Insurance Market Reform

With the proliferation of narrow network plans on the new marketplaces, consumers are being steered to plans that offer lower prices but limited choice. Insurers may offer narrow network plans to attract price-sensitive consumers who are willing to tradeoff network breadth for less costly premiums. Yet, anecdotal evidence suggests that the resulting provider networks may be narrower than expected, leaving consumers vulnerable to the financial burden of out-of-network care. This free webinar on May 19 at 1:00 p.m. EDT will address the potential policy responses to the growth of narrow network plans and will identify where more evidence is needed to inform researchers and decision makers.

On November 17, State Coverage Initiatives hosted a webinar that explored the pros and cons of the Basic Health Program. This option under the Affordable Care Act lets states provide their low-income residents ineligible for Medicaid with coverage that may be more affordable than subsidized health plans in the exchange.

Value-Based Purchasing and Consumer Engagement Strategies in State Employee Health Plans, a SCI report written by Bailit Purchasing, LLC, is a purchaser guide that lays out concise descriptions of two principal means for improving the value that states can gain through administering State Employee Health Plans (SEHPs): value-based purchasing and consumer engagement. 

Rising insurance premiums and shortages of primary care physicians are two trends that have focused state policymakers’ attention on the functioning of their local health care marketplaces. In addition, many state officials have expressed concern over the unprecedented number of hospital mergers during the last decade.