Abstract：
OBJECTIVE:To investigate how changes in insurer participation and composition as well as state policies affect health plan affordability for individual market enrollees. DATA SOURCES:2014-2019 Qualified Health Plan Landscape Files augmented with supplementary insurer-level information. STUDY DESIGN:We measured plan affordability for subsidized enrollees using premium spreads, the difference between the benchmark plan and the lowest cost plan, and premium levels for unsubsidized enrollees. We estimated how premium spreads and levels varied with insurer participation, insurer composition, and state policies using log-linear models for 15 222 county-years. PRINCIPAL FINDINGS:Increased insurer participation reduces premium levels, which is beneficial for unsubsidized enrollees. However, it also reduces premium spreads, leading to lower plan affordability for subsidized enrollees. States responding to cost-sharing reduction subsidy payment cuts by increasing only silver plans' premiums increase premium spreads, particularly when premium increases are restricted to on-Marketplace silver plans. The latter approach also protects unsubsidized, off-Marketplace enrollees from experiencing premium shocks. CONCLUSIONS:Insurer participation and insurer composition affect subsidized and unsubsidized enrollees' health plan affordability in different ways. Decisions by state regulators regarding health plan pricing can significantly affect health plan affordability for each enrollee segment.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Drake C,Abraham JMdoi
10.1111/1475-6773.13190subject
Has Abstractpub_date
2019-08-01 00:00:00pages
730-738issue
4eissn
0017-9124issn
1475-6773journal_volume
54pub_type
杂志文章abstract：OBJECTIVE:Microsimulation was used to assess the financial impact on hospitals of a surge in influenza admissions in advance of the H1N1 pandemic in the fall of 2009. The goal was to estimate net income and losses (nationally, and by hospital type) of a response of filling unused hospital bed capacity proportionately a...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12041
更新日期：2013-04-01 00:00:00
abstract：BACKGROUND:In 2004, the State of Wisconsin introduced a change to their Medicaid Policy allowing medical care providers to be reimbursed for fluoride varnish treatment provided to Medicaid enrolled children. OBJECTIVE:To determine the extent by which a state-level policy change impacted access to fluoride varnish trea...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2009.00975.x
更新日期：2009-08-01 00:00:00
abstract：OBJECTIVE:To produce cost estimates of proposed health insurance benefit mandates for the California legislature. DATA SOURCES:The 2001 California Health Interview Survey, 2002 Kaiser Family Foundation/Health Research and Education Trust California Employer Health Benefits Survey, Milliman Health Cost Guidelines, and ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00518.x
更新日期：2006-06-01 00:00:00
abstract：OBJECTIVES:In response to rising demand and increased costs for home care services for frail elderly and disabled Medicaid clients, New York City implemented cluster care, a shared-aide model of home care. Our objective: to evaluate the effects of cluster care on home care hours and costs, client functioning, depressiv...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1996-10-01 00:00:00
abstract：OBJECTIVE:To examine implementation of the Qualified Medicare Beneficiary (QMB) and Specified Low-Income Medicare Beneficiary (SLMB) programs, enacted in 1988. The article summarizes the origin of the QMB and SLMB programs, describes what we have learned about QMB and SLMB enrollment in state Medicaid programs and, des...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：2000-04-01 00:00:00
abstract：OBJECTIVE:To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. DATA SOURCES/STUDY SETTING:Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01280.x
更新日期：2011-10-01 00:00:00
abstract：OBJECTIVE:To examine the impact of the Short Stay Transfer Policy (SSTP) on practice patterns. DATA SOURCES:This study uses data from the Centers for Medicare and Medicaid Services Medicare Provider Analysis and Review (MEDPAR) file, Home Health Standard Analytical File, 1999 Provider of Service file, and data from th...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00606.x
更新日期：2007-02-01 00:00:00
abstract：OBJECTIVE:To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. DATA SOURCES:Secondary analysis of 2003-2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly avail...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01206.x
更新日期：2011-04-01 00:00:00
abstract：OBJECTIVE:To determine the effect of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on birth outcomes. DATA SOURCE:The Child Development Supplement (CDS) of the Panel Study of Income Dynamics (PSID). The PSID provides extensive data on the income and well-being of a representative sa...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01115.x
更新日期：2010-08-01 00:00:00
abstract：:This article reports an evaluation of the impact of three administrative technologies--Admission Scheduling (AS) Systems, Outpatient Surgery (OPS) Programs, and Preadmission Testing (PAT) Programs--on the number of acute care beds required by a hospital. The evaluation mechanism reported here is called the ADTECH Comp...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1985-04-01 00:00:00
abstract：OBJECTIVE:To assess the impact of out-migration of nurses on the health systems in sub-Saharan Africa (SSA). SETTING:The countries of SSA. DESIGN AND METHODS:Review of secondary sources: existing publications and country documents on the health workforce; documents prepared for the Joint Learning Initiative Global Hu...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00712.x
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To assess relationships between changes in Medicare Advantage (MA) payment rates and Medicare beneficiary hospitalizations and to simulate the effects of scheduled payment cuts on ambulatory care sensitive (ACS) and elective hospitalization rates. DATA:State Inpatient Database discharge abstracts from Arizon...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2011.01275.x
更新日期：2011-10-01 00:00:00
abstract：OBJECTIVE:An ecological framework is proposed for assessing factors important to consider in allocating funds to promote sound performance of interorganizational programs. DATA SOURCE/STUDY SETTING:This framework is used to examine the first generation of Community Clinical Oncology Programs (CCOPs) funded by the Nati...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1993-04-01 00:00:00
