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.

Turmoil in the Health Insurance Marketplaces

Issue Brief
Oct. 27, 2016

This issue brief is first in a four-part series that will summarize the latest evidence on how the Affordable Care Act has affected key areas of our health and economic systems. It explores the current volatility in the ACA’s Marketplaces and discusses key factors in their evolution over the past three years. The brief concludes with options for policymakers to address the turmoil in the Health Insurance Marketplaces. 

Marketplace Plans With Narrow Physician Networks Feature Lower Monthly Premiums Than Plans With Larger Networks

Research Brief
Oct. 4, 2016

Insurers offering plans on the Affordable Care Act’s health insurance marketplaces have used a strategy of restricted, or narrow, provider networks to limit costs. Narrow network plans are thought to be less expensive for consumers, but how much are they actually saving in premiums by choosing such plans? This study uses data from all ‘silver’ plans offered on the marketplaces in 2014 in all 50 states and the District of Columbia to categorize networks into “t-shirt sizes” and to estimate the association between the breadth of a provider network and plan premiums.

Practice Patterns in Medicaid and Non-Medicaid Asthma Admissions

Aug. 5, 2016

Jeffrey H. SilberPaul R. Rosenbaum, Wei Wang, Shawna Calhoun, James P. Guevara, Joseph J. Zorc, Orit Even-Shoshan

In Pediatrics, Jeffrey Silber and colleagues investigate whether Medicaid and non-Medicaid patients admitted to the hospital for asthma are treated differently in major children’s hospitals. Medicaid provider reimbursement levels can be significantly lower than private insurance reimbursements, making it important to analyze whether this impacts the health care received by Medicaid beneficiaries. The authors used data from 40 children’s hospitals to analyze more than 17,000 matched pairs of Medicaid to non-Medicaid children admitted for asthma in the same hospital over three years...

Effects of Autism Spectrum Disorder Insurance Mandates on the Treated Prevalence of Autism Spectrum Disorder

Research Brief
Jul. 25, 2016

State mandates requiring commercial health plans to cover services for children with autism spectrum disorder increased the number of children diagnosed with the disorder. However, diagnosis rates remain much lower than community estimates, suggesting that many commercially insured children with ASD remain undiagnosed or are insured through public plans.

Primary Care Appointment Availability for Medicaid Patients: Comparing Traditional and Premium Assistance Plans

Research Brief
Jul. 14, 2016

In 2014, Arkansas and Iowa expanded their Medicaid programs and enrolled many of their adult beneficiaries in commercial Marketplace plans. This study suggests that this “private option” may make it easier for new Medicaid patients to get primary care appointments.

Why Shopping for Health Care is Hard

Jul. 8, 2016

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

As health care costs increase, consumers are being asked to manage more of their own health care spending.  One of the most common ways this is happening is through high deductible health insurance plans. 

Impact of Medicare Advantage Prescription Drug Plan Star Ratings on Enrollment Before and After Implementation of Quality-Related Bonus Payments in 2012

Research Brief
Jun. 10, 2016

In PLOS ONE, LDI Senior Fellows Pengxiang Li and Jalpa Doshi examine the impact of the Medicare Advantage Presciption Drug Plan star ratings before and after 2012, when they became tied to bonus payments. Does an increase in a plan’s star rating have a direct impact on concurrent year plan enrollment? What’s the indirect impact (via bonus payments) of star ratings on subsequent year plan enrollment?

Show Me the Money: Economic Evaluations of Opioid Use Disorder Interventions

Issue Brief
May. 25, 2016

This Issue Brief discusses treatments for opioid use disorders and summarizes a new systematic review of economic evaluations of these interventions. The review reveals strong evidence that methadone maintenance therapy is an economically advantageous form of treatment; the economic evidence for buprenorphine and naltrexone treatments is more limited.

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