Web First. State-Based Marketplaces Using ‘Clearinghouse’ Plan Management Models Are Associated With Lower Premiums.

The state-based and federally facilitated health insurance Marketplaces, or exchanges, enrolled more than eight million people during the first open enrollment period, which ended March 31, 2014. There is significant variation in how states have designed and implemented their Marketplaces. We ex...

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Publicado en:Health Affairs Vol. 34; no. 1; pp. 160 - 170
Autores principales: Krinn, Kelly, Karaca-Mandic, Pinar, Blewett, Lynn A.
Formato: Journal Article
Publicado: Health Affairs Publishing, LLC Jan2015
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Web First. State-Based Marketplaces Using ‘Clearinghouse’ Plan Management Models Are Associated With Lower Premiums.
      aug:
        au:
          Krinn, Kelly
          Karaca-Mandic, Pinar
          Blewett, Lynn A.
        affil: Graduate, master of public policy program, Humphrey School of Public Affairs, University of Minnesota, Minneapolis
      sug:
        subj:
          Health Insurance Exchanges Administration
          State Government
          Variance Analysis
          Fees and Charges
          Program Evaluation Methods
          Human
          Comparative Studies United States
          United States
          Economic Competition
          Eligibility Determination Standards
          Insurance, Health Standards
          Benchmarking
          Government Regulations Standards
          Patient Protection and Affordable Care Act
          Administrative Research
          Organizational Structure
          Factor Analysis
          Models, Statistical Utilization
          Predictive Validity
          Funding Source
      ab: The state-based and federally facilitated health insurance Marketplaces, or exchanges, enrolled more than eight million people during the first open enrollment period, which ended March 31, 2014. There is significant variation in how states have designed and implemented their Marketplaces. We examined how premiums varied with states' involvement in the Marketplaces through governance, plan management authority, and strategy during the first year that the exchanges have been open. State-based Marketplaces using “clearinghouse” plan management models had significantly lower adjusted average premiums for all plans within each metal level compared to state-based Marketplaces using “active purchaser” models and the federally facilitated and partnership Marketplaces. Clearinghouse management models are those in which all health plans that meet published criteria are accepted. Active purchaser models are those in which states negotiate premiums, provider networks, number of plans, and benefits. Our baseline estimates provide valuable benchmarks for evaluating future performance of states' involvement in governance, plan management, and regulatory authority of the insurance Marketplaces.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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