Policy Brief

Recognizing Destabilization in the Individual Health Insurance Market

July 2010
Bernstein, J.

In June, the HCFO program convened an invitational meeting of experts, including industry analysts, insurers, actuaries, state regulators, federal policymakers, and academic researchers to discuss the medical loss ratio standard in the individual insurance market and provisions within The Patient Protection and Affordable Care Act (PPACA) for addressing any potential market destabilization. This issue brief, “Recognizing Destabilization in the Individual Health Insurance Market,” provides an overview of the meeting discussion.

Geographic Variation and Health Care Cost Growth: Research to Inform a Complex Diagnosis

October 2009
Minott, J.

As policymakers consider various cost containment measures, it is important to understand the drivers of health care costs and growth. This policy brief, "Geographic Variation and Health Care Cost Growth: Research to Inform a Complex Diagnosis," presents preliminary findings from several HCFO grants that examined the factors contributing to costs and cost growth.

Health Care Benefits-Creating the Optimal Design

July 2009
Arnold, S.A. and B.J. Austin

Impact of the Economy on Health Care

Key Findings: 

In the United States, the economy shapes the complex interactions among employment, health coverage, and costs, as well as financial access to care and health outcomes. In economic downturns, few employers drop health coverage or restrict employee eligibility. More commonly, they reduce costs by changing benefits and cost-sharing provisions. Employees in low-wage jobs, those working in small firms, and those in certain industries have been far more likely than others to have been uninsured when they lost their jobs, but this recession is affecting a broader swath of the workforce. Research on the effects of economic cycles on health status is ambiguous. Apart from the current economic downturn, the design and cost of employer-sponsored coverage have also changed over time, and more people are finding work that does not offer health benefits. The recession has kept patients from seeking inpatient and elective services. Physicians and institutional providers are also seeing more patients who cannot pay for their care. Physicians and nurses appear to be re-entering or remaining in the workforce longer than previously planned, and many physicians are establishing new financial arrangements with hospitals and other provider groups to help ensure a steady income. Two dominant structural trends—growth and consolidation—are likely to continue to reshape health care delivery, but reform legislation could significantly affect the speed as well as direction of changes.

August 2009
Bernstein, J.

The great loss of jobs and financial investments resulting from the current economic recession has adversely affected access to employer-sponsored health insurance, provider behavior and workforce trends, and population health. At the same time, a major challenge for researchers and policymakers is to distinguish between these cyclical trends and long-term structural changes to the economy.

The Individual Insurance Market: A Building Block for Health Care Reform?

May 2008
Rogal, D.

Could the individual insurance market serve as a vehicle to significantly expand health coverage? This brief synthesizes findings from several HCFO-supported projects that examine various aspects of the individual insurance market. It highlights lessons learned from experience with the existing individual insurance market and provides a framework for evaluating future policy proposals supporting its expansion. Learn more in the HCFO Policy Brief.

Regional PPOs in Medicare: What Are the Prospects?

February 2007
Pizer, S.D. et al.

What can we learn from recent research and experience related to regional Medicare preferred provider organizations (PPOs)? Steven D. Pizer, Ph.D., and colleagues explored the research on regional Medicare PPOs and examined the future prospects for this type of health plan. Findings predict that regional PPOs would be unlikely to attract large and stable enrollments without very costly ongoing subsidies from the Medicare program. Learn more in the HCFO Findings Brief.


Public Perspectives on Health Delivery System Reforms

June 2009
Bernstein, J.

Developing a fuller understanding of values, preferences, concerns, and misconceptions about health care is critical for policymakers as they shape legislation and seek support for change from the public. The HCFO issue brief "Public Perspectives on Health Delivery System Reforms," by Jill Bernstein, Ph.D., highlights findings from a companion report that provides a detailed analysis of public opinion and health services research studies of public views of health delivery system reforms.

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