States are considered “laboratories of democracy,” allowing experimentation with innovative reforms that could potentially be adopted at the national level. To test new approaches in their Medicaid programs, states have embraced Section 1115 waivers, which permit innovations that do not meet federal program rules, but still promote the program’s objectives.
Joshua M. Liao and Amol S.
Joshua M. Liao and Amol S.
Abstract [from journal]
Prices negotiated between payers and providers affect a health insurance contract's value via enrollees' cost-sharing and self-insured employers' costs. However, price variation across payers is hard to observe. We measure negotiated prices for hospital-payer pairs in Massachusetts and characterize price variation. Between-payer price variation is similar in magnitude to between-hospital price variation. Administrative-services-only contracts, in which insurers do not bear risk, have higher prices. We model negotiation incentives and show that contractual...
Health care “affordability” is a top concern for most Americans, but it means different things to different people. Affordability can be examined as an economic concept, a policy threshold, or through the decisions made by individuals and families.
Although the “affordability” of health care is a common concern, the term is rarely defined.This joint Penn LDI and United States of Care issue brief considers affordability as an economic concept, as a kitchen-table budget issue for individuals and families, and as a threshold in current policy. It reviews a range of measures that capture the cost burden for individuals and families with different forms of coverage, in different financial circumstances, and with different health concerns.
Joshua M. Liao, Anders Chen, and Amol S.
We know that high deductibles have a significant effect on spending levels, but do they affect spending growth? In a recent National Bureau of Economic Research (NBER) working paper, LDI Associate Fellow Molly Frean and LDI Senior Fellow Mark Pauly found that spending growth was significantly lower in states where privately insured employees have higher deductibles.
Supply of Primary Care Providers and Appointment Availability for Philadelphia's Medicaid Population
This brief analyzes the supply of primary care providers serving the Medicaid population in Philadelphia, and the geographic variability of this measure across the city. It also examines important measures of access – appointment availability and wait time for an initial appointment – that highlight challenges faced by Medicaid patients.
Following Medicaid expansion in Pennsylvania in 2015, more than one in five non-elderly adults in Philadelphia are now covered by Medicaid. This population faces unique challenges with accessing primary care, including fewer providers accepting Medicaid patients.