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Encounter data standards: Implications for state Medicaid agencies and managed care entities from final Medicaid managed care rule17 May 2016 - By Jeremy Cunningham and Maureen Tressel Lewis and Paul R. Houchens - Article

Encounter data provides the most transparent view of a managed care entity's delivery of healthcare services, but encounter data that is incomplete, missing information, or reported incorrectly can severely limit its effectiveness.

2014 commercial health insurance: Overview of financial results21 March 2016 - By Colin R. Gray and Jason Clarkson and Jill S. Herbold and Paul R. Houchens - Article

The 2014 edition of our annual report on the commercial health insurance market provides an overview of financial results in the individual and group insurance markets as well as focuses on enrollment changes in the individual market and the impact of the Patient Protection and Affordable Care Act of 2010’s (ACA) risk adjustment and risk corridor programs.

Benefits Perspectives: Introduction to shared savings arrangements and ACOs03 September 2015 - By Anders Larson and Paul R. Houchens - Article

This Benefits Perspective provides an introduction to accountable care organizations and shared savings arrangements for employers that sponsor self-funded group health plans.

Expansion of ASD treatment to a Medicaid EPSDT benefit27 May 2015 - By Jeremy Cunningham and Mat DeLillo and Paul R. Houchens - Article

Treatment for autism is now a required Medicaid state plan benefit under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program.

Federal exchange auto-enrollment: Emerging data and new proposals10 February 2015 - By William Gibula and Jason Clarkson and Paul R. Houchens - Article

The U.S. Department of Health and Human Services recently released new information related to federal exchange insurance renewals during the 2015 open enrollment period.

2013 Commercial health insurance: Overview of financial results19 November 2014 - By Colin R. Gray and Jason Clarkson and Paul R. Houchens - Article

An overview of health insurer financial results in 2013 can be found in this report, along with an evaluation of the changes in the health insurance industry's structure and profitability from 2010 to 2013, including changes in the medical loss ratio percentage.

The proposed federal exchange auto-enrollment process: Implications for consumers and insurers28 July 2014 - By Paul R. Houchens and Susan E. Pantely - Article

The auto-enrollment process will affect premiums and may create financial barriers to 2015 coverage.

Benefits Perspectives: Private exchanges: The future for large plan sponsors or a passing fad?12 February 2014 - By Greg J. Herrle and Paul R. Houchens and Troy M. Filipek - Article

Key issues for large plan sponsors that are evaluating a private exchange for their active employees.

2014 federal insurance exchange: Evaluation of insurer participation and consumer choice02 December 2013 - By Jason Clarkson and Michael G. Sturm and Paul R. Houchens - Article

Insurance plan information for the federal individual exchange market and 32 states has been releasedgiving consumers and the health insurance industry the first opportunity to view the landscape of the new exchange market.

2012 Commercial health insurance: Overview of financial results19 November 2013 - By Paul R. Houchens - Article

The individual health insurance market has experienced more significant changes in terms of profitability, claims cost, and administrative expenses relative to the group insurance markets in the years following the enactment of the ACA.

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