Unbiased Analysis of Today's Healthcare Issues
While that may not be his intention, a study from Robert Wood Johnson has found that few carriers are leaving the market in 2019 and in fact there is likely to be a net increase in the number of health plans offered. Favorable financial results for participating carriers is clearly the motivating factor, along with…
It appears that the answer is ‘yes’. Many studies by the Dartmouth Atlas team have shown that regions that spend more on medical care do not always get better outcomes. However, a recent paper by my Precision Health Economics colleagues James Baumgardner, Ahva Shahabi, Mark Linthicum, Seanna Vine, and Darius Lakdawalla as well as Chris Zacker…
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,…
This is the question put forth in a paper by Chen et al. (2017). The authors examine Medicare’s Acute Care Episode (ACE) Demonstration Program, which was a small, voluntary episode-based bundled payment program. According to the CMS website, There were 28 cardiac and 9 orthopedic inpatient surgical services and procedures included in the bundled payment demonstration. These…
There have been a number of moves to try to move California towards a single payer system. A single-payer bill, Senate Bill 562, was offered up last year. Some Silicon Valley tech workers are trying to move voters towards a single payer system as well. The question is, can we afford it? This is the…
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…
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…
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…
The Robert Wood Johnson Foundation has a publicly available data source you can use to find this information. Known as HIX Compare, the data contain descriptions of plans in the individual and small group markets across all 50 states. HIX Compare is the only dataset with information on nearly every individual and small group marketplace plan…
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…