Insurance and Provider Markets
Our work in Insurance and Provider Markets
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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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New Evidence Suggests a Lack of Cost-Shifting in Prescription Drug Markets
Recent legislative efforts to regulate drug prices have reignited debates about the interaction between price setting in public insurance programs and commercial market spending.
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Revisiting Early Structural Findings of Asymmetric Information’s Non-Existence in Health Insurance
AHRQ Postdoctoral Research Fellow revisits an early structural model that tests for asymmetric information in health insurance.
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The Case for Replacing “Silver Loading”
An analysis of how a public option may or may not reduce healthcare costs in the U.S.
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Association of Drug Rebates and Competition With Out-of-Pocket Coinsurance in Medicare Part D, 2014 to 2018
Research from Schaeffer Center experts Darius Lakdawalla and Meng Li in JAMA Network Open finds U.S. insurers could use drug manufacturer rebates to lower retail pharmacy prices and reduce patient out-of-pocket burden by 38% on average, or 70% in the most competitive drug classes.
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Designing a Public Option that Would Reduce Healthcare Provider Prices
An analysis of how a public option may or may not reduce healthcare costs in the U.S.
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Congress Should End Dialysis Companies’ Third-Party Games with Insurance Coverage
A new op-ed in STAT highlights practices by dialysis facilities where they try to push patients into individual market plans by financing patients’ premiums for those plans
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Insurer Formularies Complicate the Adoption of Biosimilar Cancer Therapies
A new blog post coauthored by Schaeffer Center experts in Health Affairs finds that insurer preferences for biologic and biosimilar drugs adds cost and complicates the work of hospital pharmacists and physicians.
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Enrollment in Nongroup Health Insurance by Income Group
Slightly more than half of those with incomes below 400% of the federal poverty level (FPL) were enrolled in nongroup policies that constitute minimum essential coverage.
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Payment for Dialysis Services in the Individual Market
Monthly spending on outpatient dialysis services for end-stage kidney disease patients was three times higher for patients insured in the individual market compared to patients insured through Medicare.