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Webcast: New CMS Estimates of State-by-State Health Expenditures

The Kaiser Family Foundation held a live interactive webcast on December 7, 2011, to discuss trends in state health care expenditures and the implications for national and state efforts to constrain health care costs. The webcast examines new state-by-state estimates of public and private health spending from the Centers for…

Medical Liability Reforms: Comparison of the Candidates’ Proposals

Medical Liability Reforms: Comparison of Candidate’s ProposalsBush-Cheney1Kerry-Edwards2Supports a $250,000 cap on non-economic damages and a reasonable cap on punitive damages.Supports limiting a party’s share of total damages to their proportionate share of blame for the injury inflicted.Supports action to allow providers to review best practices without fear of litigation.Opposes capping…

Better Care & Lower Costs: Exploring the Promise of Patient Engagement

03/05/10 Engaging consumers more directly in their care may improve health outcomes and help control the costs of care. This briefing, cosponsored by the Alliance for Health Reform and the AARP Public Policy Institute, focused on the potential for changing consumer behavior to promote the use of effective interventions and…

Preventive Services Covered by Private Health Plans under the Affordable Care Act

This fact sheet, Preventive Services Covered by Private Health Plans under the Affordable Care Act, examines the types of preventive services or benefits that must be covered without cost-sharing for adults and children. The fact sheet explores the rules and challenges of implementing coverage, as well as the application of reasonable medical management, and it outlines steps the government has taken to address these issues.

Impact of Potential Changes to ERISA: Litigation and Appeals Experience of CalPERS, Other Large Public Employers and a Large California Health Plan – Report

Impact of Potential Changes to ERISA:Litigation and Appeal Experience of CalPERS, Other Large Public Employers and a Large California Health PlanJune 1998By Coopers & Lybrand L.L.P.Sandra Hunt, M.P.A.John Saari, M.A.A.A.Kelly Traw, J.D.BackgroundThe Employee Retirement Income Security Act (ERISA) currently preempts state law related to the wrongful denial or delay of…

External Review of Health Plan Decisions in the States and Medicare

An analysis of the external review process, the formal dispute resolution process established by state or federal agencies, independent of disputing parties, that has the capacity to evaluate and resolve at least those disputes involving medical issues. This paper identifies critical features of external review systems in thirteen states and…

Health Plan Liability — Policy Brief

An 8-page policy brief to inform the policy debate in California about health plan liability issues, including barriers to lawsuits (ERISA), liability approaches used in other industries, and potential impact on premiums. The brief includes a variety of perspectives presented by speakers at a California Health Policy Roundtable held in…

Update on Individual Health Insurance

This report provides information about the individual health insurance market using data from the largest vendor of this type of insurance, eHealthInsurance. The report includes who is buying individual insurance, what they are actually paying for the insurance, and buying patterns. It is the first in an up-coming series of…

Pulling it Together: The Sleeper in Health Reform

The health reform legislation currently being crafted on Capitol Hill is undeniably complex.  To oversimplify slightly it can be boiled down into four parts: coverage (subsidies for private coverage and Medicaid expansions); delivery and payment reforms; insurance market reforms and regulations; and prevention, with each broad category containing a range…

A Guide to the Medicaid Appeals Process

This background brief provides a comprehensive look at the appeals process for the Medicaid program, which differs significantly from those available through the Medicare program and private health insurance. The Medicaid appeals process provides redress for individual applicants and beneficiaries seeking eligibility for the program or coverage of prescribed services,…