Impact of benefit design on cost, use, and health: Literature review
Many employers use cost-sharing in their health insurance benefit designs as a means to reduce costs and, for some designs, encourage improved enrollee health behaviors. This paper summarizes the literature on the impact that three commonly used benefit designs have on cost, use of services, and health status: High-deductible health plans, which include consumer-directed health plans; Value-based insurance design; and …
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An introduction to health care payment reform: Research foundations, implementation, operational strengths and challenges
Policymakers across the country are currently engaged in discussions on how to improve the way that health care providers are paid for the services they deliver. These discussions involve how to shift payment systems away from traditional fee for services and toward rewarding providers that achieve excellent outcomes and deliver value to their patients. While both private and public payers …
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Emerging health insurance products in an era of health reform
At least in part in response to the health coverage changes of the Affordable Care Act (ACA), many health plans are making significant changes to products that they plan to offer in the employer and individual market. While insurers were already moving away from paying for volume and toward paying for value prior to health reform, the ACA has been …
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Employee cost-sharing for health insurance in Michigan and the United States
This brief reports on trends in health insurance premiums and cost-sharing among private-sector employers in Michigan and the United States from 2002 to 2012, and provides a focused look at high-deductible health plans by employer size. From 2002 through 2012, average total premiums in the United States increased by approximately 80 percent. While employer cost-control efforts in the 1990s could …
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Private health insurance in Michigan and the U.S.: Declines in employer-sponsored insurance
More than 500,000 people in Michigan lost their private health insurance from 2008 to 2011. The primary reason for the decline in private insurance in Michigan and in the nation was the erosion of employer-sponsored insurance (ESI), the most common way that Americans get private coverage. From 1999 to 2011, the proportion of individuals covered by ESI decreased by approximately …
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Federally qualified health centers: Are they effective?
In 1964, the Office of Economic Opportunity established federally qualified health centers (FQHCs), which were initially called neighborhood health centers, as part of President Lyndon B. Johnson’s “War on Poverty.” The legislative goals for neighborhood health centers were to: Provide comprehensive, high-quality health services. Be accessible to low-income residents. Be responsive to patient needs. Offer employment, education and social assistance. …
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Federally qualified health centers: An overview
Health center is an all-encompassing term for federally qualified health centers (FQHCs) and FQHC look-alikes; they are a key component of the health care safety net that provided care to more than 20 million Americans in 2011. The Patient Protection and Affordable Care Act of 2010 (ACA) has positioned health centers to play a crucial role in the future health …
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Acute care readmission reduction initiatives: Major program highlights
Beginning October 1, 2012, the Centers for Medicare and Medicaid Services (CMS) began reducing hospitals’ Medicare payments based on 30-day hospital readmission rates. The reductions are based on hospitals’ 30-day risk-adjusted readmission rates relative to national averages. Penalties are imposed for each hospital’s percentage of potentially preventable Medicare readmissions for those conditions. Under the Patient Protection and Affordable Care Act …
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Access to health care in Michigan
Understanding the impact of health care coverage (or the lack of it) on health care access is crucial to improving health care in Michigan. The Center for Healthcare Research & Transformation (CHRT), in partnership with the Institute for Public Policy and Social Research (IPPSR) at Michigan State University, surveyed Michigan residents three times (in 2009, 2010, and 2012) on key …
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Primary care capacity and the Affordable Care Act: Is Michigan ready to expand Medicaid coverage?
Since one of the most immediate questions facing the State of Michigan is whether to expand Medicaid coverage, this issue brief focuses specifically on one area of inquiry—Michigan primary care physicians’ capacity to serve new patients in both Medicaid and the private insurance market. In the fall of 2012, the Center for Healthcare Research & Transformation (CHRT), in partnership with …
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