UnitedHealthcare has denied allegations that it gamed Medicare Advantage risk adjustment, but other insurers are taking note and might be more cautious.
Medicaid expansion and Covered California’s $100 million-a-year marketing budget have pushed the uninsured rate into the single digits, but enrollment has plateaued.
The ACA made a dent, but Texas continues to lead the country in the percentage of people without insurance. Now it has also grabbed the top spot in high-deductible insurance.
The ACA drove down the uninsured rate despite the lack of Medicaid expansion, but major insurers have left the market. In some rural areas, Florida Blue is the only insurer in the individual market.
Conservatives say Tennessee’s experience shows the ACA’s fatal weaknesses. But one expert believes that, properly nurtured, the state’s individual market could thrive.
Maine has a rich history of health care policy innovation, although it was the ACA that finally brought down the uninsured rate. An older, rural population means no guarantees.
Robert Pendleton, MD
University of Utah Health Care
University of Utah’s Value-Driven Outcomes program encourages attention to process. It’s a maligned concept in health care quality these days, but one Utah has refined to drive better outcomes.
It produces better outcomes, is easier to administer, and costs less than competing drugs. Nothing’s perfect, but this could be the beginning of a better era for payers.
