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.

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.

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.

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