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- Access to Care Among Hispanics: Implications for Understanding Community Variation
- A Comparative Analysis of Small and Large Group Health Care Utilization and Costs, 1988-1990
- A Comparative Evaluation of Risk-Adjustment Methodologies for Profiling Physician Practice Efficiency
- Administrative Costs Associated with Third Party Payment
- Administrative Simplification Challenges and Opportunities: A Physician Organization's Perspective
- Alternative Models for Ensuring Access to Primary Medical Care in Nursing Facilities
- A Methodological Evaluation of Non-Response on the Physician Component of the Community
- An Academic Health Center and Public Health Practice Collaboration: Disseminating Continuous Quality Improvement Capability to Local and State Public Health Agencies
- Analysis of the Transfer of Risk and Clinical Management Responsibilities to Physician Organizations
- An Analysis of the Effects of Medical Underwriting
- An Early Portrait of Consumer-Directed Health Benefits: Design, Integration, Penetration, and Effects
- An Empirical Investigation of Employee Health Plan Choice and Switching Behavior Under Managed Competition
- An Evaluation of the Current and Potential Impact of Consumer Survey-Based Report Cards on the Health Care Market Place
- An Evaluation of the Impact of the New York Health Care Reform Act of 1996 on Selected Clinical Outcomes, Patient Satisfaction, and Health Status
- An Investigation of the Management Uses of Health-based Risk Adjustment Tools by U.S. Purchasers and Health Plans
- A Randomized Controlled Trial of Collaborative Care: An Alternative Model for Organizing Health Care Delivery in Teaching Hospitals
- Are Highly Concentrated Health Care Markets Bad for Health Care?
- Arkansas School Health Insurance Project (ASHIP)
- Assessing the Impact of a Public Report on Hospital Quality: A Controlled Experiment in the State of Wisconsin
- Assessing the Impact of Hospital Mergers
- Assessing the Impact of Medicaid Equalization Policies on Access to Nursing Home Care
- Assessment of Quality of Care Under PPS By Examining Patient Functional Status Through Post-Hospital Period -- A Feasibility Study
- Assessment of Training Needs for Public Health Financial Managers
- A Systematic Study of Nebraska’s Regional Public Health Agency Model
- Autologous Bone Marrow Transplantation (ABMT) and the Treatment of Breast Cancer: The U.S. Experience
- Barriers to Small-Group Purchasing Coalitions
- Beyond the Gatekeeper: How Managed Care Organizations Affect the Use of Technology
- Broadening Access to Prenatal Care through Expansions: The Impact on Prenatal Care Use and Infant Mortality
- Business Views of Strengths and Weaknesses of the Employer-Based System for Providing Health Insurance Coverage
- Californians' Health Insurance Coverage: Research for Public Policy Making and Planning
- Can Disease Management Control Costs?
- Capped Prescription Benefits and Medicare Managed Care
- Causes and Consequences of Change in Local Public Health Spending
- Causes and Consequences of the HMO Underwriting Cycle
- CCRCs: An Efficient Alternative for Long-Term Care Provision and Financing?
