Updated Network Adequacy Planning Tool for States
This network adequacy planning tool for states provides an overview of the U.S. Department of Health and Human Services (HHS) regulation on minimum network adequacy standards. The tool is in Word format, and is designed to be used as a template to assist states in developing analysis plans that will inform discussions around updating network adequacy standards.
Terms and Definitions Used by States Reporting on Affordable Care Act (ACA) Enrollment
During the initial open enrollment period under the Affordable Care Act, the federal government and states operating state-based exchanges conducted various types of reporting on key indicators of interest to policymakers and the public.
Marketplace Enrollee Survey Item Matrix – Sample Questions
As those interested in conducting surveys to measure the public’s participation and experience in health insurance marketplaces under the Affordable Care Act (ACA) continue to investigate the most effective ways of doing so, access to questions utilized in previously conducted surveys will be very useful.
Aligning Measure Sets: Tools & Methods for States
Tailored to the needs of state officials and other stakeholders involved in measure set creation, this webinar addresses strategies for developing and maintaining aligned quality measure sets.
Impacts of the Affordable Care Act on Health Insurance Coverage in Oregon
Between October 2013 and April 2014 access to health insurance in Oregon expanded in two ways, leading to unprecedented changes in insurance coverage in the state. First, the state extended Medicaid coverage to many previously ineligible low-income adults. Second, the state created a health insurance marketplace that provided a resource where individuals could learn what they are eligible for, explore financial assistance options available to them, and compare commercial plans.
Considerations for State Development of Performance Measure Sets
This guide provides an overview of the steps states should take in developing a performance measure set—either on their own or in partnership with others—identifies critical considerations, and offers guidance in selecting measures.
Specialty Tier Pharmacy Benefit Designs in Commercial Insurance Policies: Issues and Considerations
As health care costs rise, one of the chief determinants of the rate of increase has been the cost of prescription drugs. Over time, additional tiers have been included in pharmacy benefit designs and, as they were added, cost sharing in the new, higher tiers has increased.
Boosting Enrollment: Lessons Learned from 2013-2014
With the recent conclusion of the initial open enrollment period under the Affordable Care Act, opportunities now exist to examine the experiences and successes of several state-based marketplaces in order to evaluate how they reached consumers and enrolled them in Qualified Health Plans
Consumer Impact Analysis Presentation
As the 2015 open enrollment period approaches, one of the most significant challenges faced by marketplaces stems from the complicated nature of premium subsidy calculations, which may lead to potentially large swings in consumers’ after-subsidy premiums and could have tax liability implications.
Addressing the Financial Impact of Renewals: Why Many Enrollees Could Benefit from Shopping
As the 2015 open enrollment period approaches, one of the most significant challenges faced by marketplaces stems from the complicated nature of premium subsidy calculations, which may lead to potentially large swings in consumers’ after-subsidy premiums and tax liability implications.