Did the ACA cause industry consolidation?

The Affordable Care Act (ACA)–among other things–mandated a number of reforms to the Medicare reimbursement system.  For instance, the ACA created Accountable Care Organizations (ACOs) and bundled payment initiatives were initiatives.  If Medicare started paying providers more based on quality and total cost of care across all provider settings, one would hypothesize that industry consolidation would accelerate.…

The Changing US Health Insurance Market

An interesting paper by Graves and Nikpay (2017) look at the evoluation of the health insurance market before and after Obamacare.  The authors find We found that the ACA’s unprecedented coverage changes increased transitions to Medicaid and nongroup coverage among the uninsured, while strengthening the existing employer-sponsored insurance system and improving retention of public coverage.…

The last Obamacare sign up?

Today is the last day to sign up for Obamacare for 2017.  If President Trump has his way, it could be the last day to sign up for Obamacare ever.  In fact, Marketplace reports that Trump administration decided to pull ads promoting last-minute sign-ups, although it reversed that decision shortly after. The media put forth mixed estimates…

Obamacare Death Spiral?

Health insurance premiums are projected to increase an astronomical 25% for plans in the health insurance exchanges. Some pundits claim that these increases represent that Obamacare is crumbling or in a death spiral. As premiums rise, healthy people flee the market. This leaves insurers with only more sick individuals which leads to premium increases. More…

Bad news for Obamacare?

Premiums are rising.  HHS Secretary Sylvia Burwell stated: Building a new market is never easy,” she told the group at HHS headquarters. “We expect this to be a transition period for the marketplace. Issuers are adjusting their prices, bringing them in line with actual data on costs.” Burwell’s comments foreshadow the higher premiums expected when…

Do narrow networks reduce cost?

Many health plans in the Obamacare health insurance exchanges aim to keep premiums down by limiting patients to a select group of providers (e.g., hospitals, physicians). The thought is, by limiting patients to a “narrow network” of providers, patients are in essence restricted to see the most efficient providers.  Some may claim that “efficient” means high quality…