- Changes in Drug Payment and Management Strategies in Physician Organization
- Changes in Drug Utilization for Seniors without Prior Prescription Drug Insurance
- Changes in Employer-Offered Health Insurance: Firms Decision Making & Employee Satisfaction
- Changes in Hospital Configurations Between 1980 and 1995 in Urban America
- Changes in Physicians’ Decisions to Treat Medicaid Patients and the Uninsured
- Changing Medicaid Physician Fees: Effects on Access and Total Cost
- Characteristics and Determinants of Intragovernmental Activity Within State Public Health Systems
- Comparing the Cost Effectiveness of Chronic Care between Medicare Advantage and FFS Medicare Beneficiaries
- Comparison of Public Health Organizational Structures Using Dynamic Network Analysis
- Competition, Volume, and Outcome in Cardiovascular Care in California
- Competitive Bidding in the Federal Employees Health Benefit Plan
- Conditions of Practice and Quality of Care: Physicians' Perceptions
- Consequences of SCHIP for Household Well-Being
- Consumer Choice of Plans, Employer Contribution Policy, and Health Plan Price
- Controlling Risk Segmentation under Employment-based Medical Savings Accounts
- Corporate Finance and Consolidation in Health Care
- Cost, Utilization, and Health Effects of Successive Changes in Cesarean Length of Stay Policy
- Cost and Efficiency in Treating High-Cost Medicare Beneficiaries: The Role of Physician Practice and Health System Factors
- Cost Effectiveness, Quality and the Future of Medical Technology Assessment
- Costs and Benefits of Physician Practices' Interactions with Health Plans
- Creating and Sharing Improved Tools for Policymakers to Assess Risk Adjustment Approaches
- Defensive Medicine as a Response to Medical Malpractice Liability in the United States
- Defining Affordability for the Uninsured and People with Chronic Conditions
- Demonstration of the Subacute Care Alternative
- Developing and Applying a Descriptive Framework for Analyzing Food Safety Resources
- Developing Risk Assessment Tools for Large Employers and Testing Risk Adjustment Approaches in Health Care Purchasing
- Does Hospice Save Medicare Money?
- Does Managed Care Work? An Empirical Study of Corporate Healthcare Cost Containment Initiatives
- Duration Limitations and Adherence to Chronic Medication
- Early Implementation Experience of Companies Offering internet-based Models for Employer Health Benefits
- Economic Impact of Adverse Health Events on the Uninsured Near Elderly
- Effect of Decreased Emergency Department Access on Patient Outcomes
- Effect of State Parity Laws on Children with Mental Health Care Needs
- Effects of a Statewide Perinatal Program for the Uninsured
- Effects of Competition and Rate Regulation on Access to Physician Services and Uncompensated Care
- Effects of Different Mechanisms on Pharmaceutical Use and Cost
- Effects of Physician Compensation Method on Physician Behavior and Satisfaction in Managed Care Organizations
- Effects of Prior Authorization of New Medications among Medicaid Beneficiaries with Bipolar Disorder
- Effects of the Balanced Budget Act and Market Forces on the Health Safety Net
- Efficiency/Quality/Outcome Trade-offs in Medicare's Prospective Payment System
- Enhancing Access to Obstetrical Care: An Evaluation of A Change in Medicaid Payment Policy
- Establishing the Value of Stable Prescription Coverage for Medicare Beneficiaries
- Evaluate Selective Contracting for Tertiary Services by Managed Care Organizations
- Evaluating Business Initiatives in Health Care Purchasing
- Evaluating Cost Efficiency of Specialist Physicians
- Evaluating Florida's Medicaid Provider Service Network Demonstration Project
- Evaluating the Medicaid Psychiatric Hospital Payment System in New Hampshire
- Evaluating the Use of Performance-Related Information and Financial Incentives in Employer Health Care Purchasing
- Evaluation of Baltimore's Mental Health Capitation Program
- Evaluation of Defined Contribution Plans on Health Insurance Choice and Medical Care Use
- Evaluation of Maine's Dirigo Health Reform
