AHIP’s Center for Policy and Research conducts and publishes original research and provides analysis and commentary on the research of others. It seeks to demonstrate the value proposition of private health insurance plans, and educate the policy community and news media about key products and market segments that are of interest to policymakers.

2014-07-18_17-37-12 January 2014 Census Shows 17.4 Million Enrollees in Health Savings Account – Eligible High Deductible Health Plans (HSA/HDHPs)
July 2014
An annual census conducted by America’s Health Insurance Plans (AHIP) of U.S. health insurance companies shows that enrollment in health savings account / high-deductible health plans (HSA/HDHPs) totaled 17.4 million in January 2014.




 
imagereportAn Analysis of Health Savings Account Balances, Contributions, and Withdrawals in 2012 
July 2014
This report provides information on the financial activity of more than 1.4 million health savings accounts (HSAs) open as of December 31, 2012.





  
Innovations in Medication Therapy Management

 
Innovations in Medication Therapy Management: Effective Practices for Diabetes Care and Other Chronic Conditions
December 2013
This report describes trends in the medication therapy management (MTM) programs being conducted by America’s health insurance plans and provides details about 16 companies’ MTM initiatives for a variety of patient populations.



 
2013 Health Insurance

 
2013 Health Insurance: Overview and Economic Impact in the States
November 2013
This report provides an overview of state health insurance facts of interest to policymakers. Key indicators are presented for each state and the District of Columbia, and cover topics such as numbers of covered lives and types of health insurance coverage, jobs and wages in the health insurance industry, and major health insurance plans operating in the state.



 
HSA 2013

 
January 2013 Census Shows 15.5 Million People Covered by Health Savings Account/High-Deductible Health Plans (HSA/HDHPs)
June 2013
An annual census by America’s Health Insurance Plans (AHIP) of U.S. health insurance carriers shows that the number of people covered by health savings account/high-deductible health plans (HSA/HDHPs) totaled 15.5 million in January 2013. This census does not include coverage associated with health reimbursement arrangements (HRAs), which are most commonly offered in the large-group market.



 
Medigap small

 
Trends in Medigap Coverage and Enrollment, 2012
May 2013
This report presents trends in enrollment in Medicare Supplement (Medigap) insurance coverage, using data on the number of policies in force as of December 2012 from the National Association of Insurance Commissioners (NAIC). The NAIC dataset contains information on most Medigap policies in force in the U.S., representing approximately 10.2 million covered lives, with policies from 262 carriers.



 
Trends in Inpatient Hospital Prices, 2008 to 2010

 
Trends in Inpatient Hospital Prices, 2008 to 2010
March 2013—American Journal of Managed Care
Unadjusted inpatient hospital prices per admission grew by 8.2% per year from 2008 to 2010 for the commercially insured population (under age 65 years) in the MarketScan data set. We estimate that approximately 1.3 to 1.9 percentage points of the growth in prices can be attributed to increased intensity per admission. Thus, we estimate that intensity-adjusted price increases ranged from 6.2% to 6.8% annually in the 2008-2010 period. Price levels and trends varied considerably across admission types, states, and localities.



 
Innovations in Medicaid Managed Care

 
Innovations in Medicaid Managed Care: Highlights of Health Plans’ Programs to Improve the Health and Well-Being of Medicaid Beneficiaries
March 2013
In this report—an update to AHIP’s 2005 Innovations in Medicaid Managed Care book—we provide details about 17 health plan initiatives dedicated to improving the health and well-being of Medicaid beneficiaries.

 
Minority Beneficiaries


 
Low-Income & Minority Beneficiaries in Medicare Advantage Plans, 2011
February 2013
New data from the Medicare Current Beneficiary Survey (MCBS) show that Medicare Advantage plans, Medicare’s private comprehensive health plans, continue to be a vital source of coverage for low-income and minority beneficiaries in 2011.


 
Medigap Thumbnail


 
Low-income & Rural Beneficiaries with Medigap Coverage, 2011
02.15.2013
Medigap supplemental coverage has long helped Medicare beneficiaries fill gaps in their benefits. Recently released data from the 2011 Medicare Current Beneficiary Survey (MCBS) serve as a reminder of the critical role played by Medigap coverage. The MCBS data show that Medigap is particularly important to low- and moderate-income beneficiaries, especially those living in rural areas.


