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Health Insurance Benefit Design

Journal Article
The Impact of the Affordable Care Act Insurance Expansions on Opioid-Related Emergency Department Visits
We leverage ACA coverage expansions to study the impact of health insurance on opioid-related emergency department visits while accounting for potentially confounding changes in relevant state-level policies.
Oct 27, 2022
Journal Article
Evaluation of Phase II of the Medicare Advantage Value-Based Insurance Design Model Test: First Two Years of Implementation (2020–2021), and Appendixes
This report presents the RAND Corporation team's findings from its evaluation of Phase II of the Medicare Advantage Value-Based Insurance Design model test, for the years 2020 and 2021.
Oct 19, 2022
Journal Article
Projected Coverage and Subsidy Impacts If the American Rescue Plan's Marketplace Provisions Sunset in 2023
An estimated 3 million people currently insured in the individual market would lose coverage and become uninsured if the American Rescue Plan's premium tax credit provisions are not extended beyond 2022.
Mar 29, 2022
Journal Article
Section 1332 Waiver Evaluation Report: Evaluating the Oregon Reinsurance Program
This report documents findings from the evaluation of Oregon's waiver, through which the state implemented the Oregon Reinsurance Program (ORP).
Mar 29, 2022
Journal Article
Section 1332 Waiver Evaluation Report: Evaluating the Minnesota Reinsurance Program
This report documents findings from the evaluation of Minnesota's waiver, through which the state implemented the Minnesota Premium Security Plan.
Mar 29, 2022
Journal Article
Section 1332 Waiver Evaluation Report: Evaluating the Alaska Reinsurance Program
This report documents findings from the evaluation of Alaska's waiver, through which the state implemented the Alaska Reinsurance Program (ARP).
Mar 29, 2022
Journal Article
Do Financial Incentives Affect Utilization for Chronically Ill Medicare Beneficiaries?
We find that Medicare Advantage beneficiaries with chronic conditions respond to changes in copays, although these responses are small. Reductions in copays lead to reduced use of specialists, suggesting that lowering copays could be a way to reduce specialist care.
Mar 4, 2022
Commentary
ACA Subsidies for Higher-Income Families Are Key to Enrolling More Americans
The House Ways and Means Committee has proposed several insurance reforms in its emergency COVID-19 relief package, including increasing subsidizes and extending subsidies to people with higher incomes. The proposed combined approach is a far more efficient means of covering uninsured Americans than enhancing subsidies only for those who are currently eligible.
Mar 1, 2021
Journal Article
Evaluation Report of the First Three Years (2017-2019) of the Medicare Advantage Value-Based Insurance Design Model Test
CMMI contracted with the RAND Corporation to evaluate the first three years of the MA VBID model test. This report serves as our second and final evaluation of the first three years of the model test.
Oct 21, 2020
Journal Article
First Annual Evaluation Report of the Medicare Advantage Value-Based Insurance Design Model Test: 2017, Year 1 of the Intervention
RAND researchers are evaluating a five-year model test to assess whether value-based insurance design can increase use of high-value services, reduce use of avoidable services, improve quality of care, and improve health outcomes and reduce spending.
Oct 21, 2020
Journal Article
Disentangling Moral Hazard and Adverse Selection in Private Health Insurance
This study disentangled the effects of moral hazard from health plan selection. Our estimates imply that 53% of the additional medical spending observed in the most generous plan in our data relative to the least generous is due to adverse selection.
Sep 24, 2020
Report
Types and Costs of Services for Dual Beneficiaries by Medicare Advantage Health Plans: An Environmental Scan
This report identifies the types of services that Medicare Advantage plans implement to meet the needs of dually enrolled and other high-cost, high-need beneficiaries and presents a typology of the services that plans implement.
Apr 12, 2019
Journal Article
Expanding Enrollment Without the Individual Mandate: Options to Bring More People Into the Individual Market
The options analyzed would increase individual market enrollment by 400,000 to 3.2 million in 2020. Net increases in total enrollment (300,000 to 2.4 million) are smaller because of offsetting decreases in employer-sponsored insurance.
Dec 27, 2018
Journal Article
What Is the Impact on Enrollment and Premiums If the Duration of Short-Term Health Insurance Plans Is Increased?
Extending the duration of short-term individual health plans will have little effect on premiums or enrollment in the individual market.
Jun 14, 2018
Journal Article
The Moral Hazard Effects of Consumer Responses to Targeted Cost-sharing
A targeted cost-sharing program implemented by the California Public Employees Retirement System led to an increase in the use of low-price colonoscopy providers.
Dec 7, 2017
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
Modeling the Economic Impact of a California Workers' Compensation Formulary
This report estimates the potential impacts of a California Workers' Compensation formulary in terms of changes in prescription drug use and spending and discusses the potential broader impacts of these changes on the California economy.
Jul 17, 2017
Report
The Benefits and Drawbacks of Alternative Tax Subsidization Approaches for Health Insurance
This report reviews the features of tax-based approaches to subsidizing health insurance, including tax credits and tax deductions, and summarizes their associated benefits and drawbacks.
Jul 13, 2017
Commentary
Ingredients for Health Care Reform
Despite their differences, the Affordable Care Act and the current proposals to replace it take a similar approach to providing health insurance. What might some alternatives look like? And how could they provide coverage to more Americans?
Jul 10, 2017
Q&A
How Would the House Health Care Plan Affect People with Pre-Existing Conditions?
The American Health Care Act would guarantee that individuals with pre-existing conditions could enroll in insurance even if they had a coverage lapse. But there is no guarantee that this coverage would be affordable, and coverage of some essential health benefits could be excluded.
May 28, 2017

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