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Report on Health Reform Implementation. Addressing Medicaid/Marketplace Churn through Multimarket Plans: Assessing the Current State of Play.

Both before and after the Affordable Care Act (ACA), the US health insurance system is characterized by fragmentation. Pre-ACA, this fragmentation included major coverage gaps, causing significant periods of coverage interruption, especially for lower-income people. The ACA does not end the problem...

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Published in:Journal of Health Politics, Policy & Law Vol. 40; no. 1; pp. 233 - 243
Main Author: Rosenbaum, Sara
Format: Journal Article
Published: Duke University Press Feb2015
Online Access:View this record in EBSCOhost
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      dt: Feb2015
      vid: 40
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      pub: Duke University Press
      place: Durham, North Carolina
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        atl: Report on Health Reform Implementation. Addressing Medicaid/Marketplace Churn through Multimarket Plans: Assessing the Current State of Play.
      aug:
        au: Rosenbaum, Sara
        affil: The George Washington University; Founding commissioner, Medicaid and CHIP Payment and Access Commission
      sug:
        subj:
          Patient Protection and Affordable Care Act
          Program Implementation
          Medicaid Standards
          Continuity of Patient Care
          Insurance Coverage
          Financing, Government Methods
          Health Insurance Exchanges
          Eligibility Determination Standards
          Patient Navigation
          Decision Making, Patient
          Managed Care Programs Classification
          Insurance, Health, Reimbursement Standards
          Certification Standards
          Insurance Carriers
          Income
      ab: Both before and after the Affordable Care Act (ACA), the US health insurance system is characterized by fragmentation. Pre-ACA, this fragmentation included major coverage gaps, causing significant periods of coverage interruption, especially for lower-income people. The ACA does not end the problem of churning among sources of public financing, but it does hold the potential for enabling people to move among sources of coverage rather than go without insurance. Several strategies for reducing coverage chum exist, but none is foolproof and all are in their early stages. Thus the ability of issuers to participate across multiple public financing arrangements and to offer stable provider networks becomes crucial to achieving continuity of care. Interviews with nine companies involved in developing or operating multimarket strategies confirm the feasibility of this approach while revealing major challenges, especially the challenge of finding providers willing to treat members regardless of the source of coverage. Strategies for increasing multimarket plans and networks represent one of the great areas of future policy and operational focus.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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