Publications: Health Insurance

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Has the Time Come for Cost-Effectiveness Analysis in U.S. Health Care?

July 17, 2009 - Three-quarters of key decision-makers from a diverse group of California-based health care organizations believe that cost-effectiveness criteria should be used when making insurance coverage decisions, according to this Commonwealth Fund-supported study. However, payers and the legal and policy communities would need to explore ways of reducing the litigation risk associated with cost-effectiveness analysis, the authors say.

In the Literature

How Health Care Reform Can Lower the Costs of Insurance Administration

July 16, 2009 - The United States leads all industrialized countries in the share of national health care expenditures devoted to insurance administration. This issue brief examines the sources of insurance administrative costs in this country, and describes how a private–public approach to health care reform could substantially lower such costs.

Issue Brief

Fork in the Road: Alternative Paths to a High Performance U.S. Health System

June 24, 2009 - A comprehensive approach to health insurance, provider payment, and care delivery system reforms has the potential to slow health care cost increases while achieving near-universal coverage. Yet, this new Commonwealth Fund analysis finds that the potential savings for families, businesses, and the federal government vary markedly, depending on whether or not a public insurance plan option is included and how such a plan is structured.

Fund Report

Front and Center: Ensuring that Health Reform Puts People First

June 11, 2009 - This report focuses on those who would benefit from such health reforms, including the estimated 116 million working-age adults, or two-thirds of all adults, who report that they are uninsured or underinsured, have medical bill or debt problems, or experience difficulties obtaining needed care.

Fund Report

Trends in Underinsurance and the Affordability of Employer Coverage, 2004–2007

June 2, 2009 - Out-of-pocket health care expenses for workers covered by employer-sponsored plans grew by more than one-third between 2004 and 2007, according to a Commonwealth Fund-supported study in Health Affairs. The higher costs are particularly burdensome for people who are sick or have modest incomes.

In the Literature

Access and Affordability: An Update on Health Reform in Massachusetts, Fall 2008

May 28, 2009 - More than two years after implementation of its landmark health insurance reforms, Massachusetts had achieved historically high levels of coverage and widespread improvements in access to care, according to this study—the latest in a series of reform updates, funded by the Blue Cross Blue Shield of Massachusetts Foundation, The Commonwealth Fund, and the Robert Wood Johnson Foundation.

In the Literature

The Massachusetts Commonwealth Health Insurance Connector: Structure and Functions

May 28, 2009 - This issue brief describes how the Connector works to promote administrative ease, eliminate paperwork, offer portability of coverage, and provide some standardization and choice of plans. Some of the structural components and functions of the Connector may be transferable to a national health reform model, say the authors.

Issue Brief

Achieving Health Care Reform—How Physicians Can Help

May 21, 2009 - Rather than wait and see how health reform legislation unfolds, physicians should help lead the effort to establish affordable, high-quality health care in this country, say Elliott S. Fisher, M.D, M.P.H., Donald M. Berwick, M.D., M.P.P., and Karen Davis, Ph.D., in a New England Journal of Medicine "Perspectives" column.

Literature Abstract

Health Insurance and Health Care Access Before and After SSDI Entry

May 20, 2009 - This report creates profiles of those with Social Security Disability Insurance (SSDI) during the three years before and after SSDI entry to illustrate changes in insurance status, health care access, and utilization.

Fund Report

What Does It Cost Physician Practices to Interact with Health Insurance Plans?

May 14, 2009 - Physicians spent on average nearly three weeks annually interacting with health plans, at an estimated annual cost to physician practices of $31 billion, or $68,274 on average per physician, per year, according to this Commonwealth Fund-supported survey.

In the Literature

Peering into the Black Box: Billing and Insurance Activities in a Medical Group

May 14, 2009 - Billing and insurance tasks in a large medical group practice consume $85,276 per full-time equivalent physician—or 10 percent of operating revenue, according to this Commonwealth Fund-supported study. Standardizing health plan benefits and billing procedures would reduce administrative complexity and costs, the authors say.

In the Literature

Meeting Enrollees' Needs: How Do Medicare and Employer Coverage Stack Up?

May 12, 2009 - In a national Commonwealth Fund survey, elderly Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than people covered by employer-sponsored plans.

In the Literature

Women at Risk: Why Many Women Are Forgoing Needed Health Care

May 11, 2009 - Rising health care costs coupled with eroding health care benefits are having a substantial effect on Americans' ability to get needed health care, with women particularly affected. Women experience cost-related access problems and medical bill problems more often than men.

Issue Brief

Progressive or Regressive? A Second Look at the Tax Exemption for Employer-Sponsored Health Insurance Premiums

May 8, 2009 - This analysis finds that limiting the current exemption on employer-sponsored health insurance premiums could adversely affect individuals who are already at high risk of losing their health coverage. Evidence suggests that capping the exemption could disproportionately affect workers in small firms, older workers, and wage-earners in industries with high expected claims costs.

Issue Brief

Testimony--Young and Vulnerable: The Growing Problem of Uninsured Young Adults and How New Policies Can Help

April 23, 2009 - Young adults are disproportionately represented among people who lack health insurance, accounting for nearly 30 percent of the 45 million uninsured people under age 65, even though they comprise just 15 percent of the population.

Testimony