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.

Effects of the ACA on Health Care Cost Containment

Issue Brief
Mar. 2, 2017

This brief reviews the evidence on how key ACA provisions have affected the growth of health care costs. Coverage expansions produced a predictable jump in health care spending, amidst a slowdown that began a decade ago. Although we have not returned to the double-digit increases of the past, the authors find little evidence that ACA cost containment provisions produced changes necessary to “bend the cost curve.” Cost control will likely play a prominent role in the next round of health reform and will be critical to sustaining coverage gains in the long term.

Price Transparency in Primary Care: Can Patients Learn About Costs When Scheduling an Appointment?

Feb. 16, 2017

Brendan Saloner, Lisa Clemens Cope, Katherine Hempstead, Karin Rhodes, Daniel Polsky, Genevieve Kenney

In the Journal of General Internal Medicine, Brendan Saloner, Daniel Polsky, Karin Rhodes, and colleagues investigate whether new patients can obtain price information for a primary care visit and identify variation across insurance types, offices and geographic areas. Cost-sharing in insurance plans incentivizes patients to shop for lower prices, but can patients obtain price information when scheduling office visits? The authors used a simulated patient methodology in which trained interviewers posed as patients (with different types of insurance) seeking new primary care...

How to Save the Individual Insurance Market Post-ACA

Feb. 10, 2017

[cross-posted from the Health Cents blog on philly.com]

Just 6% of people under age 65 buy health insurance on the individual market (rather than getting it through their jobs), but the political debate about how to arrange insurance for them is causing great turmoil and has revived discussion of the individual mandate.

What Physicians Say About Repeal of the Affordable Care Act

Jan. 25, 2017

As one of his first acts as President, Donald Trump signed an executive order signaling his intent to “seek the prompt repeal” of the Affordable Care Act.  While no one can predict what Congress will do, significant changes to the current system are likely.

Cost of Joint Replacement Using Bundled Payment Models

Research Brief
Amol Navathe, MD, PhD
Jan. 6, 2017

Evidence on the effects of bundled payment is more important than ever, while hospitals already in Medicare bundled payment programs need guidance in redesigning care. This observational study looks at whether bundled payment for joint replacement affected quality, hospital costs and post-acute care spending in a health system that was an early adopter of the model. Did the bundles save money, and if so, what produced those savings?

Insurance Coverage and Access to Care Under the Affordable Care Act

Issue Brief
Dec. 8, 2016

This brief details changes in insurance coverage and access to care under the Affordable Care Act. About 20 million individuals gained coverage under the law and access to care improved.  Despite these gains, more than 27 million individuals are still uninsured, and many others face barriers in accessing care.  As a result of the 2016 elections, the future of the ACA is uncertain.  As the next Administration and policymakers debate further health system reforms, they should consider the scope of the ACA’s effects on their constituents. 

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