- Evaluation of Medicare's Local Medical Review Policies for New Medical Technologies
- Evaluation of Natural Experiment to Raise Medicaid Fees for Physicians
- Evaluation of New York City Model to Provide Home Care Services: The Cluster Care Demonstration
- Evaluation of Reforms of the Market for Individual Health Insurance Coverage in New Jersey
- Evaluation of State Initiatives to Expand Health Insurance Among Small Businesses
- Evaluation of State Risk Pools: The Current and Potential Experience
- Evaluation of the Buyers Health Care Action Group (BHCAG) Initiative Component Three: An Assessment of the Impact of the Initiative on Health Care Delivery
- Evaluation of the Buyers Health Care Action Group Initiative
- Evaluation of the Effects of Utilization Review on Patterns of Care and Medical Expenses
- Evaluation of the Impact of the Resource Utilization Groups II System on Long-Term Care Facilities in New York
- Evaluation of the Medicare Supplementary Insurance Reform Legislation of 1990
- Evaluation of the TennCare Health Reform Plan
- Evolution of Physician Organization Under Managed Care
- Evolution of Self-Insurance in an Era of Managed Care
- Examining Effective Strategies that Local Communities Have Used to Meet Expanded Public Health Workforce Needs
- Examining the Impact of Informational Messages on Seniors' Choice of Medicare Drug Plans
- Excess Capacity, Hospital Costs, and the Effects of Market Structure
- Exit, Voice and Frailty: Consumer Behavior Under Managed Competition
- Exploration of Market-Based Risk Adjustments for Adverse Selection in Health Insurance
- Extent and Impact of the Use of Observations Stays in the Medicare Program
- Factors Affecting End-of-Life Care for Beneficiaries Who Are Dually Eligible for Medicare and Medicaid
- Factors Associated With Health Insurance Coverage for Low-Income Children
- Factors Associated with the Distribution of Physician Income: A Quantile Regression Approach
- Financing American Indian Health Care: Impacts and Options for Improving Access and Quality of Care
- Gender and Managed Care
- Geographic Variation in Alcohol, Drug Abuse, and Mental Health Services Utilization: What is the Role of Physician Practice Patterns?
- Getting Tools Used: Lessons Learned from Successful Decision Support Tools Unrelated to Health Care
- Guaranteed Renewability in Individual and Group Health Insurance: Functioning and Future Prospects
- Health and Economic Consequences of Medicaid Disenrollment in New York City
- Health Care Services for Children Placed in Foster or Kinship Care
- Health Care Utilization Among the Previously Uninsured
- Health Care Utilization Among the Previously Uninsured-- A Feasibility Study
- Health Insurance Purchasing Cooperatives: Analysis of Existing Data
- Health Plan Choice and Utilization: The Role of Plan Attributes
- Health Plan Choices and Adverse Selection in Employer Sponsored InsuranceHealth Plan Choices and Adverse Selection in Employer-Sponsored Health Insurance
- Health Plan Selection for Medicare Eligible Enrollees in the Federal Employees Health Benefits Program
- Health Savings Accounts, High Deductible Policies, and the Uninsured: Simulating the Effects of HSA Tax Policy
- HIPC Health Risk Adjusters Project
- Hospital Capital Financing in the Era of Quality and Safety: Strategies and Priorities for the Future - A Survey of CEOs
- Hospital Contracting Under Managed Care
- Hospital Mergers and Health Reform: Decreased Competition Versus Community Benefit
- Hospital Ownership and Performance: An Integrative Research Review
- Hospital Ownership Conversions
- Hospital Responses to Competitive and Regulatory Pressures: The Role of Organizational Form in Changing Markets
- Hospital Uncompensated Care Under Managed Care, Competition and Fiscal Pressure
- How Does Fragmentation of Care Contribute to the Costs of Care?
- How Do Rising Healthcare Costs Affect Worker Compensation?
- How Managed Care Growth Has Affected Health Departments’ and Physicians’ Ability to Provide Indigent Care
- How Valid are the Assumptions Underlying Consumer-Driven Health Plans?
