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SCI keeps its Federal Reform Resources webpage up-to-date with the most recent information from the states, the federal government, and health policy organizations in an effort to guide our readers through the health reform implementation process. We know there are several places to go for the latest health reform resources, and we thank you for using SCI as one of your trusted sources. Here are some of the most recent resources that can be found on our Federal Reform page:

Insurance Market Reforms

Average Exchange Premiums Rise Modestly in 2015 and Variation Increases
Avalere Health
In this new analysis, Avalere Health finds that average proposed premiums for individual market exchange plans will increase modestly in 2015, based on initial rate filings in nine states. Across the nine-state group, average monthly silver premiums will rise by 8 percent from $324 in 2014 to $350 in 2015. In particular, average monthly silver premiums will rise in eight of the states, ranging from a 2.5 percent increase in Rhode Island to a 16 percent average increase in Indiana. Oregon was the only state examined in which average premiums will decrease for 2015—falling 1.4 percent or $3 per month.

Deciphering the Data: Health Insurance Rates and Rate Review
University of Pennsylvania’s Leonard Davis Institute of Health Economics
Health insurers participating in the new Marketplaces are filing rates for 2015 during the next few months. Some states have already released data on proposed rates. There is substantial economic, policy, and political interest in the magnitude of proposed rate changes. This brief provides background for understanding the economic drivers of proposed rates, state and federal rate review authority, the effects of rate changes on Marketplace enrollees and federal spending on premium credits, and the economic and political dynamics of the rate review and approval process.

Insurance Exchanges

Premium Affordability, Competition, and Choice in the Health Insurance Marketplace, 2014
Department of Health and Human Services
As an initial step to understanding how the Health Insurance Marketplace is working in its first year of operation, this report provides an overview of health insurance plan premiums available in the Marketplace and the important role of the advanced premium tax credit (“tax credit”) in helping families afford coverage. The report analyzes data on the change in the premium cost associated with the tax credit for plans selected through the Federally-facilitated Marketplace during the initial open enrollment period. It also examines over 19,000 Marketplace plans for 2014 within the four metal levels (bronze, silver, gold, and platinum) for each of the 501 rating areas across 50 states and the District of Columbia. The analysis shows how differences in plan and market characteristics are associated with differences in premiums across the nation.

Affordable Care Act Dashboard
Breakaway Policy Strategies
To guide stakeholders through the overwhelming volume of recent developments and upcoming issues for the Affordable Care Act (ACA), Breakaway offers this ACA Dashboard, providing a visual and concise overview of key ACA updates in one place. Breakaway will provide comprehensive updates to the ACA Dashboard each month, covering the latest developments and offering a snapshot of Breakaway's health insurance exchange data and analysis.

Medicaid

Measuring Medicaid/CHIP Enrollment Progress Under the Affordable Care Act
Urban Institute
The Centers for Medicare and Medicaid Services recently released information on how many additional people were enrolled in coverage through Medicaid and CHIP since October 1, 2013, when the first open-enrollment period for the new health insurance marketplaces was launched, through April 2014, the most recent information available. This brief assesses how reported changes in enrollment in Medicaid and CHIP during this period compare with changes in Medicaid/CHIP enrollment projected by the end of 2016 by the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM).

Strategic Planning

The ACA and America's Cities: Fewer Uninsured and More Federal Dollars
Urban Institute
This report estimated the effect of the Affordable Care Act (ACA) on 14 large and diverse cities: Los Angeles, Chicago, Houston, Philadelphia, Phoenix, Indianapolis, Columbus, Charlotte, Detroit, Memphis, Seattle, Denver, Atlanta, and Miami. For each city, the researchers estimated changes in health coverage under the ACA, particularly the resulting decline in the uninsured. The report also includes an estimate of the additional federal spending on health care that would flow into these cities. For cities in states that have not expanded Medicaid eligibility, the report provides estimates both with and without expansion.

Mitigating the Effects of Churning Under the Affordable Care Act: Lessons from Medicaid
The Commonwealth Fund
Churning in health insurance enrollment has long been a problem for many people, as changes in their life circumstances create a cycle of losing and regaining eligibility for coverage. For millions of Americans, the ACA means an end to the worst form of churning—the loss of insurance coverage entirely. However, the law also introduces a new risk: individuals and families with changes in income may move back and forth between Medicaid and subsidized marketplace coverage. This issue brief examines a variety of strategies that states can employ to ease coverage transitions and help keep people insured at all times.

Survey of Non-Group Health Insurance Enrollees
Kaiser Family Foundation
This survey is the first in a series of Kaiser Family Foundation surveys taking a closer look at the entire non-group market. This first survey was conducted from early April to early May 2014, after the close of the first ACA open enrollment period. It reports the views and experience of all non-group enrollees, including those with coverage obtained both inside and outside the Exchanges, and those who were uninsured prior to the ACA as well as those who had a previous source of coverage (non-group or otherwise). The survey found that nearly six in ten Exchange enrollees were previously uninsured, and the majority of non-group enrollees give positive ratings to their new insurance plans and the value of those plans.

Delivery System Redesign

The State of Value-Based Reimbursement and the Transition from Volume to Value in 2014
McKesson Health Solutions
The health care affordability crisis is causing unprecedented changes in the health care landscape, the most significant of which is the transition from the current volume-based model to myriad models based on measures of value. This white paper outlines the challenges involved with performing population-level analyses, developing cost accounting and profitability analyses across care settings, evaluating care episodes and integrating quality data. It explores the limitations of targeted software solutions to provide cross-enterprise insights. Finally, it provides advice for healthcare executives regarding how to approach gathering quality and cost-related data and leverage technology and analytical expertise to drive risk-based contract success.

CHIPRA Quality Demonstration States Help School-Based Health Centers Strengthen Their Medical Home Features
Agency for Healthcare Research and Quality
The Agency for Healthcare Research and Quality has published the eighth Evaluation Highlight from the CMS-funded CHIPRA Quality Demonstration Grant Program. This Highlight focuses on how Colorado and New Mexico have helped school-based health centers (SBHCs) strengthen their patient-centered medical home (PCMH) features. It describes what motivated these states and SBHCs to adopt the PCMH model and how other states can support SBHCs in becoming medical homes. Body text here.