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Access to primary and preventive health care across states prior to the coverage expansions of the Affordable Care Act. 在《平价医疗法案》扩大覆盖范围之前，各州获得初级和预防性医疗保健的机会。
LDI issue brief Pub Date : 2014-07-17 DOI: 10.15868/socialsector.25005
C. Schoen, S. Hayes, David C Radely, S. Collins
{"title":"Access to primary and preventive health care across states prior to the coverage expansions of the Affordable Care Act.","authors":"C. Schoen, S. Hayes, David C Radely, S. Collins","doi":"10.15868/socialsector.25005","DOIUrl":"https://doi.org/10.15868/socialsector.25005","url":null,"abstract":"One goal of health insurance is ensuring people have timely access to primary and preventive care. This issue brief finds wide differences in primary and preventive care access among adults under age 65--across states and within states by income--before the Affordable Care Act's major insurance expansions took effect. When comparing experiences of adults with insurance, the analysis finds that state and income differences narrow markedly. When insured, middle- and lower-income adults across states are far more likely to have a regular source of care, receive preventive care, and be able to afford care when needed. The findings highlight the potential of expanding health insurance to reduce the steep geographic and income divide in primary and preventive care that existed across the country before 2014. Success will depend on the participation of all states. This brief offers baseline data for states and the nation to track and assess change.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"98 1","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2014-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83651310","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
Gaining ground: Americans' health insurance coverage and access to care after the Affordable Care Act's first open enrollment period. 取得进展:在《平价医疗法案》首次开放注册期后，美国人的医疗保险覆盖范围和获得医疗服务的机会。
LDI issue brief Pub Date : 2014-07-10 DOI: 10.15868/socialsector.18383
S. Collins, P. Rasmussen, M. Doty
{"title":"Gaining ground: Americans' health insurance coverage and access to care after the Affordable Care Act's first open enrollment period.","authors":"S. Collins, P. Rasmussen, M. Doty","doi":"10.15868/socialsector.18383","DOIUrl":"https://doi.org/10.15868/socialsector.18383","url":null,"abstract":"A new Commonwealth Fund survey finds that in the wake of the Affordable Care Act's first open enrollment period, significantly fewer working-age adults are uninsured than just before the sign-up period began, and many have used their new coverage to obtain needed care. The uninsured rate for people ages 19 to 64 declined from 20 percent in the July-to-September 2013 period to 15 percent in the April-to-June 2014 period. An estimated 9.5 million fewer adults were uninsured. Young men and women drove a large part of the decline: the uninsured rate for 19-to-34-year-olds declined from 28 percent to 18 percent, with an estimated 5.7 million fewer young adults uninsured. By June, 60 percent of adults with new coverage through the marketplaces or Medicaid reported they had visited a doctor or hospital or filled a prescription; of these, 62 percent said they could not have accessed or afforded this care previously.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"29 1","pages":"1-23"},"PeriodicalIF":0.0,"publicationDate":"2014-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82449197","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: 47
Implementing the Affordable Care Act: state action to reform the individual health insurance market. 实施平价医疗法案:国家改革个人医疗保险市场的行动。
LDI issue brief Pub Date : 2014-07-07 DOI: 10.15868/socialsector.25003
Justin Giovannelli, Kevin W Lucia, S. Corlette
{"title":"Implementing the Affordable Care Act: state action to reform the individual health insurance market.","authors":"Justin Giovannelli, Kevin W Lucia, S. Corlette","doi":"10.15868/socialsector.25003","DOIUrl":"https://doi.org/10.15868/socialsector.25003","url":null,"abstract":"The Affordable Care Act contains numerous consumer protections designed to remedy shortcomings in the availability, affordability, adequacy, and transparency of individual market insurance. However, because states remain the primary regulators of health insurance and have considerable flexibility over implementation of the law, consumers are likely to experience some of the new protections differently, depending on where they live. This brief explores how federal reforms are shaping standards for individual insurance and exam­ines specific areas in which states have flexibility when implementing the new protections. We find that consumers nationwide will enjoy improved protections in each area targeted by the reforms. Further, some states already have embraced the opportunity to customize their markets by implementing consumer protec­tions that exceed minimum federal requirements. States likely will continue to adjust their market rules as policymakers gain a greater understanding of how reform is working for consumers.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"5 1","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"2014-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75605390","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
