In November, CHIR was thankful for the latest health policy research. We read about charity care provided by non-profit hospitals, Marketplace coverage for small business and self-employed workers, and out-of-pocket costs of traditional fee-for-service Medicare versus Medicare Advantage.
The Biden Administration has proposed a rule to expand coverage of preventive services, including over-the-counter (OTC) contraceptives, without cost sharing. However, the proposal’s future is uncertain due to potential legal challenges and the political factors surrounding reproductive health. CHIR faculty Leila Sullivan and Amy Killelea discuss the proposal.
The Affordable Care Act mandates that health plans in the individual and small-group markets cover essential health benefits (EHB), with states setting the scope through a benchmark plan. A new brief for the Commonwealth Fund by CHIR faculty explores how states have used recent flexibility to expand EHB, address consumer needs, and advance health policy, while highlighting ongoing challenges
In 2023, for the first time, more than half of Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans, which offer private insurance alternatives to traditional Medicare, with 34 million enrollees in MA and 23 million in standalone Part D drug plans. A compendium of 70 policy proposals, created by Georgetown’s Center on Health Insurance Reforms, Medicare Policy Initiative offers a comprehensive resource for improving these programs, addressing issues like cost efficiency, provider networks, and many more.
The Centers for Medicare & Medicaid Services (CMS) has introduced a new option for states to update their essential health benefits (EHB) benchmark plan to include routine adult dental coverage, aiming to address disparities in oral health outcomes, particularly for low-income and minority adults. In their latest Expert Perspective for the State Health & Value Strategies program, CHIR’s JoAnn Volk and Manatt’s Tara Straw discuss considerations for states weighing this addition.
The leaves are falling but the latest health policy research is evergreen! Last month we read about health system competition in metropolitan areas, health care affordability prior to the American Rescue Plan (ARPA,) how high deductible health insurance can exacerbate racial and ethnic wealth disparities, and about unmet dental vision and hearing needs among low-income Medicare Advantage beneficiaries.
Many Americans struggle with high healthcare costs, leading state policymakers to explore transparency measures to lower prices. While transparency alone has limited impact on cost reduction, states are innovating by increasing transparency in areas like provider ownership, billing practices, and price data, which can inform broader policy solutions and have bipartisan support, paving the way for more effective cost-containment strategies. In their latest article for CHIRblog, CHIR experts Stacey Pogue and Nadia Stovicek explore transparency options for state policymakers.
In recent years, federal price transparency rules have required hospitals and health plans to publicly post their prices. However, challenges persist with data access and use, limiting the data’s effectiveness for consumers and policymakers. Two bipartisan bills in Congress seek to strengthen these rules. CHIR experts Stacey Pogue and Nadia Stovicek discuss the federal price transparency landscape in their latest article for CHIRblog.
The 2024 election results will require concerted and aggressive efforts to preserve gains in insurance coverage, improvements in health equity, and greater health care affordability. CHIR’s faculty share thoughts on the work ahead.
The U.S. health care system’s lack of regulation over provider pricing and insurer claims has led to a rise in profit-driven middlemen, such as revenue cycle management firms. While these intermediaries aim to maximize reimbursements for providers, they often increase costs for consumers and complicate access to care. This complex environment underscores the urgent need for regulatory oversight to address the inefficiencies and rising expenses in the system. In their latest piece for Health Affairs Forefront, Linda J. Blumberg and Kennah Watts break down the effect of middlemen on US health care.
The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.
