Tag: Commonwealth Fund
Issue brief examines health plan quality improvement efforts
Posted by Sara Rothenberg on July 29, 2014
In a new issue brief published by the Commonwealth Fund, researchers from Georgetown’s Center on Health Insurance reforms reviewed state action in selective contracting, informing consumers about health plan quality, and collecting data on insurers’ quality improvement efforts. The study found that 13 state-based marketplaces have taken action to implement the Affordable Care Act’s (ACA) quality improvement goals. The authors also assess technical and operational challenges states face in using the Marketplace to help drive system wide change in health care delivery.
Commonwealth Fund releases several ACA publications
Posted by Nikki Hurt on December 30, 2013
As a wrap-up to 2013, The Commonwealth Fund has published a slew of studies and reports concerning the implementation of the Affordable Care Act (ACA). Several of these publications are highlighted below.
The first publication, Realizing Health Reform’s Potential: How Are State Insurance Marketplaces Shaping Health Plan Design?, analyzes how state-based marketplaces (SBM) and state-partnership marketplaces (SPM) utilized their plan certification capabilities to enhance or alter the requirements for plans to participate in the marketplaces. The report examines the following certification areas: inclusion of essential community providers, benefit substitution, and provider networks. The second publication, What’s Behind Health Insurance Rate Increases? An Examination of What Insurers Reported to the Federal Government in 2012–2013, found that increases in healthcare rates from mid-2012 to mid-2013 can predominantly be attributed to medical trends, and a slight increase resulted from rate increases associated with the ACA. The third publication, Realizing Health Reform’s Potential: What States Are Doing to Simplify Health Plan Choice in the Insurance Marketplaces, discusses several policies employed by SBM to help simplify plan choices for consumers. Several of these policies include: incorporating meaningful difference standards (where a plan cannot be offered if it is too similar to one already in existence on the marketplace), limiting the number of plans or benefit designs an insurer may offer in the marketplace, and requiring standardized benefit designs.
Commonwealth study finds 17% of potentially eligible Americans visited ACA marketplaces in October
Posted by Nikki Hurt on November 4, 2013
A new survey conducted by The Commonwealth Fund indicated that 17% of individuals possibly eligible for insurance under the Affordable Care Act (ACA) visited the law’s online marketplace. The survey, performed October 9th-27th via the Commonwealth Fund Affordable Care Act Tracking Survey, also found that 20% of those that visited the marketplaces were between ages 19-29, and 20% of those that visited actually enrolled in a plan. The survey additionally reported that 60% of those in the sample group were aware of the purpose of marketplaces and 37% of those that did not enroll in coverage cited healthcare.gov‘s technical malfunctions as the reason for not enrolling.
Commonwealth study explores impact of forgoing Medicaid expansion on vulnerable populations
Posted by Nikki Hurt on September 5, 2013
A new study issued by the Commonwealth Fund found that 42% of those currently uninsured residing in states not expanding Medicaid will not have access to affordable health coverage. The study, In States’ Hands: How the Decision to Expand Medicaid Will Affect the Most Financially Vulnerable Americans, stated that the Supreme Court’s 2012 decision to make Medicaid expansion under the Affordable Care Act (ACA) optional for states will be particularly detrimental to those with the lowest incomes that do not meet Medicaid eligibility under conventional standards. Since about half of the states are not expanding Medicaid, about 2 of every 5 uninsured individuals will not be able to capitalize upon the expanded coverage provisions of the ACA.
Commonwealth survey finds young adults gaining insurance coverage
Posted by Nikki Hurt on August 21, 2013
A new survey conducted by the Commonwealth Fund stated that young adults, specifically those aged 19-29, actually want and enroll in health insurance. This age group, referred to as the “young invincibles,” is the targeted demographic for the Affordable Care Act (ACA), as their perceived invincibility resulting from young age and generally good health typically causes them to forgo health insurance. The Commonwealth Fund found this notion to not be factual, as two-thirds of individuals in this age group accepted health insurance offered by their employers. Additionally, 7.8 million of the 15 million young adults enrolled in their parents’ health plans gained this coverage from the dependent coverage provision of the ACA, which allows dependents to remain on a parent’s insurance plan until the age of 26. In spite of this coverage surge, the Commonwealth Fund found that only 27% of young invincibles surveyed are actually aware of the health insurance Marketplaces.
