting the stage for another hearing on the health care law by the U.S. Supreme Court. The ruling by U.S. District Judge Reed O’Connor invalidates what’s commonly referred to as Obamacare nationwide, and casts into…

The importance of competition in ACA marketplaces

Competition matters for markets…even health care markets. A paper by Van Parys (2018) relies on a database of plan premium and market characteristics among states with federally-facilitated health insurance exchange Marketplaces.  In this analysis, she finds that: In 2018, Marketplace premiums were 50 percent ($180) higher, on average, in rating areas with monopolist insurers, compared…

My take on American Patients First

In broad strokes, the American Patients First plan aims to lower list prices, lower patients’ out-of-pocket costs while maintaining incentives for innovation.   In short, this is a sensible strategy, although there are some concerns about how more restrictive formulary designs could restrict consumer choice. American Patients First in brief To maintain manufacturers incentives to innovate,…

Obamacare premiums rose 32% in 2018

Between 2017 and 2018, premiums Obamacare health insurance plans plans rose by 32%.  To be more specific, the Urban Institute reports that: The national average increase was 32.0 percent for the lowest-priced silver plans and 19.1 percent for gold plans, but the increases varied by states…State changes in average lowest-priced silver premiums ranged from a 22.5…

The costs of quality reporting

Provider pay-for-performance initiatives aim to increase reimbursement to physicians and others who provide high-quality, low-cost care to patients. Medicare has two main programs for physicians to ahcieve these goals: (i) the Merit-Based Incentive Payment System (MIPS) and (ii) the Alternative Payment Models (APM).  MIPS measures cost and quality for smaller physicians groups whereas APM requires…