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…

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…

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.

Malpractice Insurance Caps

Many people support malpractice insurance caps.  They believe that malpractice insurance award caps will reduce medical costs in two ways: i) by decreasing malpractice premiums and ii) by decreasing the amount of defensive medicine physicians practice to avoid lawsuits.  An article by Shirley Svorny, however, argues that malpractice awards are bad medicine.  Physicians who are…