Projecting Medicare Advantage Enrollment: Expect the Unexpected? June 12, 2013 Perspective This Policy Insight explores possible explanations for the continued rise in Medicare Advantage enrollment between 2010 and 2013 in spite of a projected decrease following payment changes in the Affordable Care Act (ACA).
The Future of Medicare Advantage: Are We on the Right Path? June 10, 2013 Event This June 10 briefing looked at Medicare Advantage and changes affecting it, including revised calculations of payments from CMS, and the Affordable Care Act’s reduced payments to Medicare Advantage plans. Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.
Quality of Care in Community Health Centers and Factors Associated with Performance June 10, 2013 Issue Brief This study examines quality among health centers relative to Medicaid managed care organizations (MCOs). Chronic care quality among health centers is high; gaps in women’s preventive care are a concern. Lower-performing health centers have very high uninsured and homeless rates. The expansion of Medicaid and private insurance under the ACA may foster gains in health center quality performance.
Beyond Rebates: How Much Are Consumers Saving from the ACA’s Medical Loss Ratio Provision? June 6, 2013 Perspective The Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA) saved consumers an estimated $2.1 billion last year, in the form of lower premiums and rebates, according to a new analysis by the Kaiser Family Foundation. Under health reform, insurers must issue consumer rebates if they fail to spend a certain portion of premium income on health care claims and quality improvement expenses, thereby limiting what they may spend on administrative expenses or keep as profits.
Key Lessons from Medicaid and CHIP for Outreach and Enrollment Under the Affordable Care Act June 4, 2013 Issue Brief The Affordable Care Act (ACA) will significantly increase coverage options through an expansion of Medicaid and the creation of new health insurance exchange marketplaces. However, effective outreach and enrollment efforts will be key to ensuring that new coverage opportunities translate into increased coverage. Based on a review of existing research,…
Covering The ACA May Be Almost As Hard As Implementing It June 4, 2013 Perspective This Pulling It Together was adapted from a column I published earlier this week in Politico, with a new introduction added. You can read the original Politico column here. The implementation of the ACA is news and the public will demand information about it. Journalists and news organizations have an obligation…
Financing Medicaid Coverage Under Health Reform: What is in the Law and the New FMAP Rules May 9, 2013 Issue Brief This brief examines the ACA law and new regulations related to the match rates for coverage under the ACA for Medicaid and Children’s Health Insurance Program.
Women’s Health Quiz: Health Coverage and the Affordable Care Act May 9, 2013 Quiz Health insurance coverage is a critical factor in making health care accessible to women—women with health coverage are more likely to obtain needed preventive, primary, and specialty care services. Test your knowledge of women’s health coverage and the effect of the Affordable Care Act on women with our ten-question quiz.
Testimony: Wellness Programs and Nondiscrimination Under Employer-Sponsored Group Health Plans May 8, 2013 Issue Brief This testimony by the Foundation’s Karen Pollitz before the Equal Employment Opportunity Commission included background on wellness programs, wellness incentives and nondiscrimination since 1996, and questions and issues related to proposed regulations governing the design and application of wellness programs offered in conjunction with employer-sponsored group health plans.
JAMA Forum: ACA Implementation Starts to Get Real May 8, 2013 Perspective Larry Levitt’s latest post on ACA implementation is now available on the JAMA Forum.