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Featured Research

usa_mapMarketplace Renewals: State Efforts to Maximize Enrollment into Affordable Health Plan Options
Sabrina Corlette, Jack Hoadley, Sandy Ahn

This report outlines efforts of six state-based insurance marketplaces (California, Colorado, Kentucky, Maryland, Rhode Island and Washington) to re-enroll consumers into coverage for 2015. The report highlights key changes that consumers need to be aware of, most importantly that 2014 plans may not be the same as those participating in 2015. Due to changes, many consumers could be auto-enrolled in a plan that does not maximize their premium tax credit. Researchers found, however, that some state-based marketplaces have used their flexibility under federal rules to improve consumers' experiences and ensure they get a more accurate determination of premium tax credits. Read More

\ARESUI1_Vol12CentersHpEAllenAdmin Support FilesWebsite imageshealth_insuranceMarketplace Insurance Premiums in Early Approval States: Most Markets Will Have Reductions or Small Increases in 2015
John Holahan, Linda J. Blumberg, Erik Wengle, Megan McGrath, Emily Hayes

This paper provides a detailed analysis of changes in insurers'lowest cost silver Marketplace premiums between 2014 and 2015 in multiple regions in 17 states plus the District of Columbia. In most markets studied, consumers will be able to buy a silver plan at a lower cost than in 2014 or at a small increase (less than 5%). Because competitive dynamics frequently led to different carriers offering the lowest cost silver plan in 2015 than in 2014, consumers seeking the lowest premium may have to switch insurers. Read More

\ARESUI1_Vol12CentersHpEAllenAdmin Support FilesWebsite imagesstethoscope on mapNarrow Networks, Access to Hospitals and Premiums: An Analysis of Marketplace Products in Six Cities
Rebecca Peters, John Holahan

This report examines which hospitals are included within marketplace plans in six cities (Denver; New York City (Manhattan); Portland, Ore.; Providence; Baltimore; and Richmond, Va.). The report finds that nearly all insurers offering plans through the insurance Marketplaces in six cities include many highly ranked hospitals within their provider networks. The report also concludes that every hospital in the cities studied is included in at least one Marketplace plan network. The authors also looked at how the size of a plan's provider network affected the cost of premiums. The report shows that the size of a plan's network is not necessarily tied to premiums. The authors note that although narrowing networks (i.e., limiting the amount of providers covered under a specific plan) generally led to more-competitive, lower-cost premiums, some plans with broader networks had low premiums and some plans with narrow networks had high premiums. Read More

TexasHospitalEbola US Patient Zero: Lessons on Misdiagnosis and Effective Use Of Electronic Health Records
Divvy Upadhyay, Dean F. Sittig, Hardeep Singh

On September 30th, 2014, the US Centers for Disease Control and Prevention (CDC) confirmed the first travel-associated case of US Ebola in Dallas, TX. The events surrounding the care of this first case of Ebola in the US uncovered one of the biggest vulnerabilities of outpatient medicine – misdiagnosis. The case also illustrated how the use of electronic health records (EHRs) can become a potential barrier to making a correct or timely diagnosis. In this paper, we analyze the case, discuss several missed opportunities and outline key challenges facing diagnostic decision-making in EHR-enabled health care. Until recently, diagnostic errors have not received the respect and attention they deserve and have only now begun to find a possible place on the policy agenda. Read more

\ARESUI1_Vol12CentersHpEAllenAdmin Support FilesWebsite imagesOregonFederal and State Policy Toward Association Health Plans in Oregon
Kevin Lucia, Sandy AhnSabrina Corlette

Under the ACA, health insurance sold through an Association Health Plan (AHP) to small employers must meet the same insurance standards of coverage sold in the small-group market. However, research indicates that some AHPs are now claiming single large-group health plan status under ERISA, thus sidestepping the ACA requirements for the small-group market. Through interviews with state regulatory officials, health benefit consultants, association representatives and insurers, this paper examines the experience of the AHP market in Oregon. It finds that the AHP market continues to exist for small employers in Oregon and may be positioned for growth.  Read More



Immediate Issues
The Urban Institute has launched a powerful new research tool, the Health Reform Monitoring Survey (HRMS), to provide timely insights into the Affordable Care Act. From coverage to access to affordability, the HRMS delivers critical data before federal government surveys are available. Read more

Immediate Issues
The Urban Institute is undertaking a comprehensive monitoring and tracking project to examine the implementation and effects of the ACA in ten states. Derived from extensive interviews with state officials and health care stakeholders, this series of reports documents each state’s progress in establishing a health insurance marketplace, implementing insurance reforms, and preparing for an expansion of Medicaid. Read more

New interactive map shows wide local variation in numbers of poor uninsured Americans who would be eligible for Medicaid under the ACA

mapState plans for expanding Medicaid under the ACA

Immediate Issues
The reforms implemented in Massachusetts in 2006 became the template for the Affordable Care Act. The Urban Institute has conducted numerous studies of Massachusetts' ambitious effort to transform its health care system. Read more

Health Reform Modeling Capacity

The UI Health Policy Center staff has developed a sophisticated microsimulation model that is used to estimate the impacts of health reforms and to inform policy design choices at the state and national levels.  Learn more about the HIPSM model.
All HPC Research
The ACA's Basic Health Program Option: Federal Requirements and State Trade-Offs (Policy Briefs/Health Policy Briefs)
Stan Dorn, Jennifer Tolbert
Publication Date: December 12, 2014
Public Education, Outreach and Application Assistance (Research Report)
Stan Dorn
Publication Date: December 11, 2014
Diagnosis in 'Digital India' (Opinion)
Divvy Upadhyay, Additional Authors
Publication Date: November 24, 2014

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