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Employer Sponsored Health Insurance

In the United States and other countries that do not have national health systems, employers often offer health insurance as a benefit to employees. RAND has examined how employer-sponsored health insurance impacts economic and social factors such as entrepreneurs and small businesses, national-level health care costs, industry economic performance, and labor market conditions.

Report

Private Health Plans Pay Hospitals Much More Than What Medicare Would Pay

An examination of U.S. hospital prices covering 25 states shows that in 2017, the prices paid to hospitals for privately insured patients averaged 241 percent of what Medicare would have paid. There was also wide variation in prices among states.

May 9, 2019
News Release

News Release

Private Health Plans Pay Hospitals 241% of What Medicare Would Pay

An examination of U.S. hospital prices covering 25 states shows that in 2017, the prices paid to hospitals for privately insured patients averaged 241% of what Medicare would have paid, with wide variation in prices among states.

May 9, 2019
Journal Article

Association of Reference Pricing with Drug Selection and Spending

Over an 18 month period, reference pricing for drugs was associated with a reduction in employer spending of $1.34 million but an out-of-pocket spending increase of $0.12 million for employees.

Sep 28, 2017
Report

Employers Pay More Than Medicare for Hospital Services in Indiana

Employers paid 3.5 times what Medicare would have paid for the same hospital outpatient services in Indiana — and 2.1 times the Medicare rate for inpatient care. Price transparency nationwide could help employers become better-informed purchasers of health care and stronger advocates for their employees.

Sep 7, 2017
News Release

News Release

Private Payments for Hospital Care in Indiana Are High Relative to Similar Payments Made by Medicare

The prices that large employers pay for hospital care in Indiana are high relative to national norms and are increasing over time relative to the prices that Medicare pays for the same services.

Sep 7, 2017
Multimedia

Drama over Health Care Continues

In this Call with the Experts, RAND senior economist Christine Eibner discusses the Affordable Care Act, what policymakers should consider, and changes that the current administration could make.

Apr 11, 2017
Commentary

Can a Continuous Coverage Requirement Produce a Healthy Insurance Market?

A continuous coverage requirement aims to discourage individuals from waiting until they become sick to buy insurance. This works well in theory. But there is little evidence on how it might work in practice.

Jan 4, 2017
Journal Article

Journal Article

Adverse Selection in Retiree Prescription Drug Plans

Claims data from a large U.S. employer that introduced changes in its medical and drug coverage offerings in 2002 for non-Medicare eligible retirees.

Jun 28, 2016
Report

Private Health Insurance Exchanges: Early Evidence and Implications for the Future

To date, enrollment in the private health insurance exchanges is low, and there is not enough evidence to determine whether they will become prominent in the insurance market and how they will affect employers and their employees.

May 9, 2016
Research Brief

Advancing Complementary and Alternative Medicine Professions: Practitioners Face Many Policy Hurdles to Finding Their Place in Mainstream Medicine

The policy challenges associated with coverage, licensure, scope of practice, institutional privileges, and research may prevent complementary and alternative medicine professionals from practicing to the full extent of their capabilities.

Feb 8, 2016
Journal Article

Policy Options for Providing ACA Subsidies

The ACA provides tax subsidies to qualified individuals for purchasing insurance while retaining tax exemptions for contributions to employer-sponsored insurance premiums. There are several options for leveling the financial playing field between the two markets.

Dec 10, 2015
Commentary

Insurance Enrollment Holds Steady in Advance of the 2016 Open Enrollment Period

Since September 2013, the number of people with health insurance coverage has increased by 16.6 million. But since the second ACA open enrollment period in February 2015, the number of people with coverage has remained relatively flat. The third open enrollment period began on November 1. Whether the number of uninsured will continue to decline remains an open question.

Nov 12, 2015
Commentary

A Tale of Two Deliveries, or an Out-of-Network Problem

Two mothers gave birth within weeks of each other, at the same hospital, using the same employer-sponsored insurance. Both had an epidural. But one received a surprise physician bill for anesthesiology, while the other didn't have to pay a dime. Why?

Nov 4, 2015
Report

Can the Cadillac Tax Be Made Less Regressive by Replacing It with an Exclusion Cap? Methods and Results

Examines the effects of the Affordable Care Act's Cadillac tax versus an alternative tax, based on an exclusion gap, on families in different income ranges.

Oct 8, 2015
Report

Alternatives to the ACA's Affordability Firewall

This report examines policy impacts of the Affordable Care Act's "affordability firewall," which limits subsidies to individuals lacking access to alternative sources of coverage that are "affordable," and investigates two potential modifications.

Oct 5, 2015
Report

Policy Implications of Complementary and Alternative Medicine Definitions

Complementary and alternative medicine (CAM) treats the whole person, but political definitions of CAM have focused only on treatment methods. Policies that impact patient access and care need to consider the full scope of CAM professions.

Oct 2, 2015
Report

Report

Insurance Transitions Following the First ACA Open Enrollment Period

This report examines health insurance transitions between September 2013 and November 2014 using longitudinal data from the RAND Health Reform Opinion Study.

May 6, 2015
Report

Methodology of the RAND Health Reform Opinion Study

This report describes a methodology to track transitions in health insurance enrollment between November 2014 and December 2015.

May 6, 2015
News Release

News Release

Health Coverage Grows Under Affordable Care Act

Insurance coverage has increased across all types of insurance since the major provisions of the federal Affordable Care Act took effect, with a net total of 16.9 million people becoming newly enrolled through February 2015.

May 6, 2015
Commentary

Exchange Tax Credits or Employer Coverage: What's Better for Low-Income Americans?

As the King v. Burwell case approaches, there's likely to be more discussion about potential modifications to the ACA's tax credit structure. Policymakers might consider whether there are opportunities to level the playing field for low-income workers, regardless of whether their employers offer insurance.

Feb 12, 2015

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