A new proposal in New York State seeks to reduce rising outpatient care costs by implementing site-neutral payment. The bill aims to cap payments, eliminate facility fees, and protect consumers from higher costs. In her latest article for CHIRblog, Karen Davenport breaks down this new proposal.
The Biden Administration has proposed a rule to expand coverage of preventive services, including over-the-counter (OTC) contraceptives, without cost sharing. However, the proposal’s future is uncertain due to potential legal challenges and the political factors surrounding reproductive health. CHIR faculty Leila Sullivan and Amy Killelea discuss the proposal.
The 2021 expansion of federal premium tax credits (PTCs) drove uninsured rates to a record low in 2023, but this critical financial assistance will expire after 2025 unless Congress acts. CHIR faculty Rachel Swindle and Justin Giovannelli talk more about this in their latest issue brief for the Commonwealth Fund.
A recently enacted law creates a streamlined pathway to health insurance for individuals who are found ineligible for Medi-Cal but are likely eligible for Marketplace subsidies. In a recent report, CHIR experts assess the critical policy and operational decisions to implement the program and how these choices have affected consumers’ coverage transitions.
As Medicaid unwinding draws to a close, millions of people have had to find new health coverage options, many of them through the Affordable Care Act (ACA) Marketplaces. Emma Walsh-Alker discusses what we know about how they have fared, and whether state efforts to smooth coverage transitions have been successful.
In response to widespread concerns about the impact of medical debt, the Consumer Financial Protection Bureau (CFPB) proposed a rule in June 2024 aimed at limiting the influence of medical debt on credit reports and preventing certain debt collection practices. Despite recent changes by credit agencies to exclude small medical debts from reports, many Americans still face significant medical debt, particularly affecting vulnerable populations. In a recent piece for Health Affairs Forefront, Georgetown experts examine this proposed rule and the effect it could have on consumers.
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.
Easy-enrollment programs offer states an efficient, low-cost mechanism for connecting residents with comprehensive, affordable health care coverage. In a recent post for the Commonwealth Fund, CHIR experts Rachel Swindle, Rachel Schwab, and Justin Giovannelli review state efforts and effective strategies for improving easy enrollment programs and boosting healthcare enrollment.
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.
With more outpatient care being delivered in hospital outpatient departments (HOPDs) than in previous years, consumers increasingly face high hospital facility fee charges on top of their provider’s bill for routine medical care. CHIR’s Hanan Rakine discusses the 2024 legislative session and how different states have been successful in regulating outpatient facility fees.
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.