 
Claims Survey

 
An Updated Survey of Health Insurance Claims Receipt and Processing Times, 2011
02.05.2013
This brief report updates AHIP’s periodic surveys of claims receipt and processing times for 2011 claims data; the prior update was published in January 2010 based on claims data from 2009.
Fig2 Small  Survey of Charges Billed by Out-of-Network Providers: A Hidden Threat to Affordability
01.31.2013
This report provides a snapshot, state-by-state, of exorbitant charges billed by out-of-network physicians in the 30 largest states by population. It is designed to illustrate the value of provider networks and a growing problem faced by consumers who want affordable, meaningful, access to out-of-network providers.


 
Estimated Costs of Compliance  Health Plans’ Estimated Costs of Compliance with Expanded Federal Rate Review and with Data Collection for Risk Adjustment and Reinsurance
12.21.2012
In December 2012, AHIP conducted two surveys of member health plans regarding new regulatory guidelines released by the Department of Health & Human Services (HHS) for implementation of the Affordable Care Act. Plans were asked to submit responses to surveys concerning: 1) the proposed expansion of the federal rate review and data submission process, and 2) the proposed risk adjustment and reinsurance data collection process.



 
Map image  Health Savings Accounts and Account-Based Health Plans: Research Highlights
07.24.2012 (Full Report; Slides)
This brief report highlights research and statistics on the market for account-based health plans.




 
Graph  January 2012 Census Shows 13.5 Million People Covered by Health Savings Account/High-Deductible Health Plans (HSA/HDHPs)
5.29.2012 (Report; Slides)
The annual census by America’s Health Insurance Plans (AHIP) of U.S. health insurance carriers shows that the number of people covered by health savings account/high-deductible health plans (HSA/HDHPs) totaled 13.5 million in January 2012.



 
Minority  Trends in Medigap Coverage and Enrollment, 2011
05.23.2012
This report presents trends in enrollment in Medicare Supplement (Medigap) insurance coverage, using data on the numbers of policies in force as of December 2011 from the National Association of Insurance Commissioners (NAIC) and an America’s Health Insurance Plans (AHIP) survey of newly purchased policies issued by Medigap carriers in 2011.



 
Minority  Low-Income & Minority Beneficiaries in Medicare Advantage Plans, 2010
05.03.2012
New data from the Medicare Current Beneficiary Survey (MCBS) show that Medicare Advantage plans, Medicare’s private comprehensive health plans, continue to be a vital source of coverage for low-income and minority beneficiaries in 2010.



 
Rual  Low-Income & Rural Beneficiaries with Medigap Coverage, 2010
05.03.2012
Medigap supplemental coverage has long helped Medicare beneficiaries fill gaps in their benefits. Recently released data from the 2010 Medicare Current Beneficiary Survey (MCBS) serve as a reminder of the critical role played by Medigap coverage. The MCBS data show that Medigap is particularly important to low- and moderate-income beneficiaries, especially those living in rural areas.



 
Health Care Costs  AHIP Presentation on Health Care Costs, 2012 National Policy Forum, March 7, 2012 (Joint session with Thomson Reuters)
A presentation by AHIP using Thomson Reuters MarketScan data shows current trends in hospital prices.






 
Long-Term Care Insurance  Who Buys Long-Term Care Insurance in 2010-2011?
Who Buys Long-Term Care Insurance in 2010-2011? is a twenty year study of the long-term care insurance marketplace that AHIP has undertaken with LifePlans, Inc.


 
Hospital Readmissions  Hospital Readmission Rates in Medicare Advantage Plans
February 2012—American Journal of Managed Care (PDF; Appendices; Press Release)
Based on a large sample of administrative claims data, this study measured 30-day readmission rate for hospitalized Medicare Advantage (MA) patients of 14.5% (per admission) in the 2006-2008 period. After adjustments for readmission risk and disability entitlement status, the MA readmission rate was about 13% to 20% lower than that in Medicare’s traditional fee-for-service (FFS) program. Benchmark measurements of readmission rates among MA patients can help provide an impetus for additional reductions in both MA and FFS Medicare.


 
Health Affairs Jan 2012  Medicare Advantage Chronic Special Needs Plan Boosted Primary Care, Reduced Hospital Use Among Diabetes Patients
January 2012—Health Affairs (Abstract; PDF; Full Text; Press Release)
This case study examines the model of care used by Medicare’s largest Chronic Special Needs Plan (C-SNP), Care Improvement Plus, and compares utilization rates among its diabetes patients with those of other beneficiaries enrolled in fee-for-service Medicare in the same five states. This C-SNP plan emphasizes direct contacts with patients to help identify gaps in care and promote primary and preventive health care. The comparative analysis indicates that people with diabetes in the special-needs plan—particularly nonwhite beneficiaries—had lower rates of hospitalization and readmission than their peers in fee-for-service Medicare.


