White Papers
Our work in White Papers
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Improving Bundled Payments in the Medicare Program
John Romley and Paul Ginsburg look at three ways to improve the effectiveness of bundled payment systems.
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Policy Brief: A Novel Strategy for Increasing Access to Hep C Treatment for Medicaid Beneficiaries
A state-level financing strategy could help Medicaid programs provide access to hepatitis C patients while still encouraging future pharmaceutical innovation.
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A Proposal to Enhance Competition and Reform Bidding in the Medicare Advantage Program
Schaeffer Initiative researchers propose two key changes to the MA bidding process to lower prices and enhance choice for consumers.
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Overpaying for Prescription Drugs: The Copay Clawback Phenomenon
In 2013, almost one quarter of filled pharmacy prescriptions (23%) involved a patient copayment that exceeded the average reimbursement paid by the insurer by more than $2.00.
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Prescription Drug Copayment Coupon Landscape
The researchers examined copay coupon availability for the top 200 drugs (by spending) in 2014. Of these, 132 were brand drugs, and 90 of those had coupons available.
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The Global Burden of Medical Innovation
Calculations using publicly available aggregate data suggest that the United States market accounts for 64 to 78 percent of worldwide pharmaceutical profits.
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Reining in Pharmaceutical Costs
The administration and lawmakers should prioritize four actions that could engender more cooperation and improve health over the long term.
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Medicare Advantage: Better Information Tools, Better Beneficiary Choices, Better Competition
Since the 1970s, and codified in the Tax Equity and Fiscal Responsibility Act of 1982, Medicare beneficiaries have had the choice of receiving their Medicare benefits through private health plans instead of the traditional fee-for-service (FFS) Medicare program administered by the federal government. The policy thrust of private plan participation in Medicare is that competition […]
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Taking Stock of Insurer Financial Performance in the Individual Health Insurance Market Through 2017
The Affordable Care Act (ACA) implemented wide-ranging reforms to the individual health insurance market starting in 2014, most importantly by barring insurers from denying coverage or varying premiums based on health status, requiring all plans to cover certain services and provide a basic level of financial protection, providing subsidies to help low- and moderate-income people […]
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A Better Approach to Regulating Provider Network Adequacy
Health care reforms, including those put in place by the Affordable Care Act, are making insurers more competitive. However, in their effort to lower costs, health insurers more often are selling health plans that cover fewer hospitals, and many fewer physicians. This narrowing of provider networks is a sign that market reforms may be improving […]