- Impact of Medicaid Managed Care on Access to Care and Service Use
- Impact of Medicare
- Impact of Medicare Payment Reductions For "Overpriced" Surgical Procedures on Utilization and Access
- Impact of MMA Part D on Medicare Residents in Nursing Homes
- Impact of Physician Compensation Mechanisms on the Process of Care
- Impact of Private Long-term Care Insurance on Demand for Care: Setting and Intensity
- Impact of Profitability on Hospital Responses to Financial Stress
- Impact of State Medicaid Policy Changes on Nursing Home Hospitalization
- Impact of the Medicare Home Health Prospective Payment System on Beneficiaries and Program Costs
- Impact of the Washington State Diabetes Collaborative on Patient Health and Economic Outcomes
- Impact of Various Health System Reform Options on the Distribution of Health Care Costs Across All Payers
- Implementation and Impact of Health Based Risk Adjustment
- Implementing Diagnostic Health Risk Adjustment in an Employed Population -- Phase II
- Implementing Risk-Adjustment for Medicaid
- Improving Access to Improve Quality: Evaluation of an Organizational Innovation
- Incorporating Disparities into State Strategies to Monitor and Improve Health Status
- Information Technologies and the Use of Information in Managed Care
- Informing the Design of Funding Allocation Formulas in Public Health
- Insurance Coverage, Use of Prenatal Care, and the Financing of Birth Outcomes in Nine States Pre and Post Welfare Reform
- Investigation into Specialty Payment: Effects on Cost and Treatments
- Involving Consumers in Physician Choice: Making Data into Useable Information for Chronically Ill Patients in Consumer-Directed Health Plans
- Is Small-Area Variation in Healthcare Utilization Explained by Physician Financial Self-Interest?
- Is the Impact of Managed Care on Hospital Prices Decreasing?
- Liability Problems and Transparent Disclosure to Patients as a Solution
- Local Community Strategies to Develop their Public Health Surge Capacity to Handle Emergencies Affecting Many People
- Local Funding for Health Services in Rural Counties
- Local Public Health Capacities to Address the Needs of Culturally and Linguistically Diverse Populations
- Long-Term Care Options Planning Project
- Long-Term Care Options Project (Planning Grant)
- Managed Care: Contractual Arrangements with Physicians and Implications for Pediatric Health Care Use
- Managed Care and Medicare Expenditures
- Managed Care’s Spillover Effects on the Quality of Diabetes Care for Medicare Patients
- Market-Based Reforms and the Quality of Hospital Care in New Jersey
- Market Forces in Investor-Owned Health Maintenance Organizations
- Measuring Managed Care Activity
- Measuring the Costs and Benefits of Medicare Private Fee-for-Service
- Measuring the Costs of Defensive Medicine in the United States: Phase II
- Measuring the Value of Public Health Systems
- Medicaid Eligibility Expansions for Pregnant Women, 1986-1990: Evaluating the Aggressiveness of States' Implementation
- Medicaid Long-Term Care Programs: Simulating Rate Setting and Cross-Payer Effects
- Medicaid Managed Care and Health Care Access, Use, and Quality
- Medical Malpractice Reform and Implications for Health Insurance Costs
- Medical Risk Distribution Among Competing Health Plans
- Medical Spending and Health of the Elderly
- Medicare Health Plan Decisions: Will Regional Competitive Bidding Work?
- Medicare Policy and Aging in the US and Canada
- Medicare Risk-Contracting: Impact on Access and Quality for Medicare HMO Enrollees and Vulnerable Populations
- Medicare Spending, Disparities, and Returns to Healthy Behaviors
- Meeting the Future Long-Term Care Needs of the Baby Boomers: How the Changing Structure of Families Will Affect Paid Helpers and Institutions
- Methods to Present Quality Information to Assist Consumers to Make Health Plan Decisions
- Monitoring and Evaluation of Massachusetts's Chapter 495
- Monitoring the Early Experience with Federal Health Insurance Tax Credits
- National Security and Child Health: Reexamining the Role of Medicaid and EPSDT
- New Approaches to Identifying Market Power in Health Care
- New York State ProNet (Prospectively Paid Health Network)
- Older American's Health Insurance: Emerging Concerns
- Patterns of Individual Coverage
- Paying Physician Group Practices for Quality: A Regional Natural Experiment
- Peer Pressure: Hospital Ownership Mix and Medical Service Provision
- Physician-Organization Arrangements: Impact on Integration and Managed Care
- Physician Compensation & Risk Bearing Arrangements in Medical Groups: Market Level Effects and Impacts on Physician Productivity and Risk Contracting
- Physician Compensation and Risk-Bearing Arrangements in Medical Groups: Impact on Physician Productivity
- Physician Responses to HMO Growth
- Physician Response to Medicare Payment Reductions: Impacts on the Public and Private Sectors
- Physicians' Responses to Variations in Medicare Fees for Specific Services
