Many approaches are being proposed to address our nation’s health care pricing, utilization, access, and coverage challenges. These approaches require an understanding of the issues in areas such as private health insurance markets, premium tax credits, delivery and payment reform, and state flexibility. Examples of areas of important ongoing research include: Where and why are markets working? Where and why are they failing? What can be done to increase the effectiveness of these markets? Is the path we are on sustainable, affordable, and equitable for employers and individuals?

To connect policymakers and advocates with emerging research on topics pertinent to the health reform debate, Altarum has commissioned a series of studies with funding from the Robert Wood Johnson Foundation. We are funding proposals for research that address the following pressing policy areas:

  1. Affordability and sustainability of coverage. Private and public insurance payers have grave concerns about increasing health care costs. Relevant  cost driver issues include:
    1. Risk pooling
    2. Individual and employer mandates
    3. Underlying medical cost growth
    4. Benefit design including cost-sharing and covered benefits
    5. Excess administrative costs
    6. Insurer competition
    7. Regulatory Uncertainty
  2. Expanding coverage.  Policy approaches include:
    1. Eligibility requirements including new work mandates
    2. Consumer education and outreach
    3. Benefit design simplification and other techniques to reduce consumer enrollment burden
    4. Auto-enrollment, use of defaults and other environmental nudges
    5. Premium subsidies/publicly funded coverage/favorable tax treatment/publicly funded reinsurance
    6. Societal consequences of large uninsured population
    7. Equity and addressing  disparities in health insurance enrollment
  3. Regulatory environment. The coverage that Americans receive is governed by a patchwork of state and federal agencies. Insurer regulatory requirements vary from regulator to regulator and often from state to state. Complicated by the patchwork of stata and federal regulations, policy questions center around key functions:
    1. Rate setting/rate review
    2. Market conduct
    3. Consumer assistance
  4. Care delivery issues such as provider payment and credentialing

 

 

Project Leader

Erin Butto Portrait

Erin Duggan Butto

Deputy Director, Center for Value in Health Care

erin.butto@altarum.org