The No Surprises Act is largely working as intended to protect patients from unexpected medical bills. However, the rising number of Independent Dispute Resolution (IDR) cases is creating challenges for the health care system. In a post for Health Affairs Forefront, Jack Hoadley and Kevin Lucia evaluate the causes and implications of the increasing number of IDR cases.
Utilization management is one tool that insurers can use to help keep premiums in check, but it comes with significant tradeoffs for patients. CHIR’s Megan Houston considers the history and current landscape of utilization management tools, what they are used for and what policymakers are doing to keep them in check.
In our newest monthly roundup of health policy research, CHIR’s Emma Walsh-Alker reviews studies on the potential of personalized phone outreach to boost marketplace enrollment, trends in the small-group health insurance market, and the Congressional Budget Office’s latest report comparing how much commercial insurers and Medicare pay for health services.
Connecticut’s efforts to pass a public option bill for the third year in a row came to an early end in late May when the bill lost Governor Lamont’s support. CHIR’s Maanasa Kona takes a look at the state’s latest attempt and the politics surrounding its failure.
The novel coronavirus (COVID-19) pandemic has placed enormous pressure on virtually all facets of U.S. society. Much attention has appropriately been placed on the efforts of health care providers to deliver care to those infected with COVID-19. However, less is known about the experiences of the health insurers who reimburse those health care providers for the care they deliver. In a new report supported by the Robert Wood Johnson Foundation, insurance experts at CHIR and the Urban Institute share findings from interviews with executives at 25 health insurance companies on their impressions of the ongoing ramifications of the pandemic and their response to the crisis.
For several years, we at CHIR have tracked health insurance industry trends by monitoring trade and mass media, Wall Street analyses, earnings, and other reports. In 2019, we observed an increase in reporting on contract disputes between health insurers and providers. These discussions are becoming more contentious as insurers face mounting pressure to rein in health care costs while ensuring consumers’ access to providers. CHIR’s Emily Curran digs into what’s behind the trend and what it means for patients.
Last month, health insurers reported on their third-quarter (Q3) financial earnings, offering insights on their yearly performance to date and commenting on the market and regulatory challenges they see ahead. CHIR reviewed the quarterly filings and earnings call transcripts for seven publicly traded health insurers, and found that many continue to experience financial stability in the individual market and are closely monitoring major policy changes that could have an impact on their businesses moving forward.
On December 10, the U.S. Supreme Court will hear oral arguments in Maine Community Health Options v. U.S., a case concerning the Affordable Care Act’s risk corridors program. This month, nine stakeholders filed amicus briefs in preparation of the arguments and we reviewed these briefs to identify common themes. One key theme emerged from the stakeholders reviewed: that the Court’s decision could negatively impact public-private partnerships.
Since implementation of the Affordable Care Act, insurer participation in the ACA marketplaces has fluctuated. As states prepare to enter their annual rate review processes for 2020, CHIR’s Emily Curran and Justin Giovannelli interviewed officials in seven of the state-based marketplaces to understand their strategies for maintaining insurer participation in 2019 and ensuring marketplace competition in the future.
On January 18, the Department of Health and Human Services issued its Notice of Benefit and Payment Parameters for 2020, which outlines the changes that it plans to apply to the Affordable Care Act marketplaces and insurance rules in the next plan year. The agency received over 26,100 comments on the proposal, including many from insurers, state-based marketplaces, departments of insurance, and consumer advocates. To better understand stakeholder reactions to the proposals, CHIR reviewed a sample of these comments, and, in Part I of this series, we summarize areas of support and concern from major medical insurers and associations.
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.