- Pilot Study of Variations in Medicare Spending per Beneficiary
- Preferences, Choices, and Managed Care Markets: Determinants of Consumer Trust and Satisfaction
- Premium Variation and Insurance Demand in the Individual Insurance Market
- Prescription Benefit Comprehensiveness and Costs of Care in Elderly Persons with Chronic Illness: The Medicare Enrollee Drug Study (MEDS)
- Private Insurance Markets: The Missing Link-Association Health Plans and Other Pooled Purchasing Arrangements
- Promoting Readiness and Interest in Self Management
- Public Health Entrepreneurship
- Public Health Funding and Population Health
- Public Health System Organization and Performance in Rural Communities
- Quality Assessment of South Carolina Medicaid Managed Care
- Racial and Socioeconomic Disparities in Health Care Among the Insured
- Reforming Medicare Risk Payment Through Competitive Market Forces
- Reimbursement Policy and Cancer Chemotherapy Treatment and Outcomes
- Research on Determinants of Hospital Contracts with HMOs
- Research on Risk Selection in Employer-sponsored Health Insurance
- Research on the Effect of Community Variability on Financing Strategy Effectiveness
- Research on the Governance and Management of Collective Purchasing Arrangements Under Managed Competition
- Research on the Impact of Physician Competition on Health Care Utilization
- Research on the Relationship Between Market Characteristics and the Number and Type of Medicare Enrollees in HMOs
- Resource Use and Efficiency in Episodes of Care
- Second-Generation Evaluation of Buyers Health Care Action Group (BHCAG)
- Single Payer Demonstration Project
- Small Area Variation in Medicaid Utilization and Expenditures: Implications for Cost Containment and Quality of Care
- Sources of Health Care Cost Growth
- State Experience with Pharmaceutical Assistance Programs
- State Health Policy and the State of American Medicine
- Strategies to Reduce Health Care Providers’ Administrative Burden Related to Quality Performance Measurement and Reporting
- Structural Capacities, Processes and Performance of Essential Public Health Services by Small Local Public Health Systems
- Studies of the Working Uninsured, Their Dependents and Insurance Reform on Their Behalf
- Study of the Effects of High-Deductible Health Plans on Families with Chronic Conditions
- Study on Informed Choice of Drug Coverage for Medicare Beneficiaries
- Survey to Begin Assessment of HIPC Risk Adjustment Mechanism
- Surviving the Perfect Storm: Impacts of Benefit Reductions and Increased Cost Sharing in a Medicaid Program
- Sustaining Individual Health Insurance Markets Under Community Rating and Open Enrollment
- Testing the Value of Patient-reported Physician Quality Information for Quality Improvement and Consumer Choice
- The Anatomy of ERISA Health Plans: Describing their Basic Structure and Key Areas of Variation
- The Costs and Benefits of Health Information Technology: Computerized Physician Order Entry
- The Dynamics of Health Insurance Coverage: 1996 to 2000
- The Dynamics of Spells Without Health Insurance
- The Economics of Health Information Technology in Physician Organizations
- The Effect of a Physician Gatekeeper on the Cost of, Access to, and Quality of Care in an Employed Population
- The Effect of Expanding Medicaid Coverage to Poor Uninsured Women on Maternal and Infant Health Outcomes
- The Effect of Expanding Medicaid Coverage to Poor Uninsured Women on Maternal and Infant Health Outcomes -- Planning Grant
- The Effect of Hospital Mergers on HMO Hospital Costs and Premiums, 1995-2001
- The Effect of Local Hospital Networks on the Cost and Accessibility of Hospital Services
- The Effect of Managed Care on Treatment Patterns and Health Outcomes Among Traditional Medicare Patients
- The Effect of Price on Health Plan Choices of Retirees
- The Effects of Any Willing Provider Laws
- The Effects of Health Plan Concentration on Hospital Prices, Costs, Capacity, Charity Care, and Outcomes
- The Effects of Managed Care on MRI Adoption and Use
- The Effects of Managed Care Organizations on Government Spending and Health Care Quality: Evidence from California’s Medicaid Mandates
- The Effects of PPOs on Health Care Use and Costs
- The Effects of the New York Health Care Reform Act of 1996 on Health Services Accessibility and Efficiency
- The Emerging Market for Pharmacogenomics and Health Care Competition
- The Fishing Partnership Health Plan: A Model for Reducing the Numbers of the Working Uninsured
- The Impact of Assisted Living Growth on the Market for Nursing Home Care
- The Impact of Managed Behavioral Health Market Share, Public Sector Carve-Outs, and Parity Legislation on Service Utilization for Children and Adolescents: Results from NSAF and CTS
- The Impact of Managed Care on the Appropriateness and Outcomes of Carotid Endarterectomy
- The Impact of Medicaid Managed Care on Prenatal Use and Birth Outcomes
- The Impact of Multiple Consumer Driven Health Plans Beyond Early Adoption: Here to Stay or Market Fad?
