Publications (2)4.97 Total impact
Conference Paper: State of the nation's health insurance exchanges[Show abstract] [Hide abstract]
ABSTRACT: Health insurance exchanges, or marketplaces, are a key component of the Affordable Care Act and the places where individuals and small businesses will be able to shop for affordable health coverage. As of February 2013, 17 states and the District of Columbia opted to establish a state-based exchange, 7 states were planning for a partnership exchange, and 26 states defaulted to a federal exchange. The authors will provide an overview of the state of the nation's exchanges, assessing early successes and failures during the open enrollment period and comparing the experiences of state-based exchanges to partnership exchanges and the federal exchange. The author will also examine public opinion in support of exchanges and how that relates to decisions of elected officials. Looking ahead, the author will discuss the opportunities exchanges provide for addressing public health priorities and improving population health, as well as the challenges to successful implementation of these goals.
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ABSTRACT: Safety-net hospitals will continue to play a critical role in the US health care system, as they will need to care for the more than twenty-three million people who are estimated to remain uninsured after the Affordable Care Act is implemented. Yet such hospitals will probably have less federal and state support for uncompensated care. At the same time, safety-net hospitals will need to reposition themselves in the marketplace to compete effectively for newly insured people who will have a choice of providers. We examine how five leading safety-net hospitals have begun preparing for reform. Building upon strong organizational attributes such as health information technology and system integration, the study hospitals' preparations include improving the efficiency and quality of care delivery, retaining current and attracting new patients, and expanding the medical home model.