Health insurers use of prior authorization appears to be on the rise. A recent report by CHIR researchers examines four states’ prior authorization policies for the commercial market to identify potential reform strategies to ease provider burden and improve patient access without also increasing insurers’ costs.
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.
Happy New Year! The holiday season may be over, but health policy researchers continue to bestow gifts onto our field. In December, we read about disruptions in health insurance coverage, the uninsured population, and gaps in provider network oversight. This roundup will highlight key findings of these articles, as well as their significance for our work.
Until the Affordable Care Act is fully implemented, there are gaps in our system of health coverage that can mean some families either go without coverage or must deplete their savings to afford it. But the new Health Insurance Marketplaces can help fill that gap with affordable, adequate coverage.
An energetic college senior found himself on a life detour when he was diagnosed with stage 3 Hodgkin’s Lymphoma – and almost immediately confronted with a maze of insurance denials and medical bills, until he was able to enroll in one of the high risk pools created under the Affordable Care Act. JoAnn Volk documents the story of Kalwis Lo, now 24 and looking forward to a lifetime of secure, meaningful coverage, thanks to the ACA.
Entrepreneurs with dreams of venturing out to start their own business must now navigate a “wild west” of inadequate and unaffordable insurance options. But the Affordable Care Act’s reforms will change that for entrepreneurs like Joe and Virginia Murphy. JoAnn Volk tells their story.
When Stacy Cook learned she had breast cancer, her health coverage fell short. In this latest story in our series, funded by the Robert Wood Johnson Foundation, we take a look at how the Affordable Care Act will help ensure people have affordable, adequate coverage that’s there when they need it.
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.
