Entries by David Anderson

HCCI data limitations

The Health Care Cost Institute is a valuable data resource. It collects data from four major commercial insurers: Kaiser, United Healthcare, Humana and Aetna. This data is for commercial/ESI and it provides a good but uneven insight into pricing variation in the individual, group and Medicare Advantage spaces. Usually we just see Medicare Fee for […]

Commercial and Medicare Rates

Bob Herman of Axios was paying attention to the other important healthcare related CBO report yesterday: There was another CBO health care release today. Similarly important/riveting. It's all about physician prices: https://t.co/ffUFwdQNt2 — Bob Herman (@bobjherman) June 27, 2017 This is an important report as it illustrates the spread between Medicare and Commercial rates. Unfortunately […]

A scheme in a no MLR world

Part of the Senate bill invites states to file waivers that basically would allow a state to do whatever it wanted. One of the elements of the ACA that can be waived is the requirement that insurers spend at least 80% of the premium dollars on claims. That is known as the Medical Loss Ratio […]

BCRA creates even more confused markets

The Senate’s Better Care Reconciliation Act (BCRA)[1] is a significant modification to the current Patient Protection and Affordable Care Act (PPACA)[2] exchange structure in a variety of ways.  One major change is the designation of the benchmark plan which determines the level of subsidy that the federal government provides to individual buyers on a health […]