 
Event Jan2012  AHIP Briefing—Health Plan Innovations: Caring for Medicare and Medicaid Patients with Chronic Illnesses
A discussion about the innovative ways health plans are improving the health and well-being of Medicare and Medicaid beneficiaries with complex health conditions. Health plan clinicians described their unique approaches to patient-centered care, shared real-life success stories, and presented overall program results.


 
Measuring Readmissions  Working Paper: Simple Methods of Measuring Hospital Readmission Rates
Revised 03.15.2012
This working paper summarizes the various methods used by AHIP for computing readmission rates in a series of publications over the last several years.


 
innovations2011_large  Innovations Report Series
Health insurance plans have created many innovative programs to improve the quality of care and help patients navigate the health care system. AHIP’s Innovations reports describe these initiatives in an easy-to-read, searchable format designed for policymakers, members of the media, health policy researchers, and health plan operations staff. Reports highlight best practices in:

• Patient Safety
• Reducing preventable hospital readmissions
• Disability income insurance
• Recognizing and rewarding quality
• Prevention and wellness
• Health information technology
• Chronic disease prevention and treatment
• Medicaid managed care.
 


Health Savings Accounts and Account-Based Health Plans: Research Highlights

11.30.2011
This brief report highlights research and statistics on the market for account-based health plans.

Health Literacy and America’s Health Insurance Plans: Laying the Foundation and Beyond
11.02.2011
This publication explains the innovative approaches that 27 health plans have taken to providing easily understood, actionable health and benefits information for consumers.

Summary of Benefits and Coverage and Uniform Glossary Proposed Rule: Implementation and Annual Ongoing Costs of Compliance
10.20.2011
In September 2011, AHIP conducted a survey of health insurance plans on costs of compliance with the new Summary of Benefits and Coverage (SBC) and the Uniform Glossary requirements detailed in a notice of proposed rulemaking (NPRM) issued by the Department of Health and Human Services (HHS), Department of Labor, and Department of Treasury on August 22, 2011.

Low-Income & Rural Beneficiaries with Medigap Coverage, 2009
09.28.2011
Medigap supplemental coverage has long helped Medicare beneficiaries fill gaps in their benefits. Recently released data from the 2009 Medicare Current Beneficiary Survey (MCBS) serve as a reminder of the critical role played by Medigap coverage. The MCBS data show that Medigap is particularly important to low- and moderate-income beneficiaries, especially those living in rural areas.

Low-Income & Minority Beneficiaries in Medicare Advantage Plans, 2009
09.28.2011
New data from the Medicare Current Beneficiary Survey (MCBS) show that Medicare Advantage plans, Medicare’s private comprehensive health plans, continue to be a vital source of coverage for low-income and minority beneficiaries in 2009.

2011 Health Insurance: Overview and Economic Impact in the States
09.26.2011
This report is a compendium of reference information on health insurance in the states. Key indicators are presented for each state and cover such topics as private health insurance coverage and premiums, jobs and wages in the insurance industry, premium taxes paid by insurance companies, and data on the uninsured and Medicaid.

Trends in Medigap Coverage and Enrollment, 2010-2011
07.27.2011
This report presents trends in enrollment in Medicare Supplement (Medigap) insurance coverage, using data on the numbers of policies in force as of December 2010 from the National Association of Insurance Commissioners (NAIC) and an America’s Health Insurance Plans (AHIP) survey of newly purchased policies issued by Medigap carriers through the first quarter of 2011. The NAIC dataset contains information on most Medigap policies in force in the U.S.

Small Group Health Insurance in 2010: A Comprehensive Survey of Premiums, Product Choices, and Benefits
07.08.2011
In July 2010, America’s Health Insurance Plans (AHIP) conducted a comprehensive survey of member companies offering coverage in the small group health insurance market. Responses included premium and benefit data from more than 477,000 small groups (those with 50 or fewer employees), reflecting approximately 3.7 million workers and 1.3 million dependents with coverage as of January 2010.

January 2011 Census Shows 11.4 Million People Covered by Health Savings Account/High-Deductible Health Plans (HSA/HDHPs) (Full Report; Slides)
06.14.2011 Revised 06.16.2011
An annual census by America's Health Insurance Plans (AHIP) of U.S. health insurance carriers shows that the number of people covered by health savings account/high-deductible health plans (HSA/HDHPs) totaled 11.4 million in January 2011.

Medigap: What You Need To Know
06.13.2011 Revised 07.28.2011
An informative report on how private Medicare Supplement (Medigap) insurance works, who purchases it, and what it covers. Describes recent product design changes to conform with the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).

