October 16, 2017 [cross-posted from the Health Cents blog on philly.com]
September 22, 2017 [cross-posted from the Health Cents blog on philly.com]
It’s called “adverse tiering” and it’s a benefit strategy designed to dissuade patients with expensive chronic conditions from enrolling in marketplace plans. The ACA prohibited plans from refusing to cover patients with pre-existing conditions and from charging them higher premiums. To avoid high-cost patients, some plans have structured their formularies to require substantial cost sharing for drugs in a certain class, particularly for expensive conditions such as HIV/AIDS.
[cross-posted from the Health Cents blog on philly.com]
Ask a member of Congress about human trafficking.
In The JAMA Forum, Paula Chatterjee and colleagues explore the rationale for and potential effects of repealing the Affordable Care Act (ACA). The authors argue that Medicaid will be disproportionately affected, as 12 of the 20 million individuals who gained coverage through the ACA are on Medicaid. They assess arguments for Medicaid reform, examine policy implications, and explore potential effects on patients. They examine how these changes would affect current Medicaid payment models, and posit that providers may be more limited in services they can offer to Medicaid recipients...
Forty economists and health policy experts, including Dan Polsky and Zeke Emanuel, have signed a strongly worded letter opposing the Better Care Reconciliation Act (BCRA), the Senate proposal to repeal the Affordable Care Act.
Senators supporting deep cuts in Medicaid may find that they are out of step with their low-income constituents, who report increased support for the Affordable Care Act (ACA) across party lines in states that expanded Medicaid.
After the House passed the American Health Care Act (AHCA), I asked a few of our Senior Fellows to comment on the economic problems the AHCA is designed to fix, and the economic problems it might cause, all politics aside. Dan Polsky immediately pushed back on the premise of 'politics aside':
In Health Economics, LDI Fellow Amelia Bond and colleagues raise important questions about potential positive effects of provider and insurer concentration on primary care appointment availability for new Medicaid patients. The study assesses whether the two health care industry trends of expanding Medicaid and greater integration and consolidation among insurers and providers may have implications for each other.
Using “secret shopper” data on primary care physicians' real-world behavior, the authors observed provider willingness to accept new privately insured and...
Mental health continues to live on the fringes of the health care delivery system. According to the former Surgeon General, “even more than other areas of health and medicine, the mental health field is plagued by disparities in the availability of and access to its services,” with significant barriers related to patients’ socioeconomic background.