- The Impact of Nonprofit Conversions on Community Benefit
- The Impact of Pay for Performance on Hospitals that Care for Minorities and the Poor
- The Impact of Performance Reporting on Consumer and Physician Organization Behavior
- The Impact of Pharmaceutical Formularies on Prescription Drug and Health Care Costs and Utilization
- The Impact of Quality Information on Consumer Plan Choices: Does Health Status Matter?
- The Impact of the Prospective Payment System on Nursing Home Care
- The Impacts of Undocumented Immigrants on the U.S. Health Care System
- The Incidence of Financing National Health Spending
- The Influence of Accreditation on Local Health Department Performance in NC
- The Influence of Managed Care on Physician Scope of Practice
- The Kaiser Permanente Medicare Demonstration: Policy Implications of Offering a Dual Option Benefit Package in an HMO
- The Medicaid Undercount: Real or Perceived Bias in Estimates of Coverage in General Population Surveys
- The Painful Prescription: Revisited
- The Provision and Reporting of Community Benefits by Hospitals: Lessons from Maryland
- The Relationship Between Market Forces and the Cost, Treatments and Outcomes of Medicare AMI Patients
- The Rise in Employer Health Care Costs -- Phase 1
- The Rise in Employer Health Costs -- Phase 2
- The Role of Benefit Design in Enrollment, Use and Spending in State Prescription Drug Assistance Programs for Seniors - Lessons for Medicare
- The Safety Net and Employer-Provided Health Insurance
- The Transformation of Corporate Health Care Purchasing
- The Treatment of Dying Medicare Managed Care Patients: The Role of Social and Economic Factors
- Trauma System Structure and Performance
- Trends in Medigap Insurance and the Impact of Recent Market and Regulatory Changes
- Understanding and Assessing Partnership Connections in Public Health Departments
- Understanding Medical Necessity Decision Making
- Understanding the Resource Allocation Decisions of Public Health Officials in the U.S.
- Uninsured in America: Individual and Community Factors
- Uptake and Impact of Health Risk Appraisals
- Use of Tiered Networks by Employer Sponsored Health Plans
- Using Physician Profiling Software to Evaluate the Practice Efficiency of Physician Specialists
- Utilization Review: Cost Savings and Quality of Care
- Variation in Health Care Cost Growth
- Waiting for Outpatient Care and Choice in Financing
- Web Links
- When Doctors Believe They Are Not Providing Good Care: The Sources of Professional Distress in the American Health Care System
Regulating the Medical Loss Ratio: Implications for the Individual Market
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Vol. XIV, No. 2
April 2011
PrintHow will the minimum medical loss ratio (MLR) provisions of the Patient Protection and Affordable Care Act impact the individual market for health insurance? Jean Abraham, Ph.D, and Pinar Karaca-Mandic, Ph.D., of the University of Minnesota, sought to provide state-level estimates of the size and structure of the individual market for health insurance and to investigate the impact of the new MLR regulation.