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How Exchange Market Size Matters
It's an incorrect, but convenient, shorthand to say that the Affordable Care Act establishes state-based health insurance markets. Actually, the markets are finer grained than that.
It’s an incorrect, but convenient, shorthand to say that the Affordable Care Act establishes state-based health insurance markets. Actually, the markets are finer grained than that. Each state can decide the number and configuration of coverage regions that will exist within its borders, and insurers must elect whether to offer plans on a region-by-region basis. Across a region, for a given plan, premiums and benefits are fixed.
These within-state regions are the real markets. Do their sizes and configurations matter?
According to work by Michael Dickstein and colleagues, released in an NBER working paper, they do. This is intuitive. If there is some fixed cost of entry that’s largely independent of the number of potential consumers (market size), then an insurer should be more willing to enter a bigger market vs. a smaller one. (Such fixed costs could include those for marketing or for customer service centers, for instance.) Maybe bigger markets are better for competition and consumers.
Read more at AcademyHealth: http://bit.ly/1cAbSDO
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
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Standard Criteria for Loss of Ambulation Needed in DMD
April 19th 2024A recent study suggests the differences between ambulation definitions for patients with Duchenne muscular dystrophy (DMD) can impact the identification of ambulant vs nonambulant individuals, and standard criteria across settings are needed.
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