Doctors at Your Service: An Appraisal of Direct Patient Contracting Practices

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.

Georgetown Experts Help States Weigh Solutions to Protect Consumers from Unexpected Medical Bills

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.

No QHPs Comparable to CHIP, Says (Delayed) HHS Certification

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.

Filing Fee and External Appeals

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.

Feds Propose Changes – and an Expanded Role – for Marketplace Navigators

A new proposed rule from the Obama Administration contains wide-ranging new requirements for insurance companies and marketplaces under the Affordable Care Act, including changes that expand the role of marketplace navigators. CHIR’s Sabrina Corlette shares some highlights.

Paying for Miracles – The High Cost of Cures

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.

State Efforts to Reduce Consumers’ Cost-Sharing for Prescription Drugs

High drug prices have been in the news lately, and consumers are bearing an ever-greater burden of those drug prices through health plan cost-sharing. In their latest post for the Commonwealth Fund, CHIR researchers Sabrina Corlette, Ashley Williams and Justin Giovannelli analyze state policies to try to protect consumers from high drug costs.

Shop to Renew During Open Enrollment

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.

Health Care Cost Considerations in Medical Education

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.

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.