Employer-sponsored insurance (ESI) has been central to the U.S. health care system. The Affordable Care Act (ACA) adds many requirements and imposes many costs on employers that could change how - and if - they offer employee health care coverage. But estimating the effect of changes to ESI is...
Impact of ACA on Health Premiums and Enrollment: Society of Actuaries Estimates of Health Reform LawKip Piper -
Love it or hate it, the Affordable Care Act is unprecedented in size, scope, complexity, and uncertainty. To project its impact, numerous policy, economic, competitive, and behavioral factors must be considered and assumptions made. From an analytical perspective, the ACA is a simultaneous, non-linear equation from hell. A number of...
Kip Piper -
The Affordable Care Act (ACA) created a trade-off for providers, particularly hospitals: On the one hand, Medicare fee-for-service hospital payments will be cut by $260 billion over 10 years. Some people newly eligible for Medicaid will switch from private insurance, which pays much higher provider rates than Medicaid does....
Kip Piper -
Some states have expressed interest in using premium assistance to expand Medicaid eligibility under the Affordable Care Act (ACA). Instead of serving the new ACA Medicaid expansion population through the Medicaid delivery system (through Medicaid health plans or Medicaid fee-for-service, depending on the state), the new enrollees would be...
Strategic Approach to Qualified Health Plans in Health Insurance Exchanges: Selecting and Managing QHPsKip Piper -
The qualified health plan contracting process in Health Insurance Exchanges present many opportunities and challenges for states and the Centers for Medicare and Medicaid Services (CMS). Success in implementing the Exchanges - one of the Affordable Care Act's most complex and ambitious features - will require comprehensive, well-structured strategies,...
Coordinated primary care models have shown great potential to reduce health care costs while improving care, a goal that will become even more important after the Affordable Care Act (ACA) coverage expansion provisions take full effect next year. The models typically involve communication among providers, a focus on patients...
Poor quality of care and preventable medical errors are a major cause of high costs and patient suffering. The opportunities for improvement are considerable. In addition, as states and health plans gear up for Health Insurance Exchanges (HIX), they will count quality and patient safety among their key considerations. For...
Health Costs and ACA Uncertainty Affecting Employment, Business Spending: Federal Reserve Beige BookKip Piper -
The Federal Reserve Beige Book is the central bank’s version of a routine check-up from a physician. Published eight times each year, the Beige Book compiles reports about how the economy is doing from Fed staff across the country and interviews with business leaders, economists, and other market experts...
In recent testimony to the Senate Finance Committee, Gary Cohen of the Centers for Medicare and Medicaid Services (CMS) gave an update of progress on Health Insurance Exchanges (HIX) implementation, now called Health Insurance Marketplaces. There is plenty to do, as shown in the timeline CMS presented that day,...
The subject of health benefits for Members of Congress often surfaces in political debates, with some implying that Members of Congress enjoy lavish healthcare benefits. Many citizens would be surprised to learn that the health insurance coverage available to Members of Congress is the same series of health plans...
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