Recently, the U.S. House Education and Workforce Committee approved the Transparency Telehealth Bills Act, which standardizes billing for telehealth services and eliminates extra facility fees, ensuring consumers receive only one bill for their telehealth care. CHIR’s Christine Monahan discusses what this bill means for simplifying costs and protecting consumers from unexpected out-of-pocket expenses.
As hospitals and health systems expand their ownership and control of ambulatory care practices, they are frequently charging new facility fees for routine medical services delivered in outpatient settings. These bills are driving up premiums and health expenditures for consumers, employers, and, ultimately, tax payers. With support from and working in partnership with West Health, CHIR experts are studying outpatient facility fee billing reforms and share their findings in a new online repository.
Nearly half of U.S. residents are enrolled in employer-sponsored health insurance. Many of these plans use third-party administrators (TPAs), intermediaries—frequently insurance companies themselves—that help build provider networks, design benefit packages, and adjudicate claims, among other responsibilities. But a TPA’s interests may not align with those of their employer clients. CHIR’s Christine Monahan highlights several examples of questionable insurer-TPA practices uncovered in recent years.
Amidst growing health care costs, adequate health insurance coverage is increasingly unaffordable for employers and employees. There is a growing focus on the role employer-sponsored plans can play in health care cost containment, but under the Employee Retirement Income Security Act of 1974 (ERISA), the access, affordability, and adequacy of employer coverage is dictated less by law and regulation and more by individual employers.
Last week, the Nevada Department of Health and Human Services released the results of an actuarial study projecting hundreds of millions of dollars in savings from the state’s Public Option plans within the program’s first few years. CHIR’s Christine Monahan takes a look at the estimated impact of the state’s public option-style law.
Employer-sponsored insurance is the largest source of health coverage in the U.S., but the employer market’s historic status as the “backbone” of the U.S. health care system is imperiled by rising health care costs. A public health insurance option could help reduce health care costs and expand access to coverage for people with job-based insurance, and has received increasing support among employers.
Colorado is moving quickly to set the rules for state public option-style plans, ahead of their launch in the 2023 plan year. CHIR’s Christine Monahan discusses recent rulemaking on “Colorado Option” premium reduction targets and the state’s Section 1332 Waiver Amendment Application.
The American Academy of Pediatrics recommends feeding infants breastmilk through their first year. One of the barriers to doing so is cost. The Affordable Care Act requires most health insurance plans to cover breastfeeding services and supplies without cost sharing, but gaps in access for enrollees have underscored the need for policy changes. CHIR expert and new mom Christine Monahan looks at new federal guidelines on the coverage of breastfeeding services and supplies going into effect next year and how they will make it easier for many parents to provide their infants breastmilk.
The Oregon Health Authority recently released its Public Option Implementation Report, stemming from a legislative directive to develop a plan to make a public health insurance option available in the individual (and potentially small group) market. CHIR’s Christine Monahan takes a look at what’s in the new report and what’s next for the Oregon public option initiative.
Congressional leaders requested input from the public on how to design a federal public health insurance option. CHIR’s Christine Monahan compiled and reviewed dozens of publicly available responses and shares key takeaways, as well as links so you can take a closer look.
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.
