Out of frustration with insurance companies, physicians are increasingly turning to direct patient contracting, or “concierge” practices. For some patients these can be a great value, but the spread of these practices could also cause unintended harms. Georgetown medical student Josh Barrett blogs about the pros and cons – and the implications for aspiring doctors – in his latest post for CHIRblog.
As reports of patient encounters with unexpected provider bills continue to make headlines, state and federal policymakers are working to find solutions to the problem of surprise out-of-network billing. A recent Georgetown report on the issue caught the eye of two states – Pennsylvania and Florida – that are attempting to set new standards to protect consumers from balance bills. CHIR’s Ashley Williams shares a summary of what these states heard from our report’s lead authors.
The U.S. Department of Health and Human Services has finally released a long-awaited study comparing coverage in CHIP plans to qualified health plans offered through the Affordable Care Act marketplaces. Our colleague from Georgetown University’s Center for Children and Families, Elisabeth Wright Burak, takes a look and shares the (not altogether surprising) findings.
One of the most significant consumer protections in the Affordable Care Act (ACA) is the right to appeal a denied claim, including the right to take your appeal to an independent, third-party reviewer. Although the ACA guarantees this right, recent federal rules have codified barriers to the process that still exist in some states, such as filing fees. Sandy Ahn provides a short summary of this issue.
It is every patient’s dream to hear the words, “You’re cured.” Yet the ability to cure can come with a high cost, one that health insurers are often reluctant to cover. Georgetown University medical student Joshua Barrett examines recent proposals for unique payment mechanisms for high-cost interventions that could perhaps change the way they are priced and financed.
While many consumers with marketplace coverage will be eligible for automatic renewal, there are many reasons for all consumers to shop to renew this year. For example, price changes to health plans as well as changes to the health plans themselves will impact the amount of premium tax credits and coverage for many consumers. We go over the reasons why all consumers should shop to renew this open enrollment.
Medical students are taught to care for the whole person. Shouldn’t that include care for the patient’s wallet, as well? As insurers increasingly shift costs to enrollees, Georgetown University medical student Joshua Barrett considers the role of the physician – and medical education – in helping patients stay both physically and financially healthy.
Open Enrollment 3 (OE3) is now underway and by all accounts, things are going smoothly. There are a few minor kinks with the out-of-pocket cost calculator, which officials have fixed or are working on fixing now. CHIR highlights two consumer facing tools that healthcare.gov is pilot testing and should be available to all users before the end of open enrollment.
Federal Affordable Care Act rules require the states to revisit the standard scope of benefits for individual and small business health plans – called essential health benefits or EHB – and determine whether revisions are needed. In a new blog post for the Commonwealth Fund, CHIR experts examine how the states approached this task, and what it might mean for consumers.
CHIR is pleased to release an updated online Navigator Guide on Private Health Insurance and Health Insurance Marketplaces with searchable frequently asked questions (FAQs) and easy-to-read background information on key health insurance and marketplace issues. With Open Enrollment just a few days away, get your Guide on!
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.
