14 Works

The Cost of Employer Insurance Is a Growing Burden for Middle-Income Families

Sara R. Collins & David C. Radley
Recent national surveys show health care costs are a top concern in U.S. households.1 While the Affordable Care Act’s marketplaces receive a lot of media and political attention, the truth is that far more Americans get their coverage through employers. In 2017, more than half (56%) of people under age 65 — about 152 million people — had insurance through an employer, either their own or a family member’s.2 In contrast, only 9 percent had...

After the ACA Simplified Medicaid Enrollment, the Administration and Some States Are Making It Far More Complicated

Sara Rosenbaum, Maria Velasquez, Sara Rothenberg & Rachel Gunsalus
For years, the federal government and states have sought to get rid of enrollment barriers in Medicaid. Now a number of states are reversing course: 14 states have approved or pending Medicaid 1115 demonstrations designed to restrict Medicaid eligibility. Attention has focused on the demonstrations’ work mandates, but the experiments involve much more. Other features include extensive reporting rules — in some proposals enrollees must report on their eligibility status weekly — as well as...

The Electronic Health Record Problem

David Blumenthal
It’s no secret that many physicians are unhappy with their electronic health records (EHRs). They say they spend too much time keying in data and too little making eye contact with patients. They say their electronic records are clunky, poorly designed, hard to navigate, and cluttered with useless detail that colleagues have cut and pasted to meet documentation requirements. Meanwhile, the data they really need are buried almost beyond retrieval.

The Time Is Now: The Case for Digital Health Innovation for the Poor and Underserved

Lisa Fitzpatrick
Few resources are accessible to people with low incomes, who might stand to benefit from them most. Health care regulations restricting payment for new technologies could be a reason for this access gap. But another is lack of insight among funders, developers, and health care innovation leaders into poor Americans’ access to mobile phones and the Internet, or these patients’ interest in using technology for health care needs. It has been unclear to these groups...

Technology Could Transform Care for People on Medicaid

Shanoor Seervai & Lovisa Gustaffson
To date, health care apps, remote-monitoring services, and other digital technologies have mostly been developed for middle- and high-income people, who get health coverage through an employer or purchase it on the private market. Few of these tools have been available to people with low incomes, many of whom have Medicaid. But as a new feature article illustrates, there are millions of low-income Americans who could benefit as well. The Commonwealth Fund's Shanoor Seervai and...

Trends in Postacute Care Spending Growth During the Medicare Spending Slowdown

Laura M. Keohane, Salama Freed, David G. Stevenson, Sunita Thapa, Lucas Stewart & Melinda B. Buntin
ABSTRACT Issue: Over the past decade, traditional Medicare’s per-beneficiary spending grew at historically low levels. To understand this phenomenon, it is important to examine trends in postacute care, which experienced exceptionally high spending growth in prior decades. Goal: Describe per-beneficiary spending trends between 2007 and 2015 for postacute care services among traditional Medicare beneficiaries age 65 and older. Methods: Trend analysis of individual-level Medicare administrative data to generate per-beneficiary spending and utilization estimates for postacute...

What Is the Status of Women’s Health and Health Care in the U.S. Compared to Ten Other Countries?

Munira Z. Gunja, Roosa Tikkanen, Shanoor Seervai & Sara R. Collins
Women in the United States have long lagged behind their counterparts in other high-income countries in terms of access to health care and health status. This brief compares U.S. women’s health status, affordability of health plans, and ability to access and utilize care with women in 10 other high-income countries by using international data.

How ACOs Are Caring for People with Complex Needs

Kristen A. Peck, Benjamin Usadi, Alexander Mainor, Helen Newton & Ellen Meara
ABSTRACT Issue: With an incentive to provide high-quality care while controlling costs, accountable care organizations (ACOs) may focus on patients who require the most resources and are most at risk for encountering serious problems with their care. Understanding how ACOs approach care for complex patients requires examination of their organizational strategies, contracting details, and leadership structures. Goals: Describe the specific strategies employed by ACOs that have comprehensive care management programs and processes for complex patients....

Will Evaluations of Medicaid 1115 Demonstrations That Restrict Eligibility Tell Policymakers What They Need to Know?

Sara Rosenbaum, Maria Velasquez, Rachel Gunsalus, Rebecca Morris & Alexander Somodevilla
ABSTRACT Issue: With thousands in Arkansas losing their Medicaid benefits under the state’s work-requirement demonstration, the importance of evaluating such experiments could not be clearer. In Stewart v. Azar, the court concluded that the purpose of Section 1115 demonstrations such as Arkansas’s is to promote Medicaid’s objective of insuring the poor; evaluations of these demonstrations, as required by law, inform policymakers whether this objective is being achieved. Goal: To examine the quality of evaluation designs...

Court Decision to Invalidate the Affordable Care Act Would Affect Every American

Timothy S. Jost
Texas federal court Judge Reed O’Connor delivered a judgment, in the Texas v. Azar case, invalidating the Affordable Care Act. According to legal expert Timothy S. Jost, the decision will be appealed and likely blocked from going into effect.

Registration Year

  • 2018
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Resource Types

  • DataPaper
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  • The Commonwealth Fund Website
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