Paragon Health Institute

🚨 It's not just the prices: #ACA plans have declined in quality over the last decade 🚨 Paragon's NEW paper examines the value of ACA plans, declining patient access and causes of #NarrowNetworks. READ more from Daniel Cruz & Greg Fann ⬇ https://lnkd.in/gshdPVra We identify 3 characteristics to define value and influence in #ACA participation: -Quality of provider networks -Cost-sharing -Premiums The value of health insurance products declined across these characteristics and resulted in the #ACA exchange offering lower quality plans over time when compared to Employer Sponsored Insurance (#ESI). This finding is supported by our identified characteristics: Provider networks 👨⚕️ 🏥 [Figure 3] : The percentage of individual market consumers enrolled in plans with broad provider networks declined from 36% to 11% between 2014 and 2023. An increasing share of individual market enrollees are in #Medicaid-managed-care-like (#MCO) plans. Cost-sharing 💵 [Figure 4]: As overall premiums have risen, middle-income exchange enrollees with incomes above 200% of the federal poverty level were much more likely to choose a bronze plan in 2023 (54%) than they were a decade ago (33%). Premiums 💳 : Individual market premiums have increased 50% more than employer plan premiums over the past decade. Why did this happen? 1. #ACA insurance rules have caused premiums to increase and led insurers to offer narrower and more restrictive networks over time. 2. ACA premium tax credits (#ACAPTC) have incentivized enrollees to select lower-quality plans. 3. The ACA #riskadjustment program is overcompensating insurers for lower-income enrollees who enroll in silver plans, causing significant price competition for these plans and a race to the bottom in plan quality. 4. Variance in state enforcement of #ACA rating rules further distorts and complicates plan offerings and consumer selections. While the #ACA has resulted in lower quality product offerings to date, this should be seen as a natural consequence of the current blend of the ACA regulatory environment, premium subsidy structure, risk adjustment flaws, and uneven regulatory enforcement. See below of Paragon's solutions!

📺Paragon's Brian Blase, in his recent Voice of America feature, emphasizes the importance of ACA reforms to better serve individuals. Watch Blase's appearance here⬇️ https://lnkd.in/e6hPbbfb

📙Paragon glossary term of the week: Site Neutrality Check out our glossary resource and our word OTW here⬇️ https://lnkd.in/eKZeKgGW

🚨 NEW #ParagonPIC 🚨 #ACA individual market enrollment has drastically shifted toward plans, particularly #HMOs, that include fewer providers and facilities in their networks. https://lnkd.in/eh_7Y3TE In 2014, 50% of individual market consumers were in #PPO and point-of-service (POS) plans. By 2023, that percentage had declined to 17%. In 2023, 83% of enrollees were in the more restrictive #HMO or exclusive provider organizations (#EPO). This week’s #ParagonPic, from a forthcoming Paragon research paper, maps the market share by type of network from 2014 to 2023, illustrating that individual market enrollment has shifted toward plans that include fewer providers and facilities in their networks.

What does VP Harris's #MedicareForAll mean for America's future? $44 trillion in new spending, elimination of private insurance, and more. Read the deep dive by Stephen Parente and Paragon's Theo Merkel in National Review. ⬇️ https://lnkd.in/dC56awYb

🚀During our recent virtual discussion, Mark Sendak dove into the promise and real-world success of AI in health care. Watch the full recording of the discussion here ⬇️ https://lnkd.in/eSiRj2tJ

Finalizing plans for HLTH USA in October? Make sure to stay through Wednesday morning and join us at the Policy Summit! I'm looking forward to moderating a bipartisan and business panel exploring the potential impact of our national elections on the future of healthcare with Vituity's Theo Koury, MD, The Center for American Progress' Natasha M. and the Paragon Health Institute's Theo Merkel. Join us 10/23 from 9:35 - 10:20. The Policy Summit: The 2024's Election Impact on the Future of Healthcare

🎥 In our recent discussion, Mark Sendak highlights a crucial point: the current healthcare payment structures fail to translate automation into consumer savings. Watch the full event recording here⬇️ https://lnkd.in/eSiRj2tJ

Paragon's Stephen Moses breaks down how Medicaid's flawed system is the root cause of subpar care in McKnight's Long-Term Care News. Read here⬇️ https://lnkd.in/eU9367xy