Insurance and Provider Markets
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Deductible Double Jeopardy: Patients May Pay More Out of Pocket When Pregnancy Crosses 2 Years
This cross-sectional analysis of commercially insured delivering mothers suggests that greater out-of-pocket spending is incurred when pregnancy spans 2 years, causing them to face out-of-pocket limits twice.
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Buyouts Can Bring Relief From Medical Debt, but They’re Far From a Cure
Local governments are increasingly buying – and forgiving – their residents’ medical debt.
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Seminar Series – Anup Malani
Anup Malani is a legal scholar and economist. He is the Lee & Brena Freeman Professor at the University of Chicago Law School and a Research Associate at the National Bureau of Economic Research.
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Government And Commercial Insurer Payment Rates to Hospitals: A Commentary on Priselac
Paul Ginsburg discusses how for decades, stakeholders have argued about whether competition or regulation should be the approach to constrain health care spending. By having chosen neither, he argues, our nation now finds itself with a much larger challenge. The magnitude of our health care affordability problem cries out for pursuing both competition and regulation.
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About this section
Competition is essential for a properly functioning marketplace, but industry consolidation, insurance complexity and other factors are barricading healthcare consumers from the benefits of good commerce. Schaeffer Center analysts explore ways to remove those obstacles to efficiency, while also promoting optimal care.
Our Work In Insurance and Provider Markets
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Biosimilar Drugs Underutilized Due to Commercial Insurance Restrictions
The first study to examine biosimilar drivers finds commercial insurers limit use in almost 20% of cases.
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Tweak the Affordable Care Act to Mandate Backstop Health Insurance
Universal coverage could be achieved through a “backstop” insurance that auto-enrolls uninsured patients when they seek care.
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Largest Medicare Advantage Plans Pay Big Markups for Dialysis
Large dialysis chains charge Medicare Advantage plans 27% more than the traditional, fee-for-service Medicare program.
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The Supreme Court Left Millions of Americans Uninsured: Here’s What Congress Can Do to Cover Them
Congress can expand healthcare to millions of Americans by enrolling individuals in the 12 states that did not expand Medicaid.
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Eliminating Small Marketplace Premiums Could Meaningfully Increase Insurance Coverage
Matthew Fiedler estimate that 404,000 Marketplace enrollees in the states served by HealthCare.gov currently owe a small positive premium (defined as a positive premium of less than 0.5% of the gross premium of the enrollee’s plan, which translates to around $3 per month on average).
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Value Defects In The Health Services Sector
As of 2021, US health care expenditures exceed $3.8 trillion. It’s no secret that health care is nearly as wasteful in spending on value defects—behaviors that needlessly reduce quality, negatively impact the patient experience, or add to total costs of care—as it is in delivering clinical benefits.
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