Health Insurance Exchanges: What We Can Learn from California
Thomas Jefferson University and URAC are releasing a study that examines the role of new types of health insurance created by the Affordable Care Act (A.C.A). Starting today, under the A.C.A., health insurance exchanges will offer subsidized health insurance coverage to individuals with low-to-moderate incomes who do not get coverage from their employer or from another source. The study will appear in the October, 2013 issue of Health Management, Policy and Innovation (PDF).
The study's lead author, Robert D. Lieberthal, Ph.D., Assistant Professor in the Jefferson School of Population Health, shows how lessons learned with marketplaces for healthcare can apply to health insurance exchanges.
"Based on this study, we should find better ways of tailoring health insurance to individual needs. Patients with a specific condition, such as heart disease, should be able to select a plan that has demonstrated high quality outcomes treating other individuals with that disease."
Dr. Lieberthal's model is informed by experience in states where health insurance exchanges are already working to deliver high quality health insurance, such as in California. By limiting the number of plans that consumers could receive, California was able to focus on making those plans as good as possible.
Factors such as the cost of insurance and what doctors it covers are important to patients. But these factors are only part of what makes health insurance worthwhile—valuable health insurance helps to ensure high quality care for patients. Numerous studies have linked high quality health insurance to better outcomes.
"There may be a lot of confusion, and even frustration, with health insurance exchanges, because they are new," said Dr. Lieberthal. "However, health insurance exchanges can be successful if they use proven methods to develop and deliver great health insurance that already work in practice."
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Jefferson University Hospitals