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Comparing Individual Health Coverage On and Off the Affordable Care Act's Insurance Exchanges. 比较《平价医疗法案》的保险交易所内外的个人健康保险。
LDI issue brief Pub Date : 2015-08-18 DOI: 10.15868/socialsector.25045
M. Mccue, M. Hall
{"title":"Comparing Individual Health Coverage On and Off the Affordable Care Act's Insurance Exchanges.","authors":"M. Mccue, M. Hall","doi":"10.15868/socialsector.25045","DOIUrl":"https://doi.org/10.15868/socialsector.25045","url":null,"abstract":"The new health insurance exchanges are the core of the Affordable Care Act's (ACA) reforms, but how the law improves the nonsubsidized portion of the individual market is also important. This issue brief compares products sold on and off the exchanges to gain insight into how the ACA's market reforms are functioning. Initial concerns that insurers might seek to enroll lower-risk customers outside the exchanges have not been realized. Instead, more-generous benefit plans, which appeal to people with health problems, constitute a greater portion of plans sold off-exchange than those sold on-exchange. Although insur­ers that sell mostly on the exchanges incur an additional fee, they still devote a greater portion of their premium dollars to medical care. Their projected admin­istrative costs and profit margins are lower than are those of insurers selling only off the exchanges.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"39 2 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2015-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83649557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Serving Older Adults with Complex Care Needs: A New Benefit Option for Medicare. 为有复杂护理需求的老年人服务:医疗保险的新福利选择。
LDI issue brief Pub Date : 2015-07-01 DOI: 10.15868/socialsector.25043
M. Moon, I. Hollin, L. Nicholas, C. Schoen, K. Davis
{"title":"Serving Older Adults with Complex Care Needs: A New Benefit Option for Medicare.","authors":"M. Moon, I. Hollin, L. Nicholas, C. Schoen, K. Davis","doi":"10.15868/socialsector.25043","DOIUrl":"https://doi.org/10.15868/socialsector.25043","url":null,"abstract":"Medicare was originally designed to protect beneficiaries from the financial burden of acute episodes of illness. As lifespans lengthen, Medicare must adapt to serve beneficiaries with substantial long-term physical or cognitive impairment who need personal care assistance. These beneficiaries often incur high out-of-pocket costs for Medicare-covered services as well as home and community care not covered by Medicare. This latter category of care is often key to continued independence. To improve Medicare's capacity to serve such beneficiaries, and to prevent unnecessary institutionalization, this issue brief, one in a series on Medicare's future challenges, proposes a complex care benefit option that would include home and community services, and describes how it might be structured to balance the goals of improving care for beneficiaries and ensuring affordability.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"7 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86923532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Predictable Unpredictability: the Problem with Basing Medicare Policy on Long-Term Financial Forecasting. 可预测的不可预测性:基于长期财务预测的医疗保险政策的问题。
LDI issue brief Pub Date : 2015-07-01 DOI: 10.15868/socialsector.25042
S. Glied, Abigail Zaylor
{"title":"Predictable Unpredictability: the Problem with Basing Medicare Policy on Long-Term Financial Forecasting.","authors":"S. Glied, Abigail Zaylor","doi":"10.15868/socialsector.25042","DOIUrl":"https://doi.org/10.15868/socialsector.25042","url":null,"abstract":"The authors assess how Medicare financing and projections of future costs have changed since 2000. They also assess the impact of legislative reforms on the sources and levels of financing and compare cost forecasts made at different times. Although the aging U.S. population and rising health care costs are expected to increase the share of gross domestic product devoted to Medicare, changes made in the program over the past decade have helped stabilize Medicare's financial outlook--even as benefits have been expanded. Long-term forecasting uncertainty should make policymakers and beneficiaries wary of dramatic changes to the program in the near term that are intended to alter its long-term forecast: the range of error associated with cost forecasts rises as the forecast window lengthens. Instead, policymakers should focus on the immediate policy window, taking steps to reduce the current burden of Medicare costs by containing spending today.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"160 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90232619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Medicare Payment Reform: Aligning Incentives for Better Care. 医疗保险支付改革:为更好的医疗服务调整激励。
LDI issue brief Pub Date : 2015-06-29 DOI: 10.15868/socialsector.25041
G. Anderson, K. Davis, S. Guterman
{"title":"Medicare Payment Reform: Aligning Incentives for Better Care.","authors":"G. Anderson, K. Davis, S. Guterman","doi":"10.15868/socialsector.25041","DOIUrl":"https://doi.org/10.15868/socialsector.25041","url":null,"abstract":"The Affordable Care Act (ACA) has provided the Medicare program with an array of tools to improve the quality of care that beneficiaries receive and to increase the efficiency with which that care is provided. Notably, the ACA has created the Center for Medicare and Medicaid Innovation, which is developing and testing promising new models to improve the quality of care provided to Medicare beneficiaries while reducing spending. These new models are part of an effort by the U.S. Department of Health and Human Services to increase the proportion of traditional Medicare payments tied to quality or value to 85 percent by 2016 and 90 percent by 2018. This issue brief, one in a series on Medicare's past, present, and future, explores the evolution of Medicare payment policy, the potential of value-based payment to improve care for beneficiaries and achieve savings, and strategies for accelerating its adoption.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"33 10","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2015-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72601210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 18
How Insurers Competed in the Affordable Care Act's First Year. 保险公司在《平价医疗法案》实施的第一年是如何竞争的?
