Geographical distribution of patients visiting a health information exchange in New York City. (1/24)


Steps to reduce favorable risk selection in medicare advantage largely succeeded, boding well for health insurance exchanges. (2/24)


The experience of Massachusetts shows that consumers will need help in navigating insurance exchanges. (3/24)


Health insurance premium tax credit. Final regulations. (4/24)

This document contains final regulations relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.These final regulations provide guidance to individuals related to employees who may enroll in eligible employer-sponsored coverage and who wish to enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the premium tax credit.  (+info)

Patient Protection and Affordable Care Act; standards related to essential health benefits, actuarial value and accreditation. Final rule. (5/24)

This final rule sets forth standards for health insurance issuers consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Specifically, this final rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value. This rule also finalizes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges and amends regulations providing an application process for the recognition of additional accrediting entities for purposes of certification of qualified health plans.  (+info)

Patient Protection and Affordable Care Act; establishment of the multi-state plan program for the Affordable Insurance Exchanges. (6/24)

The U.S. Office of Personnel Management (OPM) is issuing a final regulation establishing the Multi-State Plan Program (MSPP) pursuant to the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Through contracts with OPM, health insurance issuers will offer at least two multi-State plans (MSPs) on each of the Affordable Insurance Exchanges (Exchanges). One of the issuers must be non-profit. Under the law, an MSPP issuer may phase in the States in which it offers coverage over 4 years, but it must offer MSPs on Exchanges in all States and the District of Columbia by the fourth year in which the MSPP issuer participates in the MSPP. This rule aims to balance adhering to the statutory goals of MSPP while aligning its standards to those applying to qualified health plans to promote a level playing field across health plans.  (+info)

Measuring quality in the early years of health insurance exchanges. (7/24)

OBJECTIVES: To identify quality measures that health plans can reliably report during the early years of health insurance exchanges and over time, and to suggest strategies to increase the availability of quality results to use in rating and monitoring plans. STUDY DESIGN: Projection of a set of measures available for public reporting based on prevalence and experience with health plans' reporting of the quality measures. METHODS: For the quality measures included in the federal Initial Core Set of Adult Health Care Quality Measures for Medicaid-Eligible Adults, we looked at the proportion of people in the United States who would be eligible for each measure, and if available, the number of plans that in the past were not able to report reliable Healthcare Effectiveness Data and Information Set results to the National Committee for Quality Assurance because of low membership. We developed estimates of each state's exchange enrollment, and used the number of plans currently accredited in the state to estimate how many plans will offer coverage to determine the average exchange plan membership per state in 2014 and 2018. RESULTS: In the early years exchange plans should be able to report a set of 14 preventive, chronic care, and access-to-service measures. As health plan membership grows through the years, more measures, including behavioral health, can be phased in. CONCLUSIONS: In 2015 and 2016, all exchanges should require plans to report the 14 measures and if needed, use suggested strategies to build the results for public reporting.  (+info)

Some families who purchased health coverage through the Massachusetts Connector wound up with high financial burdens. (8/24)