Report finds state differences in EHBs
Posted by Sara Rothenberg on October 23, 2014
A new report from University of Pennsylvania researchers, funded by the Robert Wood Johnson Foundation, finds that significant state variation exists in the Affordable Care Act (ACA) essential health benefits (EHB), which insurers must cover to offer plans on the exchanges. 45 states consider chiropractic care an EHB, 26 states include autism spectrum disorder services in their EHB package, and only five states considered weight loss programs and acupuncture as EHBs. The report states that the variation in EHB requirements is mostly a result of allowing states to determine their own essential health benefit package by using a “benchmark plan” already offered in the state as a model.
Georgetown releases report on post-ACA network design
Posted by Sara Rothenberg on September 23, 2014
Researchers at Georgetown University’s Center on Health Insurance Reforms (CHIR) conducted a six-state case study to assess changes in the network design of plans offered through the health insurance marketplaces, as well as the response of state officials in the face of consumer and provider concerns. The report finds that insurers have narrowed their networks, relative to what they offered in the past, however states and insurers reported few consumer complaints about the ability to obtain medically necessary care in-network. Most of the study states are unlikely to take action to change their standards for network adequacy, however, half of the states studied will require insurers to provide better, up-to-date provider directories, so that consumers can better understand which providers are in which plan networks before they buy.
Study looks at remaining uninsured
Posted by Sara Rothenberg on July 29, 2014
A new study by the Urban Institute funded by the Robert Wood Johnson Foundation finds that two-thirds of the nation’s remaining uninsured adults have incomes at or below 138 percent of the federal poverty level (FPL). While this is the target population of the Affordable Care Act’s (ACA) Medicaid expansion, 40 percent of the uninsured live in states that chose not to expand Medicaid. The study found that affordability was the main reason people did not get health insurance, yet many uninsured individuals had limited awareness of potential financial help available to them.
New brief discusses premium rate review
Posted by Nikki Hurt on June 20, 2014
The Robert Wood Johnson Foundation and the Leonard Davis Institute of Health Economics at Penn released a brief on premium proposals and rate review under the Affordable Care Act (ACA). The brief, Deciphering the Data: Health Insurance Rates and Rate Review, discusses the economic, political, and regulatory factors that contribute to rate determinations. Additionaly, the brief discusses how states with prior approval for rate review authority increased their capacity and scope to coincide with requirements under the ACA.
Report discusses use of narrow networks
Posted by Nikki Hurt on May 30, 2014
Under the Affordable Care Act (ACA), many insurers have been creating plans with narrower provider networks. A new report discusses how to use narrow networks as a means to contain costs, but not compromise patient access to care. The report, published by the Urban Institute and The Center on Health Insurance Reforms at Georgetown University, suggests that the appropriate balance between consumer choice and containing costs can be achieved through regulations, transparency, and oversight.
Georgetown and RWJF publish new navigator resource guide
Posted by Nikki Hurt on March 12, 2014
Georgetown University’s Center on Health Insurance Reform, in conjunction with the Robert Wood Johnson Foundation, released a navigator resource guide for the Affordable Care Act (ACA). The guide serves as a primer for health insurance reform and is intended to supplement official training documents released by the administration. Topics addressed in the guide include: health insurance marketplaces, benefit standards, cost standards, rating, and premium tax credits.
RWJF publishes navigator resource guide
Posted by Nikki Hurt on November 22, 2013
The Robert Wood Johnson Foundation (RWJF), in conjunction with Georgetown University’s Center on Health Insurance Reform, recently published their Navigator Review Guide. Navigators are trained to help individuals understand their coverage options under the Affordable Care Act (ACA) and help them select plans most appropriate for their needs. The Navigator Resource Guide is divided into three sections:
- Enrollment issues for individuals without coverage options from an employer;
- Enrollment issues for individuals with coverage options from an employer, but who may want to learn more about additional options under the ACA; and
- Enrollment issues for small employers.
The 102 page document is designed to provide additional information and supplement the training for navigators working with private insurance under the ACA.
New Resources Available to Help Understand and Digest Health Information Laws
Posted by Nikki Hurt on September 13, 2013
Health Information & the Law, a project at the George Washington University School of Public Health and Health Services (SPHHS), released new resources on a website that offers easy-to-understand content on key issues related to the use and exchange of health information and how it affects the transformation of the U.S. health care system to a patient-centered, value-based system.
“The exchange of health information is critical to the transformation of our health care system,” says Jane Hyatt Thorpe, JD, project co-director and associate professor of health policy at the SPHHS. “These two new resources will help policymakers, consumers, health professionals, providers, and others better understand how health information laws can support rather than hinder the exchange of health information.”
The two new resources, Fast Facts and Myth Busters, add to the website’s library of material on federal and state laws governing the access, use, release and publication of health information.
Both offer insight into federal and state laws and regulations that govern health information, including implications for health care delivery, payment and beyond. Examples of the new resources now available at HealthInfoLaw.org include:
- Fast Facts: What types of data do public health agencies collect?
- Myth Buster: MYTH: Public health data exception to HIPAA
- Fast Facts: How is data collected & used in a health insurance marketplace?
- Myth Buster: MYTH: Patients may sue providers for disclosing patient health information in violation of HIPAA
This library of resources will continue to grow over time and will include Fast Facts and Myth Busters on topics such as privacy and confidentiality, health information technology, HIPAA, public health data, health insurance marketplaces, and security. These new series augment existing resources available at HealthInfoLaw.org including summaries of federal and state laws and regulations governing health information as well as in-depth analyses, comparative state maps and decision tools.
“Health information laws can be quite complex,” said Lara Cartwright-Smith, JD, MPH, project co-director and assistant research professor of health policy at the SPPHS. “These new resources, as well as the other content on the website, are intended to break down common misperceptions and barriers and highlight opportunities for broader health information exchange.”
Health Information & the Law is a project of the George Washington University’s Hirsh Health Law and Policy Program, developed with support from the Robert Wood Johnson Foundation.
The new resources and additional material can be accessed at www.HealthInfoLaw.org.
Georgetown Health Policy Institute and RWJF discusses shift to EHB
Posted by Nikki Hurt on August 14, 2013
A report recently published by Georgetown University’s Health Policy Institute, funded by the Robert Wood Johnson Foundation (RWJF), describes how states and health insurers are adopting the Affordable Care Act’s (ACA) essential health benefits (EHB) requirements. Pursuant to the ACA, insurers offering plans in the individual and small group health insurance Marketplaces are required to offer benefits within the 10 specified EHB categories. RWJF found that for most Americans, benefit coverage will not drastically change. If anything, most individuals will now have access to services previously not covered by insurance, such as maternity health, mental health, and prescription drugs.
Health Affairs brief discusses premium tax credits
Posted by Nikki Hurt on August 3, 2013
A new policy brief published by Health Affairs, in conjunction with the Robert Wood Johnson Foundation, explains the premium tax credit that will be provided to eligible individuals under the Affordable Care Act (ACA). According to the ACA, individuals with an income between 100-400% of the federal poverty level purchasing health insurance through the Marketplaces will qualify to receive a subsidy to offset a portion of the premium costs. The brief specifically focuses on the premium tax credit provisions within the law, how the subsidies will be calculated and administered, and the various methods by which the government and third-party entities are educating the public on the subsidies.