Select Empirical Realities of the Individual Health Insurance Market as Structured by the Affordable Care Act

With the recent filing of the American Health Care Act (AHCA) to ‘repeal and replace’ Obamacare (that I’ve discussed previously on this blog), it is useful to ensure that everyone has a clear understanding of the scale of the potential impact. While the AHCA (and the ACA, even more so) did lots of different things, … Read moreSelect Empirical Realities of the Individual Health Insurance Market as Structured by the Affordable Care Act

The Bill to ‘Repeal and Replace’ Obamacare May Break the Individual Health Insurance Market

Congressional Republicans have unveiled their bill to ‘repeal and replace’ Obamacare.  The bill includes provisions that would adversely affect older Americans and place financial strains on states and hospitals, and may even break the individual health insurance market.  On the plus side, it appears to have little political support, so may be ‘dead on arrival.’ … Read moreThe Bill to ‘Repeal and Replace’ Obamacare May Break the Individual Health Insurance Market

Nurse Practitioners Should Be Allowed Full Independent Practice

Nurse practitioners can provide safe, high-quality primary care, independent of physician supervision.  The data is clear.  Only politics prevents this expansion of access. Introduction The dentist sat at the witness table.  In her left hand, she held aloft a replica of a human skull, and in her right, a syringe with a comically large needle.  … Read moreNurse Practitioners Should Be Allowed Full Independent Practice

The Mechanics and Implications of High Risk Pools as a Potential Element of National Health Care Reform

Health insurance high risk pools have been mentioned by President Trump and Congressional Republicans as a potential element of their Obamacare replacement plans, but they are not a new idea.  Past experience with high risk pools suggests that they can help to address issues of affordability, stability, and fairness in the individual health insurance market.  … Read moreThe Mechanics and Implications of High Risk Pools as a Potential Element of National Health Care Reform

Be Careful What You Ask For… Considerations for State Policymakers Regarding Medicaid Block Grants

Obamacare isn’t the only health care program being targeted by President Trump and congressional Republicans.  Medicaid, the health care financing program for low-income Americans – jointly funded by the federal government and the states – has been identified as a program in need of dramatic reform.  Although proposed Republican reforms to the program differ, common … Read moreBe Careful What You Ask For… Considerations for State Policymakers Regarding Medicaid Block Grants

On the Importance of State-Level e-Health Advocacy

Due to the amount of health care regulation at the state level, there is a significant opportunity to improve the regulatory environment for e-health technologies and services by engaging in state-level e-health advocacy.  In Texas, the Texas e-Health Alliance (TeHA) has been doing just that for the last 6 years and has achieved a number … Read moreOn the Importance of State-Level e-Health Advocacy

Telemedicine is Becoming Mainstream, but Opportunities to Increase Utilization Remain

Private health insurance companies are increasingly paying for telemedicine services, but public payers like Medicaid and Medicare continue to include restrictions, while other opportunities remain to improve the telemedicine ecosystem through more streamlined regulation and provider education. I recently had the opportunity to moderate a panel on telemedicine at a conference focused on health care … Read moreTelemedicine is Becoming Mainstream, but Opportunities to Increase Utilization Remain

Zika-Related Microcephaly Will Have an Impact on State Medicaid Expenditures

In addition to the individual health impacts of the Zika virus, the subsequent cases of microcephaly will have an impact on families and state Medicaid programs.  The first locally transmitted case of the Zika virus in Texas was identified earlier this week in Brownsville, which lies at the state’s southern tip.  While not unexpected, this … Read moreZika-Related Microcephaly Will Have an Impact on State Medicaid Expenditures

What are the Implications of the Election on Health Information Technology?

In the near term, uncertainty in federal policy regarding health care in general, and health information technology (HIT) in particular, are likely to cause health care organizations to delay major new investments, including those in HIT.  In the longer term, trends in value-based purchasing, through both public programs and private payers, are likely to increase … Read moreWhat are the Implications of the Election on Health Information Technology?

Death Spiral or Market Adjustment?

Significant recent increases in premiums in the individual health insurance market have created a debate over whether these premium increases are the beginning of a ‘death spiral’ for this market, or just an appropriate market adjustment.  The fact that premiums are higher for employer-sponsored insurance than in the individual health insurance marketplaces suggests that recent … Read moreDeath Spiral or Market Adjustment?