This document reviews current research outlining the key drivers of health care costs and advances a new policy framework for bending the cost curve and improving the quality of patient care.
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.
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.
A new report from Milliman, Inc. helps explain how the Affordable Care Act’s (ACA) coverage expansion, new benefits, and market reforms will impact individual market health insurance premiums in 2014. The report highlights how some provisions will increase premiums while others will make health care coverage more affordable for consumers. The focus of this report is to highlight the broad range of changes happening in the marketplace and the wide variation in impact that is likely to occur.
This presentation from Oliver Wyman examines the impact of ACA market reforms on affordability.
An article from actuaries at Oliver Wyman published in Contingencies highlights the impact of the Affordable Care Act’s (ACA) age rating restrictions on premiums.
In this report we have quantified the total premiums by state that will be assessed and estimated per member per year costs of this assessment by line of business.
Studies on Hospital Readmissions, Featuring Health Plan Innovations and Comparisons of Medicare Advantage (MA) and Medicare’s Traditional FFS Program.
Milliman examined states that enacted guaranteed issue and community rating reforms in the absence of an individual mandate, and found that they saw their individual insurance markets deteriorate. This report updates Milliman’s August 2007 report on the impact of guaranteed issue and community rating (CR) reforms adopted in eight states in the 1990s.
A technical analysis by Oliver Wyman estimates that the new health insurance tax in the Affordable Care Act (ACA) “will increase premiums in the insured market on average by 1.9% to 2.3% in 2014,” and by 2023 “will increase premiums 2.8% to 3.7%.” AHIP commissioned this report as part of its ongoing effort to raise awareness about the impact the tax will have on consumers, employers and public program beneficiaries.
The Affordable Act imposes a fee on health insurers that amounts to a de facto “health insurance premium tax” that will raise the cost of health insurance for American families and small employers. Specifically, under the law, an annual fee applies to any U.S. health insurance provider, with the intent of raising nearly $90 billion over the budget window.
New data from the Medicare Current Beneficiary Survey (MCBS) show that Medicare Advantage plans, Medicare’s private comprehensive health plans, were a vital source of coverage for low-income and minority beneficiaries in 2008.
an effort to assist policymakers, regulators, providers, health plans, and
others in considering the rules and regulations that are being formulated for ACOs,
AHIP hosted a forum on ACOs on September 23, 2010, in Washington, DC that
included a panel of four experts who provided guidance on the implementation of
the Shared Savings Program and discussed various aspects of market power
and antitrust concerns as they relate to ACOs.
This paper summarizes the key lessons and themes discussed by the
presenters as well as the participants.
Heritage Foundation backgrounder on the impact of new Medicare Advantage cuts included in the ACA, which states that these cuts “will restrict senior citizens and the disabled to fewer and worse health care choices, reducing their access to quality health care.”
the public and private sectors are exploring and implementing innovative care
and payment models designed to improve delivery of care and encourage Americans
to stay healthy. This white paper examines
the concept of Accountable Care Organizations (ACOs), often defined as
organizations of health care providers that agree to be held accountable for the quality, cost and overall
care for a defined population of patients and that seek to receive shared
savings if they meet certain quality and costs goals.
This Hay Group presentation provides an overview of how health insurance premiums are calculated and the factors that contribute to premium increases.
The Congressional Budget Office released its latest projections on the impact new cuts to Medicare Advantage will have on the millions of seniors enrolled in the program. CBO is projecting MA enrollment will decline from 11.7 million enrollees in 2011 to 7.5 million in 2018.
Wyman has developed an actuarial model to study the impact of different reform
proposals on the individual and small employer health insurance market. According to this model, if the age band is
compressed to 3:1, premiums for the youngest-healthiest third of individuals
would be 35% higher in Year 1 compared to reform with 5:1 rating bands.
A report by Milliman, Inc. examined the impact of enacting guarantee issue and community rating without covering everyone. According to the report, these initiatives have the potential to cause individuals to wait until they have health problems to buy insurance. This could cause premiums to increase for all policyholders, increasing the likelihood that lower-risk individuals leave the market, which could lead to further rate increases. If this continues, the pool or market could essentially collapse or shrink to include only the high-risk population.