Author Archive: Christine Monahan

How HHS and DOL Can Deliver Price Relief to American Families

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President Trump’s price relief memorandum calls for reducing unnecessary administrative costs and rent-seeking behavior in health care. With federal agencies empowered to gather information and potentially drive reforms to eliminate wasteful spending, CHIR’s Christine Monahan discusses how they can effectively implement this directive by investigating intermediaries like pharmacy benefit managers (PBMs) and third-party administrators (TPAs) that increase consumer and employers costs through profit-driven practices.

U.S. House Education and Workforce Committee Moves Telehealth Billing Legislation

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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.

New Nationwide Data on Outpatient Facility Fee Reforms

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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.

Questionable Conduct: Allegations Against Insurers Acting as Third-Party Administrators

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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.

ERISA 101: The United States’ Hands-Off Approach to Regulating Employer Health Plans

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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.

Nevada Actuarial Study Projects Significant Savings from Public Option Plans

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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.

What the Data Say About Offering Public Option Plans to Workers with Employer-Sponsored Insurance

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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.

Updated Breast Pump Coverage Guidelines Provide Important Protections for Families but More Guidance May Be Needed to Increase Access

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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.

Oregon’s Public Option Implementation Report Emphasizes Cost Containment, Health Equity

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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.

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.