http://www.lahealthaction.org/index.php/library/index en vcalderon@lahealthaction.org Copyright 2012 2012-05-16T22:04:34-08:00 http://lahealthaction.org/index.php/library/full_entry/3957/ Report providing the 2012 Milliman Medical Index measurements of 14 American cities, including Los Angeles, on total cost of healthcare for a typical family of four covered by a preferred provider plan (PPO). The report finds that family healthcare spending in 2012 reached a new high averaging $20,728, a cost roughly equivalent to that of a basic mid-size sedan. The report provides scenarios detailing potential outcomes of the Supreme Court ruling on ACA and how the different rulings may effect future PPO payments for Americans. Health Insurance and Coverage Programs, Employment-based Health Insurance, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care 2012-05-16T20:56:33-08:00 http://lahealthaction.org/index.php/library/full_entry/3930/ Policy brief providing findings from the recent Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults and insight as to how the ACA will help end the insurance gaps and consequent interruptions in care that so many Americans experience every year. The findings of the survey underscore the need for federal and state policymakers to press ahead with their work implementing the law. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion 2012-04-19T18:16:16-08:00 http://lahealthaction.org/index.php/library/full_entry/3938/ Policy brief providing a summary of the federal Medicaid eligibility rule changes, which includes information on the impact to California. This simplified version of the rule changes provides a great overview of policy change associated with the Affordable Care Act. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion 2012-04-12T18:53:38-08:00 http://lahealthaction.org/index.php/library/full_entry/3901/ Issue brief examining new state action on a subset of “early market reforms.” The analysis finds that 49 states and the District of Columbia have passed new legislation, issued a new regulation, issued new subregulatory guidance, or are actively reviewing insurer policy forms for compliance with these protections. These findings suggest that states have required or encouraged compliance with the early market reforms, and that efforts to understand how states are responding cannot focus on legislative action alone. The findings also raise important questions regarding how states may implement the Affordable Care Act’s broader 2014 market reforms, and suggest the need for continued tracking of state action. Health Insurance and Coverage Programs, Employment-based Health Insurance, Health Care Reform and Expansion 2012-03-22T22:19:09-08:00 http://lahealthaction.org/index.php/library/full_entry/3881/ Fact sheet providing information to California consumers with key Affordable Care Act (ACA) reforms to are likely to affect them. The guide includes a list of ACA reforms already in effect and the reforms scheduled to be implemented in 2014, the 2014 coverage options and cost considerations for uninsured California individuals and families, the 2014 coverage options and cost/benefit considerations for Californians with insurance through employer plans, individually purchased plans, or Medicare, and a description of potential federal developments, including U.S. Supreme Court review, that may affect implementation of the ACA or its individual provisions Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion 2012-03-19T21:55:58-08:00 http://lahealthaction.org/index.php/library/full_entry/3877/ Policy brief addressing the potential impact of removing the minimum coverage requirement (MCR) or "individual mandate" from the ACA. Based on analysis using the California Simulation of Insurance Markets (CalSIM) model, the authors found that the ACA will reduce California's eligible uninsured population from 4.63 to 2.72 million by 2019, a reduction of 41%. However without the MCR, the ACA will only be able to reduce the amount of eligible uninsured from 4.63 to 3.76, a reduction of only 19%. Therefore, eliminating the MCR from the ACA would substantially lower the number of newly insured Californians and undermine the goal of the law to substantially increase insurance coverage for the uninsured. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion 2012-01-30T18:21:07-08:00 http://lahealthaction.org/index.php/library/full_entry/3793/ Report examining 2007 California Health Interview Survey (CHIS) data to analyze the mental health of California's adult population. Data showed that 1 in 12 Californians reported symptoms consistent with serious psychological distress and experienced difficulty functioning at home or at work. Over half of these adults reported receiving no treatment for their disorders, and about one-quarter received "inadequate" treatment, defined as less than four visits with a health professional over the past 12 months or using prescription drugs to manage mental health needs. Data also showed that 8.1% of Los Angeles adults have serious psychological distress and at least a moderate level of impairment in one or more life domains. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion, Health Care Delivery Systems 2011-11-30T19:14:58-08:00 http://lahealthaction.org/index.php/library/full_entry/3749/ Report examining market share, enrollment, financial performance, and consumer satisfaction of various California health plans. In 2011, L.A. County Department of Health Services (DHS) Community Health Plan saw a 2% increase in enrollment, with 82% of total enrollment being Medi-Cal, AIM or Healthy Families. L.A. Care saw a 3% increase, with 100% of total enrollment being Medi-Cal, AIM or Healthy Families. L.A. Care also serves 11% of all Medi-Cal beneficiaries, a 9% increase from 2009. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Care Reform and Expansion 2011-11-02T19:43:13-08:00 http://lahealthaction.org/index.php/library/full_entry/3642/ Report on information collected in the 2011 Current Population Survey (CPS) Annual Social and Economic Supplement (ASEC) which shows that in 2010, median household income declined, the poverty rate increased and the percentage without health insurance coverage was not statistically different from the previous year. However, nearly 1 in 5 California residents lacked health insurance last year, one of the highest rates in the nation. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Status and Issues, Vulnerable Populations and Health Disparities 2011-09-14T18:02:30-08:00 http://lahealthaction.org/index.php/library/full_entry/3655/ Policy brief analyzing Census Bureau data that shows California's poverty rate rose to 16.3% in 2010--its highest point in 13 years--in which children accounted for more than one out of three Californians living in poverty. Data also shows that more than one out of five Californians under the age of 65 (21.4%) lacked health coverage in 2010, compared to 19.6% in 2006, and the share of Californians under the age of 65 with job-based health coverage was 52.9%in 2010, down from 56.4% in 2006. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Status and Issues, Maternal and Child Health, Vulnerable Populations and Health Disparities 2011-09-13T19:16:15-08:00 http://lahealthaction.org/index.php/library/full_entry/3633/ Report providing a baseline estimate of the number of underinsured and uninsured adults in 2010, and examining how federal health reform can help. The number of underinsured adults—those with health insurance, but high medical expenses relative to income—rose by 80 percent between 2003 and 2010, from 16 million to 29 million. Provisions in the Affordable Care Act to increase affordability could reduce the number of underinsured by 70 percent. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion 2011-09-08T18:47:23-08:00 http://lahealthaction.org/index.php/library/full_entry/3582/ Policy brief focusing on the foundational requirements needed in order for the Exchange to operate efficiently and accountably, and in order to be perceived as such by varied public and private stakeholders. These requirements include staffing, sales, marketing and communications and metrics. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Care Reform and Expansion 2011-08-10T19:47:32-08:00 http://lahealthaction.org/index.php/library/full_entry/3581/ Policy brief describing a change-agent model for the California Health Benefit Exchange (CBHE) that would have a longer planning horizon and would involve more collaboration with other purchasers. A change-agent Exchange would feature incentives aimed at achieving long-term improvements in health care quality, costs, and efficiency, with lower-cost, higher-quality outcomes. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Care Reform and Expansion 2011-08-10T19:30:38-08:00 http://lahealthaction.org/index.php/library/full_entry/3580/ Policy brief describing the values and features of a service-center option for the California Health Benefit Exchange (CBHE) and strategies such an Exchange should consider to maximize its chances of success. A service-center Exchange would aim to become a trusted shopping destination for health care consumers by offering a wide range of products, as well as quality information and support. Core to this model is the assumption that by focusing on consumer needs and experiences, the Exchange will attract a large and diverse pool of enrollees, which should both lower premiums and also allow for the cost of future enhancements to be spread across a larger population. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Care Reform and Expansion 2011-08-10T19:27:38-08:00 http://lahealthaction.org/index.php/library/full_entry/3579/ Policy brief describing establishing a price-leader option for the California Health Benefit Exchange (CHBE) as primarily a cost-focused store that offers the most competitively priced health plans. A price-leader Exchange will exercise its authority under state law to engage in selective contracting and would limit participation to carriers with the lowest prices while focusing on minimizing operations costs through lean administration, and on maximizing opportunities for automation and self-service by consumers. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Care Reform and Expansion 2011-08-10T19:19:00-08:00 http://lahealthaction.org/index.php/library/full_entry/3578/ Policy brief introducing the set of papers contrasting three possible strategic models for the California Health Benefit Exchange (CHBE). These models reflect different visions regarding the Exchange's primary goals might be to help bring to the surface assumptions and differences in viewpoint that might impede CHBE's ability to establish a clear path forward. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Care Reform and Expansion 2011-08-10T19:09:34-08:00 http://lahealthaction.org/index.php/library/full_entry/3572/ Report on California's experience with PacAdvantage and the Health Insurance Plan of California (HIPC) to inform development of the Small Business Health Option Programs (SHOP) for the California Health Benefits Exchange, which highlights five key lessons: 1) The key value proposition of SHOP Exchanges is meaningful consumer choice; 2) Adverse selection will remain a significant concern post-PPACA; 3) Policymakers must be vigilant and adaptable in preventing risk selection against SHOP exchanges; 4) Participation in SHOP exchanges must be attractive for health plans; and 5) Successfully marketing SHOP exchanges means building partnerships. Health Insurance and Coverage Programs, Employment-based Health Insurance, Health Care Reform and Expansion 2011-08-04T17:41:20-08:00 http://lahealthaction.org/index.php/library/full_entry/3523/ Report describing and reporting on the implementation of eight private Accountable Care Organizations (ACOs) that use, or are planning to deploy, a shared payer–provider risk payment model. Still in an early developmental phase, these payment models vary in their design and in how they define shared risk. The authors note that providers currently lack the infrastructure required to take on and manage risk successfully, though some payers are providing such support. Providers will need more data and analytic capabilities to manage the patient populations for which they take on financial risk and to negotiate appropriate risk-sharing arrangements with payers. Health Insurance and Coverage Programs, Employment-based Health Insurance, Health Care Reform and Expansion, Health Care Delivery Systems 2011-07-25T18:15:37-08:00 http://lahealthaction.org/index.php/library/full_entry/3482/ Report on health insurance coverage from the CDC's 2010 National Health Interview survey. Nationally in 2010, 48.6 million persons of all ages (16.0%) were uninsured at the time of interview, 60.3 million (19.8%) had been uninsured for at least part of the year prior to interview, and 35.7 million (11.7%) had been uninsured for more than a year at the time of interview. The percentage of children under age 18 years who were uninsured at the time of interview was 7.8%. In California at the time of the interview, 20.6% of persons were uninsured and 22.2% of persons had public coverage. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care, Children's Health and Coverage 2011-07-11T17:31:35-08:00 http://lahealthaction.org/index.php/library/full_entry/3473/ Policy brief outlining challenges facing the uninsured unemployed and potential sources of insurance, including through a spouse's plan, COBRA, the non-group insurance market and public programs. The new health reform law will increase coverage options for the unemployed through an expansion in Medicaid and subsidizing coverage purchased in new health insurance Exchanges, though most coverage provisions do not take effect until 2014. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion 2011-06-23T18:30:25-08:00