“Fast-track” enrollment strategies save states money and increase insurance coverage by streamlining Medicaid enrollment. Learn how it worked in Illinois and West Virginia.
Challenging Health Insurance Premium Rate Increases: Part 5 – Involving Consumers in the Rate Review Process
This is the fifth in our series of blogs that share tips and best practices from state consumer advocates about how to effectively participate in the health insurance rate review process.
This post describes how consumer feedback can keep health insurers’ premium rate increases in check, particularly when those consumers explain why the increases are unaffordable.
A recent analysis by the Kaiser Family Foundation showed that, compared to Americans who live in cities, rural Americans are poorer and more likely to have jobs that don’t offer health insurance. The analysis, which is based on Census Bureau data, found that rural Americans are more likely to fall into what is called the Medicaid “coverage gap”—they have been left without affordable health insurance options because their state chose not to expand Medicaid to more low-income people.
Our infographic shows how a consumer’s costs vary depending on the provider he or she chooses for a sample medical procedure that is subject to reference pricing.
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.
In health care, one of the most common questions asked by doctors, researchers, policymakers, and even patients is, “What works?” The answer lies in measuring and quantifying the quality of the different types of health care services that patients receive. To do this, quality measures are developed, typically through evidence-based research that points to a specific treatment, procedure, or drug as the clinical standard of care for a disease or condition. This research (often in the form of clinical trials) underpins much of what is practiced in medicine, providing critical information that helps the field determine the most effective treatments and approaches to helping patients.
Top 9 Occupations of the Employed but Uninsured in Virginia Who Would Benefit from Medicaid Expansion
Those who would most benefit from expanding Medicaid in Virginia are working individuals and families with incomes up to 138 percent of the federal poverty level ($27,310 for a family of three in 2014). 59% of this population is employed but uninsured.
This report outlines major factors, such as the use of community-based roundtables for navigators and assisters, that led to Maine’s successful enrollment efforts in the health insurance marketplace.
Each month, we will report on selected health care stories and trends that are shaping the direction and implementation of the Affordable Care Act.
“How much does it cost?” is the first question that consumers ask when comparing health insurance plans. In the coming months, they’ll have an answer as health insurance companies begin announcing premium rates for 2015. The news from this past month is encouraging—proposed rate increases for the individual market in 2015 could be more modest than what we expected to see in some states.
Challenging Health Insurance Premium Rate Increases: Part 4 - How to Challenge the Amounts Health Insurers Keep for Administrative Expenses, Reserves, and Surpluses
This blog examines how advocates can challenge the amounts insurers keep on hand for administrative expenses, reserves, and surpluses. Health insurers set their premium rates to cover two primary categories of expenses: future medical costs and administrative costs for processing claims. In this post, we’ll explore how, as part of the rate review process, you can evaluate what insurers are spending on administrative costs, as well as the amounts they keep on hand as reserves (to pay future claims) and surpluses (the money left over).