LDI issue brief Pub Date : 2015-06-24 DOI: 10.15868/socialsector.25038
K. Swartz, M. Hall, T. Jost
{"title":"How Insurers Competed in the Affordable Care Act's First Year.","authors":"K. Swartz, M. Hall, T. Jost","doi":"10.15868/socialsector.25038","DOIUrl":"https://doi.org/10.15868/socialsector.25038","url":null,"abstract":"Prior to the Affordable Care Act (ACA), most states' individual health insurance markets were dominated by one or two insurance carriers that had little incentive to compete by providing efficient services. Instead, they competed mainly by screening and selecting people based on their risk of incurring high medical costs. One of the ACA's goals is to encourage carriers to participate in the health insurance marketplaces and to shift the focus from competing based on risk selection to processes that increase consumer value, like improving efficiency of services and quality of care. Focusing on six states--Arkansas, California, Connecticut, Maryland, Montana, and Texas--this brief looks at how carriers are competing in the new marketplaces, namely through cost-sharing and composition of provider networks.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"18 1","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2015-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87067929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Experiences and Attitudes of Primary Care Providers Under the First Year of ACA Coverage Expansion: Findings from the Kaiser Family Foundation/Commonwealth Fund 2015 National Survey of Primary Care Providers. 在ACA覆盖范围扩大的第一年，初级保健提供者的经验和态度:来自凯撒家庭基金会/联邦基金2015年全国初级保健提供者调查的结果。
LDI issue brief Pub Date : 2015-06-18 DOI: 10.15868/socialsector.25037
Liz Hamel, M. Doty, Mira Norton, Jamie Ryan, Mollyann Brodie, M. Abrams, Rose Kleiman, A. Audet
{"title":"Experiences and Attitudes of Primary Care Providers Under the First Year of ACA Coverage Expansion: Findings from the Kaiser Family Foundation/Commonwealth Fund 2015 National Survey of Primary Care Providers.","authors":"Liz Hamel, M. Doty, Mira Norton, Jamie Ryan, Mollyann Brodie, M. Abrams, Rose Kleiman, A. Audet","doi":"10.15868/socialsector.25037","DOIUrl":"https://doi.org/10.15868/socialsector.25037","url":null,"abstract":"A new survey from The Kaiser Family Foundation and The Commonwealth Fund asked primary care providers--physicians, nurse practitioners, and physician assistants--about their views of and experiences with the Affordable Care Act (ACA) and other changes in health care delivery and payment, as well as their thoughts on the future of primary care. In this first brief based on the survey, many providers reported seeing an increased number of patients since the coverage expansions went into effect, but not an accompanying compromise in quality of care. A large majority of primary care providers are satisfied with their medical practice, but a substantial percentage of physicians expressed pessimism about the future of primary care. Similar to the population overall, providers' views of the ACA are divided along party lines. A second brief will report on providers' reactions to other changes occurring in primary care delivery and payment.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"20 1","pages":"1-21"},"PeriodicalIF":0.0,"publicationDate":"2015-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88812488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 12
Does Medicaid Make a Difference? Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014. 医疗补助有影响吗?联邦基金两年期健康保险调查结果，2014年。
LDI issue brief Pub Date : 2015-06-01 DOI: 10.15868/socialsector.25039
D. Blumenthal, P. Rasmussen, S. Collins, M. Doty
{"title":"Does Medicaid Make a Difference? Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014.","authors":"D. Blumenthal, P. Rasmussen, S. Collins, M. Doty","doi":"10.15868/socialsector.25039","DOIUrl":"https://doi.org/10.15868/socialsector.25039","url":null,"abstract":"As millions of Americans gain Medicaid coverage under the Affordable Care Act, attention has focused on the access to care, quality of care, and financial protection that coverage provides. This analysis uses the Commonwealth Fund Biennial Health Insurance Survey, 2014, to explore these questions by comparing the experiences of working-age adults with private insurance who were insured all year, Medicaid beneficiaries with a full year of coverage, and those who were uninsured for some time during the year. The survey findings suggest that Medicaid coverage provides access to care that in most aspects is comparable to private insurance. Adults with Medicaid coverage reported better care experiences on most measures than those who had been uninsured during the year. Medicaid beneficiaries also seem better protected from the cost of illness than do uninsured adults, as well as those with private coverage.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"12 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86268114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Mobile health and patient engagement in the safety net: a survey of community health centers and clinics. 移动医疗和患者参与安全网:对社区卫生中心和诊所的调查。