The Federal Medical Loss Ratio (MLR) Calculations -- Background and Initial Costs of Compliance
06.06.2011
In January 2011, AHIP conducted a survey of health insurance plans on costs of compliance with the new national Medical Loss Ratio (MLR) rule, as enacted in the Affordable Care Act (ACA) and described in an "interim final" rule issued by the Department of Health and Human Services (HHS) on December 1, 2010.

Health Care Cost Summit Report: Slowing the Growth of Health Costs – How to Bend the Cost Curve
03.09.2011
Economists, policy makers and budget experts have warned for decades that health care costs are the nation’s most urgent fiscal problem. Unfortunately, while agreement on the problem is easy, bi-partisan solutions have been much more elusive. This summit linked health care, health insurance, economic, and budget policy experts in a discussion of the politics of cost containment and ways to address the problem of ever-increasing health care costs. The conference was held in Washington, DC on March 9, 2011, at the Westin Georgetown hotel.

Insurers' Efforts to Prevent Health Care Fraud
01.27.2011
This report presents updated information based on AHIP's 2010 study of fraud and abuse claims, detection strategies, and reported savings attributable to anti-fraud efforts from 2006 to 2008. The study included both quantitative data collection and open-ended questions that allowed anti-fraud professionals to describe their views and challenges.

Recent Trends in Hospital Prices in California and Oregon (Full Report; Slides )
12.09.2010
Using data from California’s Office of State Health Planning and Development (OSHPD) and Oregon’s Office of Health Policy and Research (OHPR), this report presents new data on the growth of hospital prices in California and Oregon.

Low-Income & Rural Beneficiaries with Medigap Coverage, 2008
12.06.2010
Medigap supplemental coverage has long helped Medicare beneficiaries fill gaps in their benefits. Recently released data from the 2008 Medicare Current Beneficiary Survey (MCBS) serve as a reminder of the critical role played by Medigap coverage. The MCBS data show that Medigap is particularly important to low- and moderate-income beneficiaries, especially those living in rural areas.

An Analysis of Health Savings Account Balances, Contributions, and Withdrawals in 2009
12.06.2010
A comprehensive study of financial activity in health savings accounts (HSAs). Data collected from three large banks contain detailed account information of more than 1.2 million HSA accounts open as of December 31, 2009.

Using AHRQ’s 'Revisit' Data to Estimate 30-Day Readmission Rates in Medicare Advantage and the Traditional Fee-for-Service Program (Full Report)
10.12.2010 Revised
New 30-day readmission rate calculations using “revisit” data from AHRQ show consistently lower rates among Medicare Advantage patients.

Health Plans’ Estimated Costs of Implementing ICD-10 Diagnosis Coding
09.30.2010
A survey of health plans shows the incremental costs for implementation of ICD-10 over the next three years will be substantial.

Characteristics of Medigap Policies, December 2009
09.09.2010
Medigap policies continued to be an important source of coverage for Medicare beneficiaries in 2009.

Innovations in Reducing Preventable Hospital Admissions, Readmissions, and Emergency Room Use (Full Report; Highlights)
06.07.2010
A review of health plan programs to revitalize primary care, improve care coordination, and help patients avoid adverse health events.

January 2010 Census Shows 10 Million People Covered By HSA Qualified High-Deductible Health Plans (Full Report; Slides)
05.19.2010
An annual census by America’s Health Insurance Plans (AHIP) of U.S. health insurance carriers shows that the number of people covered by health savings accounts/high-deductible health plans (HSA/HDHPs) totaled 10.0 million in January 2010. As in previous years, AHIP received participation from virtually all private health insurance carriers in the HSA/HDHP market for this census. This census does not include coverage associated with health reimbursement arrangements (HRAs), which are most commonly offered in the large-group market.

Working Paper: Using State Hospital Discharge Data to Compare Readmission Rates in Medicare Advantage and Medicare’s Traditional Fee-for-Service Program (Full Report; Summary)
05.14.2010
The latest in a series of studies comparing MA and FFS enrollees’ health care outcomes uses new data from nine states’ publicly available hospital discharge data from AHRQ and the states of Texas and Pennsylvania. Reductions in risk-adjusted hospital readmission rates averaged 14-29 percent among Medicare Advantage enrollees, depending on the readmission rate measure used, compared with FFS enrollees.

Update A Survey of Health Care Claims Receipt and Processing Times, 2009
01.26.2010
AHIP’s periodic survey of claims receipt and payment timing, updating the most recent previous report published in May 2006.

Trends and Innovations in Disability Income Insurance: An Update from America’s Health Insurance Plans
01.04.2010
Highlights of disability insurers’ creative programs to help employees and employers overcome multiple challenges and succeed in a difficult economy.