Author Archive: CHIR Faculty

State Policy Options to Encourage Greater Use of Telehealth in State-Regulated Health Plans

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The COVID-19 pandemic has brought renewed and urgent interest in using telehealth to enable remote access to care across service areas and provider types. CHIR’s JoAnn Volk and Sabrina Corlette summarize federal legislation and guidance as well as actions state departments of insurance can take to encourage greater access to telehealth services in an article for the Robert Wood Johnson Foundation’s State Health & Value Strategies project.

Keeping Surprise Billing Out Of Coronavirus Treatment

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Surprise medical bills, which were already a concern for many consumers, are expected to increase because of the coronavirus crisis. While Congress should adopt a comprehensive solution for all patients, protecting those affected by coronavirus is critical and should be done quickly. In a post for the Health Affairs Blog, Jack Hoadley, Kevin Lucia, and Katie Keith propose an immediate, short-term solution that Congress could adopt now to protect patients from surprise bills due to coronavirus.

States Don’t Know What’s Happening in their Short-term Health Plan Markets and That’s a Problem

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In the midst of a global pandemic, consumers continue to be sold skimpy short-term plans that may not cover necessary testing and treatment. In their latest post for the Commonwealth Fund’s To the Point blog, Dania Palanker and Christina Goe assess the ability of insurance regulators to understand the scope of the short-term plan market in their states and its impact on consumers’ ability to access and afford care.

State-Based Marketplaces Find Value, Potential Opportunity for Growth in Small-Business Offering

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Small businesses have historically struggled to provide coverage to their workers. The ACA sought to address these issues through the Small Business Health Options Program (SHOP), creating marketplaces for small employers to offer coverage to their employees. In a new post for the Commonwealth Fund’s To the Point blog, CHIR experts take a look at ways that state-based marketplaces are investing in their SHOPs, and how some are seeing enrollment growth and savings for small businesses.

On its 10th Anniversary, during a Public Health Crisis, the Affordable Care Act is More Important Than Ever

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The past few weeks have tested the U.S. health care system. In a world where we are all at risk of contracting and spreading COVID-19, access to health care is a universal human need. On the 10th anniversary of the Affordable Care Act, CHIR takes some time to consider how battling this pandemic would have been even more difficult if it weren’t for this groundbreaking federal law.

What Are State Officials Doing to Make Private Health Insurance Work Better for Consumers During the Coronavirus Public Health Crisis?

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Many people may hesitate to seek coronavirus testing and treatment because they face significant deductibles or other cost-sharing under their insurance policy. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR experts Sabrina Corlette, Kevin Lucia, and Madeline O’Brien take a look at how states are stepping up to require insurance companies to expand their coverage in the face of an unprecedented public health crisis.

When Things Fall Apart: A Roadmap for State Regulators Managing Fallout from Provider-Payer Contract Disputes

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High profile contract disputes between insurers and providers appear to be on the rise, raising the risks of disruptions for patients and unexpected out-of-network billing. In a new report for the Robert Wood Johnson Foundation, CHIR experts examine best practices among state regulators and insurers to protect consumers and provide recommended policies and procedures to mitigate risks when a provider leaves a health plan network.

Coronavirus Exposes Big Gaps in the U.S. System Of Coverage: What Can States Do to Help?

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The cost of medical care associated with the novel coronavirus can be a barrier for many people who should get tested, raising a public health risk. Given our patchwork quilt system of health insurance coverage and the lack of a timely and comprehensive federal response, CHIR’s Sabrina Corlette and Kevin Lucia consider actions states can take to encourage people to get the care they need.

How States Are Using Independent Dispute Resolution to Resolve Out-of-Network Payments in Surprise Billing

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As Congress and a number of states craft legislation to protect consumers from surprise out-of-network billing, a critical issue is resolving how insurers will pay out-of-network providers for their services. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Jack Hoadley and Maanasa Kona assess the experience of states that use an independent dispute resolution process to determine these payments.

Addressing Surprise Billing by Setting Payment Standards for Out-of-Network Providers

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The thorniest issue in pending legislation to protect consumers from surprise medical billing is how to resolve disputes between payers and providers over appropriate payment. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR experts Maanasa Kona, Jack Hoadley, and Katie Keith examine the seven states that have adopted a payment standard for out-of-network bills.

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.