Tag: health insurance

Third-Party Administrators – The Middlemen Of Self-Funded Health Insurance

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Pharmacy benefit managers have received significant public attention for their exploitative, cost increasing practices, but similar practices of third-party administrators (TPAs) have received relatively little public attention. In their latest piece for Health Affairs Forefront, Karen Handorf, Christine Monahan, and Kennah Watts argue that understanding TPA business models and how they generate profits requires looking under the hood at their agreements with health care providers and other third-party intermediaries.

Considerations for Federal Agencies Tasked with Improving Health Plan Price Transparency Data

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While the health plan price transparency data available under current guidance and enforcement have proven challenging to access and use, a renewed focus under the Trump administration aims to improve Transparency in Coverage (TiC) data. In this blog, CHIR experts Stacey Pogue and Nadia Stovicek present insights into known issues with TiC machine-readable files, a recent executive order’s implications, and the issues that limit access to publicly available TiC data.

Health Insurance Transitions For Young People With Diabetes Can Be Life Threatening

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As Congress debates policies that would disenroll millions of people from both Medicaid and marketplace coverage, young adults living with diabetes could face coverage losses and challenges finding private insurance that is both comprehensive and affordable. In their latest piece for Health Affairs, Amy Killelea and Christine Monahan explore how variations in health insurance coverage can make health coverage transitions difficult for these young adults.

Federal Rule Gives Regulators Enhanced Tools to Ensure Equitable Access to Behavioral Health Care

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Last fall, the Biden Administration finalized a rule updating standards for the Mental Health Parity and Addiction Equity Act (MHPAEA). In their latest piece for the Commonwealth Fund, CHIR’s JoAnn Volk and Billy Dering discuss the new requirements for use of “non-quantitative treatment limits” that impose significant barriers to behavioral health treatment.

New Executive Order Outlines Next Steps For Health Care Price Transparency

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In February, the Trump administration issued an executive order outlining steps for federal agencies to promote healthcare price transparency for patients, employers, and policymakers. In her latest piece for Health Affairs, Stacey Pogue explores how this executive order could improve areas where healthcare price transparency has historically faced challenges.

Georgetown CHIR & Association of Health Care Journalists Release Update to Health Insurance Tool

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The Association of Health Care Journalists has released an updated, interactive 50-state Media Guide to help journalists navigate the complexities of the U.S. health care system, offering detailed data on health insurance coverage, state policies, and regulatory agencies. Developed in partnership with Georgetown University’s Center on Health Insurance Reforms, the guide includes a national overview, state-level resources, and essential tools for reporting on health coverage and consumer experiences.

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.