Private Insurance Coverage

In 2014, there were a total of 1,299 mergers and acquisitions in the health care sector – a record number, up from 1,035 the year before. This briefing will discussed the driving forces behind this recent increase in consolidation; the scope and extent of consolidation among doctors, hospitals and insurers; implications for consumers and other […]

With the third open enrollment period for health insurance marketplaces launching November 1st, this briefing took a detailed look at what consumers can expect regarding premiums, health plan availability and affordability. Speakers provided the latest information about premium trends and drivers, health plan availability and new tools designed to help consumers make informed choices. They highlighted changes from […]

This briefing, the second in a three-part series on the role of consumers and patients in our health care system, discussed the role of consumers in today’s health care coverage market, exploring questions such as: How is the evolving insurance marketplace affecting the choices consumers have when selecting a health plan, whether through a health […]

In advance of the third open enrollment period for health coverage under the Affordable Care Act, this briefing examined coverage trends, who has gained coverage and who remains uninsured, and why those uninsured individuals have not obtained coverage. Speakers also discussed insurance marketplace efforts to expand the focus from primarily enrollment to include assisting consumers […]

The Affordable Care Act (ACA) created new health insurance marketplaces for small businesses, known as Small Business Health Options Program (SHOP) marketplaces, and made substantial changes to the regulation of health insurance for small businesses. For purposes of health insurance regulation, small businesses have traditionally been defined by states as businesses with up to 50 […]

Efforts are underway throughout the Medicare program to better manage beneficiaries’ chronic conditions, with the goal of improving quality and lowering the costs of care. With an estimated 31 million Medicare beneficiaries suffering from a chronic condition such as cardiovascular disorders, diabetes and cancer, many still do not receive the coordinated services they need to […]

Almost three in ten Medicare beneficiaries are enrolled in the Medicare Advantage (MA) program, which offers a choice of competing private health plans – typically managed care plans such as HMOs and PPOs. The Affordable Care Act (ACA) made significant changes to the way Medicare Advantage plans are paid, including tying a portion of payments […]

With the launch of the Affordable Care Act’s second open enrollment period this week, millions of people are again expected to flood marketplace websites to enroll or reenroll in health plans. At the same time, insurance commissioners are announcing draft regulations to help their states respond to an issue that was the subject of major […]

One day after this briefing, on November 15, the second open enrollment period begins for health plans sold in federal and state marketplaces. More than 7 million people who bought insurance for 2014 can shop around for new plans or stay where they are. Those who received federal subsidies will face a redetermination process to […]

Some new health plans sold in the insurance marketplaces are offering consumers networks that exclude certain doctors, hospitals and other medical providers. While some claim that these networks hamper provider access and choice, others contend that this approach, if done the right way, helps consumers by creating competition and controlling costs. The federal and state […]