Entries by David Anderson

Insurers leaving the Exchanges

Some drop-outs are more important than others. We’ve seen some insurance companies drop out of the Exchanges this year. My take on a New York drop-out was that it was good news as the enrollment was miniscule and the products were not reasonably priced. The insurer was just too small to compete and there was […]

Pioneering bonuses and integration

One of the big system reforms embedded within PPACA is a move towards payments for quality instead of quantity.  The Medicare payment structure is changing at the pilot project level.  The formation of Accountable Care Organizations (ACOs) are designed to shift some of the risk of high cost care away from the government and other […]

Risk adjustment and the Red Queen race

The three R’s of Obamacare are Reinsurance, Risk Corridors and Risk Adjustment. These three steps are attempts to stabilize the individual on-Exchange marketplace by changing the incentive structure of insurance companies. Reinsurance and Risk Corrdidors are short term plans while Risk Adjustment is a long term program. We’ll talk a lot about Risk Adjustment today, but […]

Invisible primaries, influence and Iraq

Jonathan Bernstein describes the invisible primary as being far more important than the visible primaries of people voting as the invisible primary sets the conditions for the visible primary.  He sees the selectorate involved in the invisble primary as such: Remember, we’re in the “invisible primary” stage, in which party actors politicians, party-aligned groups, campaign […]

Healthcare 2020

Last week, I made a comment at the end of a post about my son and his first asthma attack: A high first dollar health plan (which is where the entire US system is going) Very valued and insightful commenter JL asked a very good set of questions about my thoughts on the intermediate future […]