LDI issue brief Pub Date : 2015-05-13 DOI: 10.15868/socialsector.25031
Andrew Broderick, F. Haque
{"title":"Mobile health and patient engagement in the safety net: a survey of community health centers and clinics.","authors":"Andrew Broderick, F. Haque","doi":"10.15868/socialsector.25031","DOIUrl":"https://doi.org/10.15868/socialsector.25031","url":null,"abstract":"Patient-centered technologies have emerged as a way to actively engage patients in care. The reach and potential of cell phones to engage diverse patient populations is great. Evidence of their effectiveness in improving health-related outcomes is limited. Researchers conducted an online survey of community health centers and clinics to assess if and how health care providers in the safety net use cell phones to support patient engagement. The findings indicate that the use of cell phones in patient care is at an early stage of deployment across the safety net. Organizations identify chronic disease management as an area where cell phones offer considerable potential to effectively engage patients. To promote widespread adoption and use, technical assistance to support the implementation and management of interventions, evidence-based or best practice models that highlight successful implementation strategies in care delivery, and the introduction of new payment or reimbursement policies will be essential.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"12 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2015-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85938398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 39
Medicaid benefit designs for newly eligible adults: state approaches. 新合格成年人的医疗补助福利设计:州方法。
LDI issue brief Pub Date : 2015-05-11 DOI: 10.15868/socialsector.25032
S. Rosenbaum, D. Mehta, Mark Dorley, C. Hurt, S. Rothenberg, Nancy Lopez, S. Ely
{"title":"Medicaid benefit designs for newly eligible adults: state approaches.","authors":"S. Rosenbaum, D. Mehta, Mark Dorley, C. Hurt, S. Rothenberg, Nancy Lopez, S. Ely","doi":"10.15868/socialsector.25032","DOIUrl":"https://doi.org/10.15868/socialsector.25032","url":null,"abstract":"The Affordable Care Act gives states the option of providing less-generous Medicaid coverage to adults who become eligible through the law's expansion of the program. Based on a review of the benefit design choices made by states that had expanded Medicaid by the end of 2014, we find that states have chosen to offer more generous coverage than what is required under federal law, either narrowing or eliminating the distinction between coverage levels for newly eligible adults and those for traditional adult beneficiaries, such as pregnant women, parents and guardians, or beneficiaries with disabilities. This suggests that states view the newly eligible beneficiaries as having the elevated health and health care needs that are common among low-income populations.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"24 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2015-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88334462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
The Affordable Care Act's payment and delivery system reforms: a progress report at five years. 《平价医疗法案》的支付和交付系统改革:五年进度报告。
LDI issue brief Pub Date : 2015-05-07 DOI: 10.15868/SOCIALSECTOR.25091
M. Abrams, Rachel Nuzum, M. Zezza, Jamie Ryan, Jordan Kiszla, S. Guterman
{"title":"The Affordable Care Act's payment and delivery system reforms: a progress report at five years.","authors":"M. Abrams, Rachel Nuzum, M. Zezza, Jamie Ryan, Jordan Kiszla, S. Guterman","doi":"10.15868/SOCIALSECTOR.25091","DOIUrl":"https://doi.org/10.15868/SOCIALSECTOR.25091","url":null,"abstract":"In addition to its expansion and reform of health insurance coverage, the Affordable Care Act (ACA) contains numerous provisions intended to resolve underlying problems in how health care is delivered and paid for in the United States. These provisions focus on three broad areas: testing new delivery models and spreading successful ones, encouraging the shift toward payment based on the value of care provided, and developing resources for systemwide improvement. This brief describes these reforms and, where possible, documents their initial impact at the ACA's five-year mark. While it is still far too early to offer any kind of definitive assessment of the law's transformation-seeking reforms, it is clear that the ACA has spurred activity in both the public and private sectors, and is contributing to momentum in states and localities across the U.S. to improve the value obtained for our health care dollars.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"68 1","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2015-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83270977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 50
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