Entries by David Anderson

A response to AER re evaluating by Excel

I recently read an interesting but I think incomplete and less than pragmatic paper in the American Economic Review by Fang and Gong. In that paper they use Medicare Part B claims data to advance what they argue is a good first pass claims fraud detection methodology. They seek to identify individual National Provider Identification […]

CSR Cash day

Today was the day when Cost Sharing Reduction (CSR) subsidies were to be paid for insurers. The CSR obligation was incurred by the federal government on February 1st for all CSR qualified policies in effect for the month of February. There was some worry (mine especially) that given the former House vs Burwell case that […]

Selling three ways across state lines

When I worked at UPMC Health Plan, our core business area was Western Pennsylvania with a slow amorphous growth to the eastern portion of the state. We were a Pennsylvania focused company but we would sell across state lines. Some years we sold Medicare Advantage in West Virginia and Ohio and other years, we would […]

Proposed Rule and Cassidy-Collins

I chased my kids through a museum yesterday.  Part of the day had them go through a butterfly’s life cycle and there were parts where grown-ups were just too big for it.  So I stepped aside and thought about health policy.  Specifically the proposed rule that widens the actuarial value bands from +/-2 to -4/+2. […]

Competency and conscience

I want to highlight two events from yesterday.  First James Joyner’s response to the mass resignation of the membership of the President’s Advisory Commission on Asian Americans and Pacific Islanders:   That’ll teach him. Now he’ll have to pack the commission with people hand-picked by Steve Bannon. https://t.co/1jGxMx780u — James Joyner (@DrJJoyner) February 17, 2017 […]

A question for Doug J

Yesterday, Politico highlighted my post on the distributional impacts of expanding actuarial bands. I like that piece a lot. It gets into the weeds very quickly on a relevant policy discussion and illuminates some of the trade-offs and quirks of the structure. Politico highlights a couple of writers a day. These links and names get […]

Governing is hard

The Republican Party has an ACA problem.  The ACA is deficit reducing.  Most of that was because it raised taxes on upper income families and cut back Medicare reimbursement rates for Medicare Advantage.  The Republicans are ideologically indifferent to cutting back Medicare Advantage reimbursement rates especially as Medicare Advantage has continued to grow in popularity so […]