A state policy framework for integrating health and social services. 保健和社会服务一体化的国家政策框架。
LDI issue brief Pub Date : 2014-07-01 DOI: 10.15868/socialsector.25002
Tricia McGinnis, Maia L Crawford, S. Somers
{"title":"A state policy framework for integrating health and social services.","authors":"Tricia McGinnis, Maia L Crawford, S. Somers","doi":"10.15868/socialsector.25002","DOIUrl":"https://doi.org/10.15868/socialsector.25002","url":null,"abstract":"Recognizing that health is determined by a variety of interrelated factors, states are looking to connect health care, public health, and social services to help achieve improved population health, better care, and reduced cost of care. This issue brief describes three essential components for integrating health, including physical and behavioral health services and public health, and social services: (1) a coordinating mechanism, (2) quality measurement and data-sharing tools, and (3) aligned financing and payment. It also presents a five-step policy framework to help states move beyond isolated pilot efforts and establish the infrastructure necessary to support ongoing integration of health and social services, particularly for Medicaid beneficiaries.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"17 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77255292","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: 22
Mitigating the effects of churning under the Affordable Care Act: lessons from Medicaid. 减轻《合理医疗费用法案》下员工流失的影响:来自医疗补助计划的教训。
LDI issue brief Pub Date : 2014-06-17 DOI: 10.15868/socialsector.25001
S. Rosenbaum, Nancy Lopez, Mark Dorley, J. Teitelbaum, T. Burke, Jacqueline Miller
{"title":"Mitigating the effects of churning under the Affordable Care Act: lessons from Medicaid.","authors":"S. Rosenbaum, Nancy Lopez, Mark Dorley, J. Teitelbaum, T. Burke, Jacqueline Miller","doi":"10.15868/socialsector.25001","DOIUrl":"https://doi.org/10.15868/socialsector.25001","url":null,"abstract":"Through a combination of three needs-based public programs--Medicaid, the Children's Health Insurance Program, and tax credits for purchasing private plans in the new marketplaces--the Affordable Care Act can potentially ensure continuous coverage for many low- and moderate-income Americans. At the same time, half of individuals with incomes at less than twice the poverty level will experience a form of \"churning\" in their coverage; as changes occur in their life or work circumstances, they will need to switch among these three coverage sources. For many, churning will entail not only changes in covered benefits and cost-sharing, but also in care, owing to differences in provider networks. Strategies for mitigating churning's effects are complex and require time to implement. For the short term, however, the experiences of 17 states with policies aimed at smoothing transitions between health plans offer lessons for ensuring care continuity.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"23 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2014-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90266040","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: 7
Growth and variability in health plan premiums in the individual insurance market before the Affordable Care Act. 在《平价医疗法案》之前，个人保险市场中健康计划保费的增长和变化。
LDI issue brief Pub Date : 2014-06-05 DOI: 10.15868/socialsector.24999
J. Gruber
{"title":"Growth and variability in health plan premiums in the individual insurance market before the Affordable Care Act.","authors":"J. Gruber","doi":"10.15868/socialsector.24999","DOIUrl":"https://doi.org/10.15868/socialsector.24999","url":null,"abstract":"Before we can evaluate the impact of the Affordable Care Act on health insurance premiums in the individual market, it is critical to understand the pricing trends of these premiums before the implementation of the law. Using rates of increase in the individual insurance market collected from state regulators, this issue brief documents trends in premium growth in the pre-ACA period. From 2008 to 2010, premiums grew by 10 percent or more per year. This growth was also highly variable across states, and even more variable across insurance plans within states. The study suggests that evaluating trends in premiums requires looking across a broad array of states and plans, and that policymakers must examine how present and future changes in premium rates compare with the more than 10 percent per year premium increases in the years preceding health reform.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"4 1","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2014-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75511071","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
The federal medical loss ratio rule: implications for consumers in year 2. 联邦医疗损失率规则:对第二年消费者的影响。
LDI issue brief Pub Date : 2014-05-12 DOI: 10.15868/socialsector.25027
M. Mccue, M. Hall