abstract：:A multitrait - multimethod design was employed to assess the construct validity of three commonly used methods for assessing patient compliance: physiological assessments (e.g., blood chemistries), ratings by health professionals, and patient self-reports. Subjects were patients receiving ambulatory hemodialysis treat...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1984-04-01 00:00:00
abstract：OBJECTIVE:. To examine the effect of premiums and benefits on the health plan choices of older enrollees who choose Federal Employees Health Benefits Program (FEHBP) health plans as their primary payer. DATA SOURCES:Administrative enrollment data from the Office of Personnel Management (OPM) and plan premiums and bene...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00580.x
更新日期：2006-10-01 00:00:00
abstract：PURPOSE:We report the validation of an instrument to measure mistrust of health care organizations and examine the relationship between mistrust and health care service underutilization. METHODS:We conducted a telephone survey of a random sample of households in Baltimore City, MD. We surveyed 401 persons and followed...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2009.01017.x
更新日期：2009-12-01 00:00:00
abstract：OBJECTIVE:To determine whether Medicaid managed care is associated with lower hospitalization rates for ambulatory care sensitive conditions than Medicaid fee-for-service. We also explored whether there was a differential effect of Medicaid managed care by patient's race or ethnicity on the hospitalization rates for am...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2005.00340.x
更新日期：2005-02-01 00:00:00
abstract：OBJECTIVE:To determine if sufficient nurse staffing reduced in-hospital fractures in acute care hospitals. DATA SOURCES/STUDY SETTING:The Japanese Diagnosis Procedure Combination inpatient (DPC) database from July 2010 to March 2014 linked with the Surveys for Medical Institutions. STUDY DESIGN:We conducted a retrosp...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12529
更新日期：2017-06-01 00:00:00
abstract：:A decision to add a new treatment program has widespread and long-lasting implications for both the patient and the organization. Information about the interactions among the institution, the patient, and the treatment modality are seldom available. Cognitive rehabilitation is a relatively new treatment modality that ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：OBJECTIVE:To examine the implications of serious and chronic health problems on the willingness of enrollees to switch health plans if they are dissatisfied with their current arrangements. DATA SOURCE:A large (20,283 respondents) survey of employees of three national corporations committed to the model of managed com...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1999-06-01 00:00:00
abstract：OBJECTIVES:To test whether concordance or discordance of patient participation between patients and physicians is associated with higher satisfaction, and to examine the effects of patients' and physicians' participatory styles on patients' satisfaction with their physicians. DATA:Data collected in the Texas Tech 5000...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00233.x
更新日期：2004-04-01 00:00:00
abstract：OBJECTIVE:To assess the value of a novel composite measure for identifying the best hospitals for major procedures. DATA SOURCE:We used national Medicare data for patients undergoing five high-risk surgical procedures between 2005 and 2008. STUDY DESIGN:For each procedure, we used empirical Bayes techniques to create...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01407.x
更新日期：2012-10-01 00:00:00
abstract：OBJECTIVE:To test the hypothesis that a greater commitment to strategic adaptation, as exhibited by more extensive implementation of a subacute/rehabilitation care strategy in nursing homes, will be associated with superior performance. DATA SOURCES:Online Survey, Certification, and Reporting (OSCAR) data from 1997 to...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00649.x
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To develop a taxonomy of governing board roles in U.S. hospitals. DATA SOURCES:2005 AHA Hospital Governance Survey, 2004 AHA Annual Survey of Hospitals, and Area Resource File. STUDY DESIGN:A governing board taxonomy was developed using cluster analysis. Results were validated and reviewed by industry exper...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00835.x
更新日期：2008-08-01 00:00:00
abstract：OBJECTIVE:The Standard Gamble (SG) technique is recommended for measurement of individuals' preferences under uncertainty and to express the outcome of different therapeutic choices in utility values to be used in clinical decision analysis and health program evaluation. The article alerts users of this technique to pr...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1994-06-01 00:00:00
abstract：:The growth of unionization among hospital workers was sharply accelerated by the 1974 amendments to the National Labor Relations Act covering voluntary hospital workers. With continuing inflationary pressures in the hospital sector, the cost implications of the recent and projected growth of hospital unions is of some...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1984-12-01 00:00:00
abstract：OBJECTIVE:To describe the landscape of state antitrust activity and review related research and policy issues. In particular, to examine state laws that attempt to immunize mergers among healthcare providers from state and federal antitrust prosecution and consent decrees issued by state attorneys general permitting he...
journal_title：Health services research
pub_type： 杂志文章,评审
doi：
更新日期：1998-12-01 00:00:00
abstract：OBJECTIVE:To examine the association between dialysis facility chain affiliation and patient mortality. STUDY SETTING:Medicare dialysis population. STUDY DESIGN:Data from the United States Renal Data System (USRDS) were used to identify 3,601 free-standing dialysis facilities and 34,914 Medicare patients' incidence t...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01219.x
更新日期：2011-06-01 00:00:00
abstract：OBJECTIVE:To explore and understand approaches to user engagement through investigating the range of ways in which health care workers and organizations accommodated the introduction of computerized physician order entry (CPOE) and computerized decision support (CDS) for hospital prescribing. STUDY SETTING:Six hospita...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12581
更新日期：2017-10-01 00:00:00
abstract：OBJECTIVE:To review two indirect methods, geocoding and surname analysis, for estimating race/ethnicity as a means for health plans to assess disparities in care. STUDY DESIGN:Review of published articles and unpublished data on the use of geocoding and surname analyses. PRINCIPAL FINDINGS:Few published studies have ...
journal_title：Health services research
pub_type： 杂志文章,评审
doi：10.1111/j.1475-6773.2006.00551.x
更新日期：2006-08-01 00:00:00
