The Incidental Economist

Federal Employees Health Program Experiences Lack Of Competition In Some Areas, Raising Cost Concerns For Exchange Plans, by Timothy D. McBride, Abigail R. Barker, Lisa M. Pollack, Leah M. Kemper and Keith J. Mueller (Health Affairs)

The Affordable Care Act calls for creation of health insurance exchanges designed to provide private health insurance plan choices. The Federal Employees Health Benefits Program is a national model that to some extent resembles the planned exchanges. Both offer plans at the state level but are also overseen by the federal government. We examined the availability of plans and enrollment levels in the Federal Employees Health Benefits Program throughout the United States in 2010. We found that although plans were widely available, enrollment was concentrated in plans owned by just a few organizations, typically Blue Cross/Blue Shield plans. Enrollment was more concentrated in rural areas, which may reflect historical patterns of enrollment or lack of provider networks. Average biweekly premiums for an individual were lowest ($58.48) in counties where competition was extremely high, rising to $65.13 where competition was extremely low. To make certain that coverage sold through exchanges is affordable, policy makers may need to pay attention to areas where there is little plan competition and take steps through risk-adjustment policies or other measures to narrow differences in premiums and out-of-pocket expenses for consumers.

Why Accountable Care Organizations Are Not 1990s Managed Care ReduxAccountable Care Organizations, by Ezekiel J. Emanuel (The Journal of the American Medical Association)

If Accountable Care Organizations Are the Answer, Who Should Create Them?Who Should Create Accountable Care Organizations?, by Victor R. Fuchs and Leonard D. Schaeffer Emanuel (The Journal of the American Medical Association)

Two Hundred Years of Hospital Costs and Mortality — MGH and Four Eras of Value in Medicine, by Gregg S. Meyer, Akinluwa A. Demehin, Xiu Liu and Duncan Neuhauser. (The New England Journal of Medicine)

What are the public policy implications of a neurobiological view of addiction?, by Coral E. Gartner, Adrian Carter and Brad Partridge (Addiction)

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