Journal Publication

Health Affairs: States With Stronger Health Insurance Rate Review Authority Experienced Lower Premiums In The Individual Market In 2010–13

healthaffairslogoPress Release: “A new study published today [August 3, 2015] found state-level prior approval authority over individual market health insurance rates were in effect from 2010 to 2013 was associated a 10 percentage point lower rate of increase in premiums.The research was published in the August issue of Health Affairs, and was conducted at the University of Minnesota School of Public Health in collaboration with the University of California, Berkeley School of Public Health.”

“Study authors collected rate review authority and anticipated loss ratio requirements from each state and the District of Columbia by examining statutes, regulations, and bulletins and distributed a questionnaire to each state and the District of Columbia.

‘Our findings suggest that rate review by states with prior approval authority may be a viable option for moderating the growth in health insurance premiums,’ said Richard Scheffler, Ph.D., principal investigator and distinguished professor of health economics and public policy at UC Berkeley. ‘Given the massive rate increases in premiums being proposed this year, our results could not be timelier.'”

The full press release can be read here.

The full article, published in the August issue of Health Affairs, can be read here.

Review of Industrial Organizations: Market Power, Transactions Costs, and the Entry of Accountable Care Organizations in Health Care

 

11151An article by Petris Center Director Richard M. Scheffler and Christopher Whaley, H. E. Frech III, Benjamin R. Handel, Liora Bowers, and Carol J. Simon was published in the Review of Industrial Organizations journal on July 15, 2015.

Abstract

“ACOs were promoted in the 2010 Patient Protection and Affordable Care Act (ACA) to incentivize integrated care and cost control. Because they involve vertical and horizontal collaboration, ACOs also have the potential to harm competition. In this paper, we analyze ACO entry and formation patterns with the use of a unique, proprietary database that includes public (Medicare) and private ACOs. We estimate an empirical model that explains county-level ACO entry as a function of: physician, hospital, and insurance market structure; demographics; and other economic and regulatory factors. We find that physician concentration by organization has little effect. In contrast, physician concentration by geographic site—which is a new measure of locational concentration of physicians—discourages ACO entry. Hospital concentration generally has a negative effect. HMO penetration is a strong predictor of ACO entry, while physician-hospital organizations have little effect. Small markets discourage entry, which suggests economies of scale for ACOs. Predictors of public and private ACO entry are different. State regulations of nursing and the corporate practice of medicine have little effect.”

The full journal article can be accessed here.

New Studies Assess Accountable Care Organizations (ACOs) after the Passage of the Affordable Care Act

Screen Shot 2015-08-03 at 2.11.52 AM“‘Accessing Accountable Care Organizations: Cost, Quality, and Market Power,’ a special issue of the Journal of Health Politics, Policy and Law (volume 40, issue 4), is an in-depth look at accountable care organizations (ACOs): networks of hospitals, physicians or other health care providers that share financial and medical responsibility for the coordinated care of a patient.

Now numbering over 700 throughout the United States, ACOs were rare prior to the passage of the Affordable Care Act. Their increased presence has sparked a debate about issues important to patients, providers, and taxpayers throughout the nation. ‘Integrated health delivery systems and accountable care organizations are becoming ubiquitous in our health care system,’ Richard Scheffler, special issue editor, states. ‘They potentially could bend the cost curve and improve the quality of care, but they also present a threat to the competitiveness of health care markets.'”

Read the full press release here.

The full journal can be found here.