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11 Matching News Items

1.  The Feds Are Wrong: Lots of Wellness Programs Violate the ADA
The Incidental Economist Link to more items from this source
Nov. 20, 2015
"Workplace wellness programs discriminate. That's what they do.... The Affordable Care Act makes an exception, however, for wellness-based discrimination.... At the same time, the Americans with Disabilities Act ... says that employers can't conduct medical examinations, including medical histories, unless they're 'voluntary.' ... The question thus boils down to whether the EEOC can reasonably say that a health assessment is still 'voluntary' if there's a substantial financial penalty for refusing to take it. Notice that the ACA has no bearing on that inquiry. It's purely a question of the meaning of the ADA."
2.  The Latest Research on Accountable Care Organizations
The Incidental Economist Link to more items from this source
Oct. 31, 2014
"[The author] would give ACOs another five or so years before drawing any strong conclusions about what they can do. Even a few years of generally positive results is insufficient to declare victory. It's reasonable to be optimistic, but cautiously so. A lot could still go wrong."
3.  Can the 'Better Care, Lower Cost Act' Live Up to Its Name?
The Incidental Economist Link to more items from this source
Feb. 17, 2014
"Last month, Senators Wyden, Isakson, Welch, and Paulsen introduced an ambitious bill for Medicare reform.... [T]he bipartisan proposal aims to shift the program away from fee-for-service by amplifying the ACO model.... The text of the new bill seems to emphasize a role for telemedicine and remote patient monitoring, but the most successful programs identified by the CBO -- which still didn't achieve net savings for Medicare -- employed significant in-person interaction between patients and physicians or care managers. Initiatives that relied primarily on telephone interaction had little to no effect on spending or hospital admissions, on average."
4.  Does the Risk Corridor Program Have a Fatal Technical Flaw?
The Incidental Economist Link to more items from this source
May 4, 2014
"[T]he risk corridor program lacks any appropriations language. That won't matter for exchange insurers that have lower medical costs than they anticipated. They'll still be on the hook for making risk corridor payments-payments that, according to CBO, will amount to about $16 billion over the three-year life of the program. But the lack of an appropriation could matter a lot for insurers with heftier-than-expected costs. In [the Congressional Research Service's] view, HHS cannot pay them the $8 billion they're set to receive through the program.*"
5.  Compensation Under Profit Maximization and the Effect of Employer-Provided Health Insurance
The Incidental Economist Link to more items from this source
Aug. 29, 2012
"Consider a profit-maximizing firm ... that offers its employees compensation in the form of an annual salary ($50,000) and health insurance (annual $15,000 premium).... Now imagine a law is passed that outlaws employee-sponsored health insurance.... [N]ow the firm does not offer the $15,000 premium coverage. But, it still may offer a salary. Assume nothing else changes. If the firm is still profit maximizing, what salary does it offer under the new law?"
6.  After King v. Burwell, Could New State Exchanges Qualify for Subsidies?
The Incidental Economist Link to more items from this source
Apr. 21, 2015
"The fight in [King v. Burwell] is about the meaning of a provision of the Internal Revenue Code linking the subsidies to the cost of a plan purchased on " 'an Exchange established by the State under 1311.' Section 1311, in turn, says that '[e]ach State shall, not later than January 1, 2014, establish an American Health Benefit Exchange.' Did the states have to hit that January 2014 deadline in order to establish exchanges 'under 1311'? ... If the Supreme Court sides with the plaintiffs, it will have taken a highly literal approach to the ACA -- an approach that might give juice to the argument that post-King exchanges haven't been properly established 'under 1311.' "
7.  Resounding Victory for Obama Administration in ACA Premium Subsidy Litigation
The Incidental Economist Link to more items from this source
Jan. 15, 2014
"Friedman closes by referring to the purpose of the ACA to provide for near-universal coverage. The challengers' interpretation, he says, 'runs counter to this central purpose.' Accepting it 'would violate the basic rule of statutory construction that a court must interpret a statute in light of its history and purpose.' At any rate, even if the statute were ambiguous -- and Friedman is crystal clear that he doesn't think it is -- the administration's interpretation, he says, would be upheld as a 'permissible construction of the statute.'" [Halbig v. Sebelius, No. 13-062 (D.D.C. Jan. 15, 2014)]
8.  Adverse Selection at Every Turn
The Incidental Economist Link to more items from this source
Aug. 26, 2013
"The difficulty consumers face in appreciating the value of plans and the resistance they exhibit in plan switching has a risk pooling effect.... That consumers don't perfectly identify their costs under each plan and have status quo bias (inertia) undoes some of this selection. That's not to say you want to keep people in the dark just for the risk pooling effect. It's just to point out that there a selection issue that arises as people are better informed and, perhaps, more willing to switch plans on that basis."
9.  Do Wellness Programs Work?
The Incidental Economist Link to more items from this source
Sept. 4, 2013
"For wellness programs, there are two notions of 'working,' health improvement and cost saving. The evidence on both is not very encouraging.... RAND found that wellness programs were associated with 'statistically significant and clinically meaningful improvements in exercise frequency, smoking behavior, and weight control, but not cholesterol control.' Nevertheless, the observed changes were small.... Without much analysis, employers overwhelmingly believe wellness programs save money. RAND found they did, but not to a statistically significant degree after four years."
10.  New Evidence Suggests a Lack of Cost-Shifting in Prescription Drug Markets
The Incidental Economist Link to more items from this source
Feb. 17, 2022
"[B]iosimilar entry in the EU caused sharp reductions to global revenue but [the authors] observe little evidence of offsetting revenue increases in the US market relative to prior trend. These results are consistent with the theory that drug makers are already using their market power in full. At a minimum, revenue targeting arguments must contend with the reality that firms appear willing to accept revenue losses internationally, despite holding similar market power in the US commercial market as they would in the wake of Medicare price regulation."
11.  Health Insurance Saves Lives -- That Means It Improves Health, Too
The Incidental Economist Link to more items from this source
May 5, 2014
"Past investigations of how health insurance impacts health offered conflicting results, but have also faced limits to external validity. Policy changes tend to only impact one payer (Medicare, Medicaid, VA) or population (elderly, children, HIV+ patients) at a time -- these are the vagaries of reality. Massachusetts expanded coverage in a much broader sense: the state extended Medicaid eligibility to those under 100% FPL and subsidized the individual market coverage for residents below 300% FPL."

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