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.

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.

Common and Costly Hospitalizations Among Insured Young Adults Since the Affordable Care Act

May. 11, 2016

Alexander Bain, Charlene Wong, Gail Slap, Daniel Polsky, Raina Merchant, Yaa Akosa Antwi, David Rubin, Carol Ford

In the Journal of Adolescent Health, Alexander Bain and colleagues, including Charlene Wong, Daniel Polsky, Raina Merchant, and David Rubinm, identify the most prevalent and costly inpatient hospitalizations in a national cohort of privately insured young adults since the implementation of the Affordable Care Act. The researchers analyzed 158,777 hospitalizations among 4.7 million young adults from January 2012 to June 2013. They find that the top diagnoses for young adult female hospitalizations were pregnancy related (71.9%) and mental illness (8.9%). The top diagnoses for young...

The Murky Benefits of Price Transparency

May. 6, 2016

Price transparency—the ability to know the price of something before buying—is a mainstay of most markets. It has been touted as a way to reduce health care spending by enabling a new breed of cost-conscious consumers to comparison shop for care. A new JAMA study suggests that it might not be that simple.

For Third Enrollment Period, Marketplaces Expand Decision Support Tools to Assist Consumers

Research Brief
Apr. 4, 2016

In Health Affairs, Charlene Wong and colleagues go shopping on the most recent iteration of ACA marketplaces. They find added features to help consumers browse and pick a health plan, including total cost estimators and provider look-up tools. Marketplaces differ in how they estimate out-of-pocket costs and how they display plan choices, although most continue to present plans in premium order.

High Cost Sharing and Specialty Drug Initiation Under Medicare Part D: A Case Study in Patients With Newly Diagnosed Chronic Myeloid Leukemia

Research Brief
Apr. 1, 2016

Does high cost sharing in Medicare Part D drug plans affect whether and how quickly patients initiate a recommended and life-extending drug treatment? In American Journal of Managed Care, LDI Senior Fellows Jalpa Doshi, Pengxiang Li and colleagues assess whether Medicare patients newly diagnosed with chronic myeloid leukemia (CML) and subject to significant coinsurance, take longer to initiate tyrosine kinase inhibitors (TKI) treatment than low-income (subsidized) Medicare patients subject to a nominal copayment. 

Biologic therapy adherence, discontinuation, switching, and restarting among patients with psoriasis in the US Medicare population

Mar. 22, 2016

Jalpa Doshi, Junko Takeshita, Lionel Pinto, Penxiang Li, Xinyan Yu, Preethi Rao, Hema N. Viswanathan, Joel M. Gelfand

In the Journal of the American Academy of Dermatology, Jalpa Doshi and colleagues, including Penxiang Li and Preethi Rao, investigate real-world utilization patterns of biologic therapy in Medicare beneficiaries with psoriasis. Studies indicate low adherence to biologics among patients with psoriasis, yet little is known about the adherence level in the Medicare population. Using data from the Medicare Chronic Condition Data Warehouse Part A, B, and D files with 12-month follow-up after index prescription, Doshi and colleagues conducted a retrospective claims analysis on 2707...

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