All Articles In 'Employer Health Plans'
Comparative Effectiveness Research: How Agency for Healthcare Research and Quality Spent $474 Million in ARRA Funds
As part of the $1.1 billion provided to the Department of Health and Human Services (HHS) earmarked for comparative effectiveness research (CER) under the American Recovery and Reinvestment Act (ARRA or Recovery Act) of 2009, $474 [...]
Health Insurance Administrative Expenses: Details on Administrative Expenses of Health Plans in Large Group, Small Group, and Individual Markets
Health insurance plans are required to report their administrative expenses. For health plans in the for the large group, small group, and individual insured markets, an new report from Milliman details insurers’ administrative expenses in five [...]
Health Plans and Quality Improvement Reporting Under the Affordable Care Act: Recommendations for Implementing Reporting of Quality Improvement Strategies
The Affordable Care Act (ACA) requires the Centers for Medicare and Medicaid Services (CMS) issue employer group health plan quality improvement reporting requirements. Reports shall cover specified quality improvement activities regarding plan or coverage benefit and [...]
Essential Health Benefits: Preliminary Analysis of Essential Health Benefits and Potential Benchmark Health Benefit Plans for Virginia
The Patient Protection and Affordable Care Act (ACA) requires benefit plans offer a minimum set of essential health benefits. Those include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use [...]
Guaranteed Issue and Community Rating Reforms: Actuarial Analysis of Impact on Individual Health Insurance Markets
In previous research, Milliman, one of the nation’s top actuarial firms, provided an overview of the impact made by guaranteed issue and community rating reforms on the health insurance markets within eight states in the 1990s. Retained [...]
Individual Mandate: Projecting the Strength of the Individual Mandate on Health Insurance Participation
The Affordable Care Act (ACA) requires that most Americans have health insurance that meets minimum federal requirements. Under the controversial mandate, starting in 2014, most individuals under 65 must purchase minimum essential health insurance coverage or [...]
Healthcare Quality and Cost: Engaging Employers as Change Agents in Lowering Costs and Improving Quality
As the second-largest health care service purchaser, employers have an opportunity to use their substantial market leverage as a means to augment quality. If mobilized and motivated, employers could act as a key change agent by [...]
Prevention: Variation in Cost of Diabetes, Cancer, and Cholesterol Screenings
More than 75 percent of total health care costs cover preventable chronic conditions like diabetes, heart disease, and cancer. The Affordable Care Act (ACA) mandates that self-insured employers and health plans provide common, evidence-based wellness screenings [...]
Medicare Secondary Payer: Options for Improving Medicare Payment Recoveries from Individual, Non-Group Health Plans
The Centers for Medicare and Medicaid Services (CMS), charged with protecting Medicare’s fiscal integrity, works to recover payments made by Medicare that are the responsibility of non-group health plans. While CMS has not always been aware [...]
Employer Sponsored Health Insurance: Changes in Health Premiums and Employee Contributions for Health Insurance
The Agency for Healthcare Research and Quality (AHRQ) has released interesting new data on increases in premiums and employee contributions for employer-sponsored health insurance coverage (ESI) from 2001 to 2009. Types of Employer-Sponsored Health Insurance Coverage: [...]
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