…or more cancer diagnoses than average. Risk corridors (or risk sharing) involve creation of a fund so that plans with unusually high gains pay back some of those gains and those with unusually high losses are partially compensated. These measures have been in use for Part D for nine years. So how has this system worked in that program? The…
…plans will meet minimum standards for benefits and cost-sharing – no more swiss cheese coverage. State and Federal Regulators Should Make Sure Consumers Get the Right Information – and Act to Stop Any Illegal Cherry Picking State insurance departments have the primary responsibility to ensure that insurance companies are not targeting sicker enrollees for cancellations. They can also provide guidance…
This blog originally appeared as a column in the Indianapolis Business Journal and is re-printed here in its entirety. Battles over the Affordable Care Act have raged since President Obama signed it into law in March 2010—and it’s time they stop. As of this writing, open enrollment for plans offered through the federal Marketplace, the site available to people in…
…Children’s Health Insurance Program—through the marketplace. Achieving the vision for marketplaces as a seamless one-stop shop for obtaining coverage will largely depend on new IT systems that operationalize numerous policy and logistical decisions, provide real-time eligibility assessments, enroll people in appropriate coverage, and ensure premiums are paid correctly. Getting these systems right—under very tight deadlines—is an enormous task. Like all…
…a sicker risk pool – and the higher claims costs for insurers. Because it’s too late in the year for insurers to recalculate and re-file their premium rates for review, they could be exposed to significant losses and it could even threaten their solvency. The bottom line? An attempt to delay the individual mandate is tantamount to an attempt to…
…job. Her doctor told her she should stop working permanently because of the severity of her symptoms. But Karen was hoping to put off that day, and worked as long as she could before taking a second short-term disability leave. It was during that time that she came to terms with the difficult reality of her condition. MS is a…
…for Improving Maternal and Infant Health Outcomes to “identify specific opportunities and strategies to provide better care, while reducing the cost of care for mothers and infants covered by Medicaid/CHIP.” States are beginning to alter their Medicaid payment policies to discourage elective deliveries: Texas stopped paying for them altogether, while Washington State began paying a bonus to hospitals that met…
…workers to get the care they need. Yet we don’t have evidence that financial incentives delivered as higher health plan costs really work. It’s one of the areas a recent Rand report notes needs more research, noting, “Employers overwhelmingly expressed confidence that workplace wellness programs reduced medical costs, absenteeism, and health related productivity losses. But at the same time, only…
…of who operates the Marketplace, CMS is working to ensure streamlined and secure access to a variety of information sources that are essential for operation.” He continued that the exchanges will be on track to fulfill the one of the key aims of the law: to provide a one-stop shop for public or private coverage. Mr. Cohen further noted that…
…in every state by October 1, 2013. Exchanges are intended to address the current barriers to affordable and adequate health coverage in the individual and small-group markets by providing a seamless, one-stop experience for individuals to apply for financial assistance, compare health plans, and enroll in public or private coverage. Similarly, Small Business Health Options Program (SHOP) exchanges are designed…
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.
