Research Roundup: Marketplace Enrollment, Medicare Advantage And Surprise Bills
Each week, KHN compiles a selection of recently released health policy studies and briefs.
JAMA Internal Medicine:
Association Between Having An Automatic Reenrollment Option And Reenrollment In The Health Insurance Marketplaces
Of the 11.4 million US health insurance marketplace enrollees in 2019, 3.4 million were automatically reenrolled based on their marketplace coverage in 2018. Marketplace enrollees are automatically reenrolled in their current health plan the following year unless they actively change their enrollment status by discontinuing their coverage or selecting a new plan. Enrollees who actively select a plan have been reported to make better plan choices; however, requiring enrollees to make a plan selection each year may be associated with their becoming uninsured. In January 2019, the Centers for Medicare & Medicaid Services requested public comments on eliminating automatic reenrollment for marketplace enrollees. While evidence suggests that administrative barriers to reenrollment are associated with reductions in Medicaid coverage, it is unknown whether elimination of automatic reenrollment is associated with decreases in reenrollment in the marketplaces. (Drake and Anderson, 9/23)
Are Medicare Advantage Plans Using New Supplemental Benefit Flexibility To Address Enrollees’ Health-Related Social Needs?
Beginning in plan year 2019, the Centers for Medicare & Medicaid Services (CMS) increased flexibility for Medicare Advantage plans to allow them to cover new benefits to help address enrollees’ health-related social needs or long-term care needs. This brief describes interviews with 10 Medicare Advantage plans, Medicare Advantage experts, and social service providers to discuss new benefits added under this flexibility and additional policy changes that may be needed to encourage wider adoption of these optional benefits. We also assess the resources available to provide these new benefits using publicly-available data from CMS. (Skopec, Ramos and Aarons, 9/19)
USC-Brookings Schaeffer Initiative For Health Policy:
California Saw Reduction In Out-Of-Network Care From Affected Specialties After 2017 Surprise Billing Law
While this analysis cannot provide a definitive answer as to the impacts of California’s surprise billing policy, we do observe a modest shift toward claims from in-network service providers across all the affected specialties timed to the law’s implementation, and we do not see similar changes for emergency medicine, which was unaffected by the law. That these shifts toward in-network care are consistent across the affected specialties contradicts CMA’s claim of widespread diminishing network breadth. Moreover, the timing and magnitude of the changes we observe provide some suggestive evidence that California’s law may have reduced the share of services delivered out-of-network by the affected specialties. Notably, such a decline in the frequency of out-of-network care after California’s 2017 law would comport with predictions from economic theory, as the law reduces the rewards to remaining out-of-network. (Adler, Duffy, Ly and Trish, 9/26)
Access To Office-Based Buprenorphine Treatment In Areas With High Rates Of Opioid-Related Mortality: An Audit Study
Improving access to treatment for opioid use disorder is a national priority, but little is known about the barriers encountered by patients seeking buprenorphine-naloxone ("buprenorphine") treatment. ...Many buprenorphine prescribers did not offer new appointments or rapid buprenorphine access to callers reporting active heroin use, particularly those with Medicaid coverage. Nevertheless, wait times were not long, implying that opportunities may exist to increase access by using the existing prescriber workforce. (Beetham, Saloner, Wakeman et. al., 9/23)