When health plans design their provider networks, they need to ensure that these networks are adequate and provide meaningful access to care. The Affordable Care Act established the first-ever federal rights guaranteeing private insurance consumers access to adequate networks.
In communities of color, where rates of uninsurance and poor health outcomes are higher than in white communities, the differences between those who have insurance and those who lack it are stark.
What makes up an “adequate” network of health care providers for consumers from diverse racial and ethnic groups? Our new brief describes policies to help achieve such networks—and strategies to put these policies in place.
From screening prospective clients to guiding consumers through the application process, volunteers are helping navigator and assister programs with enrollment efforts.
Consumers, employers, and policymakers all need greater transparency in health care pricing. Learn what federal and state policymakers can do to improve access to health care price information.
Four Strategies for Improving Programs that Help Low-Income Medicare Beneficiaries with Health Care Costs
Low-income people with Medicare often struggle with high out-of-pocket health care costs. This brief identifies four strategies that advocates and policymakers can use to improve the programs that help these beneficiaries.
“Fast-track” enrollment strategies save states money and increase insurance coverage by streamlining Medicaid enrollment. Learn how it worked in Illinois and West Virginia.
Explains how reference pricing programs, when implemented in consumer-friendly ways, can minimize price variation and encourage consumers to shop for care based on price and quality.
Although the Affordable Care Act now offers individuals greatly expanded access to health coverage, simply having an insurance card does not guarantee access to high-quality health care.
Designing Silver Health Plans with Affordable Out-of-Pocket Costs for Lower- and Moderate-Income Consumers
This brief identifies silver plan designs that make the upfront cost for care more affordable. You’ll also find policy and advocacy strategies to help advocates and policy makers effectively promote similar plan designs in other marketplaces across the country.