Health Insurance

Financial and structural characteristics of the public and private programs that cover medical costs. LDI analyzes how to expand and improve coverage through insurance exchanges, employer-sponsored insurance, and public programs.

Public Opinion and Health Reform

Mar. 19, 2018

As policymakers debate the best way to address pressing health care challenges, one ‘opinion’ that is sometimes drowned out is that of the public. At a recent Penn LDI seminar, Mollyann Brodie, PhD, MS, Senior Vice President for Executive Operations and Executive Director of Public Opinion and Survey Research at the Kaiser Family Foundation (KFF), underscored the value of public polling when it comes to health care policy and politics.

Characteristics of Hospitals Earning Savings in the First Year of Mandatory Bundled Payment for Hip and Knee Surgery

Mar. 8, 2018

Amol S. NavatheJoshua M. Liao, Yash Shah, Zoe Lyon, Paula ...

In JAMA, Amol Navathe and LDI colleagues Joshua Liao, Paula Chatterjee, Dan Polsky, and Ezekiel Emanuel examine hospital savings and quality results for the first year of the Comprehensive Care for Joint Replacement (CJR) bundled payment program. Since April 2016, Medicare has bundled payments for hip and knee replacements at 799 hospitals through CJR. The program incentivizes quality and cost containment by providing retrospective bonus payments that increase as hospitals exceed their cost and quality benchmarks, or imposing penalties if hospitals fall short. While the CJR...

The Effect of Integration of Hospitals and Post-Acute Care Providers on Medicare Payment and Patient Outcomes

Research Brief
Mar. 6, 2018

Vertical integration between hospitals and skilled nursing facilities (SNFs) increases Medicare payments for the first 60 days of care by $2,424 (17%), compared to hospital-SNF pairs that are not vertically integrated. These integrated hospital–SNF pairs also experience a decline in 30-day rates of rehospitalization or death of 5 percentage points on a base rate of 31.3%. Vertical integration between hospitals and home health agencies (HHAs) has little effect on Medicare payments and patient outcomes, nor does informal integration in either setting.

State Efforts to Close the Health Coverage Gap

Feb. 6, 2018

This review examines prominent state efforts to expand health coverage to the remaining uninsured. It analyzes and compares efforts in Massachusetts, Vermont, Colorado, California, and Nevada and highlights insights and themes that emerge. It explores the context and climate for reform within the state, stakeholder involvement, political coalitions, financing, and possible opposition. As such, it serves as a case study in how different states build, or fail to build, the popular and political will towards health care coverage for all residents. This is the first in a series of reports that will monitor and analyze developments at the state level to expand coverage and improve access to care.

Association of Patient Out-of-Pocket Costs With Prescription Abandonment and Delay in Fills of Novel Oral Anticancer Agents

Research Brief
Jan. 19, 2018

High out-of-pocket (OOP) costs may limit access to novel oral cancer medications. In a retrospective study, nearly one third of patients whose OOP costs were $100 to $500 and nearly half of patients whose OOP costs were more than $2,000 failed to pick up their new prescription for an oral cancer medication, compared to 10% of patients who were required to pay less than $10 at the time of purchase. Delays in picking up prescriptions were also more frequent among patients facing higher OOP costs. 

Making Shoppable Care More Probable

Dec. 7, 2017

The late, great economist Uwe Reinhardt once likened the ability of U.S. consumers to shop for health care to sending blindfolded shoppers into a department store. In a new report to the Pennsylvania Insurance Commissioner, the “Shoppable Care Work Group” provides advice on how to take the blindfold off.

Pages