{"id":7723,"date":"2024-01-26T09:05:00","date_gmt":"2024-01-26T14:05:00","guid":{"rendered":"https:\/\/chirblog.org\/?p=7723"},"modified":"2024-01-26T08:19:46","modified_gmt":"2024-01-26T13:19:46","slug":"looking-under-the-hood-enhanced-rate-review-to-improve-affordability","status":"publish","type":"post","link":"https:\/\/chirblog.org\/looking-under-the-hood-enhanced-rate-review-to-improve-affordability\/","title":{"rendered":"Looking Under the Hood: “Enhanced” Rate Review to Improve Affordability"},"content":{"rendered":"\n
By Sabrina Corlette and Vrudhi Raimugia<\/em><\/p>\n\n\n\n Health insurance rate review has long been an annual ritual for state insurance departments. In most states, proposed rate increases are assessed based on whether they are “adequate,” “excessive,” or “discriminatory.” State insurance regulators often do not take into account whether the rate is affordable for the consumer and whether the insurance company is working to get its policyholders the best deal possible from providers of health care goods and services.<\/p>\n\n\n\n Yet the prices charged by providers and suppliers are widely recognized as the primary drivers of premium increases in the U.S. Providers in many health care markets are able to charge commercial insurers prices well in excess of actual costs, largely because consolidation in the provider market has given health systems considerable market power. Absent meaningful competition in these markets, some states are turning to regulatory options to keep prices in check. One of these regulatory options is an enhanced form of premium rate review, in which regulators are empowered to review whether the provider prices that compose such a large proportion of consumers\u2019 premiums are reasonable or within prescribed cost growth targets.<\/p>\n\n\n\n