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.

Why the SGR should matter to medical educators

Nov. 26, 2013

The Sustainable Growth Rate (SGR) formula – a source of unpredictability in Medicare payments to physicians – may finally be repealed. While this might seem unrelated to medical education, what happens next could have a significant impact on academic medicine and the training of students, residents and fellows.

Why Repealing the ACA’s “Risk Corridor” Program is a Bad Idea

Nov. 20, 2013

A seemingly arcane but important provision in the Affordable Care Act (ACA) created a system of risk corridor payments during 2014-2016 for insurers offering individual coverage through the exchanges. Similar to an existing risk corridor system for insurers offering Medicare prescription drug coverage, the ACA’s risk corridor system will partially shield insurers from unexpectedly high costs in relation to premiums for coverage sold on the exchanges.

Medicaid Reform, New York Style

Nov. 16, 2013

New York State Health Commissioner Nirav Shah, MD, MPH gave the Samuel Martin III Memorial Lecture yesterday at the Leonard Davis Institute, and described New York’s ongoing plans to improve health outcomes while containing the growth of Medicaid costs. The investments might surprise you, as they lie beyond the usual borders of the health care system. Shah calls it the Health-In-All-Policies Approach.

Learning from Massachusetts: Standardization in the Health Insurance Marketplace

Oct. 24, 2013

Insurance is a complex product, and choosing among different plans is a complex decision. As states and the federal government roll out health insurance exchanges, “choice architecture”—how options are presented—will affect what consumers choose. According to LDI Senior Fellow Amanda Starc, standardizing plans and information about plans can help consumers make better decisions.

Out2Enroll Campaign to Launch October 11 (National Coming Out Day)

Sep. 26, 2013

In just six days, the new Health Insurance Marketplaces will open their virtual doors and the next phase of implementing the Affordable Care Act (ACA) will begin. The Obama Administration, recognizing that the ACA holds particular relevance for the LGBT community, recently held a briefing at the White House for LGBT leaders across the US. I attended and represented the new Penn Medicine Program for LGBT Health.

Senior Advisor to the President Valerie Jarrett and HHS Secretary Kathleen Sebelius gave these opening remarks to set the stage for the day:

Is Medicare Advantage Good for Your Health?

Jun. 17, 2013

A new National Bureau of Economic Research (NBER) working paper by Afendulis, Chernew, and Kessler says yes. If this working paper holds up to peer review, these findings will offer an important endorsement of the Medicare Advantage program. The paper attributes large and striking reductions in all hospitalizations (22%), hospitalizations for ambulatory sensitive conditions (18%), and mortality (15%) to Medicare Advantage as illustrated in the graph below.