{"title":"The federal medical loss ratio rule: implications for consumers in year 2.","authors":"M. Mccue, M. Hall","doi":"10.15868/socialsector.25027","DOIUrl":"https://doi.org/10.15868/socialsector.25027","url":null,"abstract":"For the past two years, the Affordable Care Act has required health insurers to pay out a minimum percentage of premiums in the form of medical claims or quality improvement expenses--known as a medical loss ratio (MLR). Insurers with MLRs below the minimum must rebate the difference to consumers. This issue brief finds that total rebates for 2012 were $513 million, half the amount paid out in 2011, indicating greater compliance with the MLR rule. Spending on quality improvement remained low, at less than 1 percent of premiums. Insurers continued to reduce their administrative and sales costs, such as brokers' fees, without increasing profit margins, for a total reduction in overhead of $1.4 billion. In the first two years under this regulation, total consumer benefits related to the medical loss ratio--both rebates and reduced overhead--amounted to more than $3 billion.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"26 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2014-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83290115","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
Implementing the Affordable Care Act: State Action to Establish SHOP Marketplaces. 实施《平价医疗法案》:各州建立购物市场的行动。
LDI issue brief Pub Date : 2014-03-14 DOI: 10.15868/socialsector.24991
S. Dash, Kevin W Lucia, Amy Thomas
{"title":"Implementing the Affordable Care Act: State Action to Establish SHOP Marketplaces.","authors":"S. Dash, Kevin W Lucia, Amy Thomas","doi":"10.15868/socialsector.24991","DOIUrl":"https://doi.org/10.15868/socialsector.24991","url":null,"abstract":"The Affordable Care Act seeks to help small employers offer coverage by reforming the small-group market and establishing Small Business Health Options Program (SHOP) marketplaces. Seventeen states and the District of Columbia chose to operate their own SHOP marketplaces in 2014, with the federal government operating the SHOP marketplace in 33 states. This brief examines state decisions to enhance the value of SHOP marketplaces for small employers and finds that most have set predictable participation and eligibility requirements and will offer a competitive choice of insurers and plans. States also are seeking to facilitate small employers' shopping experience through online tools and access to personalized assistance. While not all SHOP marketplaces are yet functioning as intended, their establishment offers an opportunity to identify successful strategies for improving the affordability and accessibility of coverage for small employers.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"10 1","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2014-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90364292","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: 0
Improving HPV vaccination rates. 提高HPV疫苗接种率。
LDI issue brief Pub Date : 2014-03-01
Alexander G Fiks
{"title":"Improving HPV vaccination rates.","authors":"Alexander G Fiks","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Despite national guidelines and proven health benefits, vaccination rates for the human papillomavirus (HPV) remain far below those of other vaccines recommended for adolescents. HPV is the most common sexually transmitted infection in the U.S; it is responsible for about 25,000 new cancers each year. A series of three shots is recommended for all girls and boys at age 11-12, but significant barriers exist to starting and finishing this series. This Issue Brief examines some of the barriers and summarizes a successful, multipronged clinical intervention to improve vaccination rates.</p>","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"19 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32200137","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: 0
Making sense of the Medicare physician payment data release: uses, limitations, and potential. 理解医疗保险医生支付数据的发布:用途、限制和潜力。
LDI issue brief Pub Date : 2014-01-01 DOI: 10.15868/socialsector.25018
Kavita K. Patel, D. Masi, Caitlin Brandt
{"title":"Making sense of the Medicare physician payment data release: uses, limitations, and potential.","authors":"Kavita K. Patel, D. Masi, Caitlin Brandt","doi":"10.15868/socialsector.25018","DOIUrl":"https://doi.org/10.15868/socialsector.25018","url":null,"abstract":"In April 2014, the Centers for Medicare and Medicaid Services released a data file containing information on Medicare payments made to physicians and other providers. Though an important achievement in promoting greater health system transparency, limitations in the data have hindered key users, including consumers, payers, and providers, from discerning meaningful information from the file. This brief outlines the significance of the data release, the limitations of the dataset, the current uses of the information, and proposals for rendering the file more meaningful for public use.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"4 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87776604","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
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