Commonwealth study finds state-based Exchanges will exceed federal requirements
Posted by Nikki Hurt on July 11, 2013
A new report by the Commonwealth Fund, conducted by researchers from Georgetown University’s Health Policy Institute, discusses the progress state-based Exchanges (SBE) have made in designing and developing their Exchanges. The report, Implementing the Affordable Care Act: Key Design Decisions for State-Based Exchanges, found many of the SBE will likely exceed requirements placed upon them under the Affordable Care Act (ACA). For instance, several states will be reporting quality data in their individual Exchange in 2014, while others will be offering the employee-choice model in the small business health options program (SHOP) Exchange also for plan year 2014. These findings bolster the claim that states created their Exchanges in a manner that is most conducive to and reflective of the needs of their residents.
Commonwealth Fund reports on ways to increase specialty care access to Medicaid patients
Posted by Nikki Hurt on June 7, 2013
There are several barriers in place that decrease access to specialty care for many Medicaid beneficiaries. Some of these deterrents to specialty care include low physician reimbursements, administrative burdens of treating Medicaid patients, and non-medical challenges often experienced by Medicaid beneficiaries. A new study released by The Commonwealth Fund examines six models that are currently being used by safety-net hospitals, community health centers, and state Medicaid programs to help Medicaid patients gain access to specialty services. Some of the strategies in these models include: delivering specialty care at primary care facilities, expanding the role of primary care physicians, and hiring staff that coordinate care among different providers for Medicaid beneficiaries.
Commonwealth finds millions of Americans still lacking affordable coverage
Posted by Nikki Hurt on April 26, 2013
According to a new survey released by the Commonwealth Fund, 84 million Americans were either uninsured or under-insured in 2012. In addition, 75 million Americans in 2012 were either actively paying or having difficulty paying their medical bills, indicating that medical debt is still a prominent issue. Findings were not bleak for all demographics, however, as the 2012 Biennial Health Insurance Survey also found that the proportion of uninsured individuals ages 19-25 decreased from 48% to 41% in 2012. This phenomenon is most attributable to the Affordable Care Act’s (ACA) provision that allows children to remain on their parents’ health insurance until age 26.
Commonwealth Fund study finds insurers spend less than 1% of premium dollars on health care quality improvement
Posted by Nikki Hurt on March 22, 2013
The medical loss ratio (MLR), a requirement within the Affordable Care Act (ACA), states that insurers must spend either 80% or 85% of their premium dollars on medical claims or quality improvement. A new Commonwealth Fund study found that in 2011, insurers spent less than 1% of their premium dollars on quality improvement measures, which translates to a combined spending of $2.3 billion, or $29 per subscriber. The study describes how different insurer types (publicly traded, nonprofit, provider-sponsored, etc.) allocate their premium dollars, specifically focusing on measures for quality improvement.
Commonwealth Fund publishes field report on ACOs
Posted by Nikki Hurt on March 14, 2013
In a field report published yesterday, the Commonwealth Fund discusses the progress made by accountable care organizations (ACOs) in improving health care quality and efficiency. ACOs, established by the Affordable Care Act (ACA) as a Medicare delivery system option, are designed to systematically improve health care delivery and mitigate cost increases by forming contractual relationships between physicians and payers.
This report details the successes and challenges experienced by seven hospital-physician groups that are considered early-adapters of the ACO model. These entities are involved, or will soon be involved, in risk-sharing arrangements with public and private payers. Representatives from the featured ACOs discuss their strategies for integrating clinicians, managing practices, designing incentives, and sharing rewards. The goal of this report is to educate providers in methods that promote partnership and success in ACOs.