Private Markets
In the context of health policy, "private markets" encompasses the activities of private sector entities that finance and deliver health care. Most health care services, even those financed by public programs like Medicare and Medicaid, are provided by private hospitals, physicians, clinics, and other providers that interact in local markets. Private health insurance plans are important players as well. The interactions among plan sponsors (chiefly employers), plans, and providers, along with governmental incentives and constraints, shape access to and the quality and costs of health care services. Governments' interventions in protecting consumers through regulation, providing a health care safety net, and being an insurer are influential as well. States, in particular, play significant roles in regulating insurance, licensing providers, and administering Medicaid and the Children's Health Insurance Program (CHIP).
The Forum's work in this area focused primarily on health insurance design and regulation in the large group, small group, and individual markets; the organization, financing, and delivery of health care services; and the health care workforce. In addition, the Forum has conducted a series of site visits to study market dynamics in local communities.
Strong Providers, Big Prices: A Look at Provider Market Power in Health Care
Forum Session
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February 12, 2016
Show Me the Data! What's at Stake in the SCOTUS Case on Claims from Self-Insured Health Plans?
Forum Session
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February 5, 2016
Site-Neutral Payments for Post-Acute and Ambulatory Care Services: What’s at Stake?
Forum Session
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June 5, 2015
Annual Report 2014
Annual Report
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April 1, 2015
Shifting Sands: Health Center Finances Under Health Reform
Forum Session
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March 20, 2015
Health Policy Essentials: Public Health, Medicaid & CHIP, and Private Insurance
Fundamentals Briefing
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February 13, 2015
Health Policy Essentials 2015
Briefing Book
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February 6, 2015
Health Policy Essentials: Medicare and Health Care Spending
Fundamentals Briefing
—
February 6, 2015
Health Policy Essentials 2015
Briefing Book
—
February 6, 2015
Community Collaboration to Improve Population Health
Forum Session
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January 30, 2015
Bundled Payment in Medicare and Private Insurance: Version 2.0
Forum Session
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December 12, 2014
Private Exchanges: The Next Big Thing in Employer-Sponsored Insurance?
Forum Session
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November 21, 2014
Achieving Health Information Exchange: Vision, Progress, Prospects
Forum Session
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September 12, 2014
Pediatric Dental Coverage in State and Federally Facilitated Exchanges: The 2014 Plan Year Experience
Forum Session
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July 25, 2014
Managing Physician Self-Referral: Recent Evidence and Potential Strategies
Forum Session
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July 18, 2014
Controlling Opioid Drug Excess: Health Plan Interventions
Forum Session
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June 20, 2014
Pioneer ACOs: The Frontier of Delivery System Reform?
Forum Session
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June 13, 2014
Moving Toward Global Payment: Maryland’s New All-Payer Model
Forum Session
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May 30, 2014
Transforming Payment and Health Care Delivery: Early Reports from the State Innovation Model (SIM) Initiative
Forum Session
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April 18, 2014
Telehealth: Into the Mainstream?
Forum Session
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April 11, 2014
Annual Report 2013
Annual Report
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April 1, 2014
Management of Chronic Care Needs: What Will It Really Take to Coordinate Care?
Forum Session
—
March 14, 2014
Telehealth: Into the Mainstream?
Issue Brief
No. 853
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March 10, 2014
Health Care in the Motor City: Thriving or Surviving?
Site Visit
—
February 19–20, 2014
Going Out of Network: Why It Happens, What It Costs, and What Can Be Done
Forum Session
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December 6, 2013
Implementing Pediatric Medical Homes: Challenges of Improving Primary Care for Children
Forum Session
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November 8, 2013
Transforming Behavioral Health Practice, Payment, and Policy: Too Fast, Too Slow, or Just Right?
Forum Session
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September 20, 2013
Patient-Centered Medical Home: Research Results Mixed, Experience Yields Optimism
Forum Session
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September 13, 2013
The Affordable Care Act and HIV/AIDS: Implications for Coverage, Access to Care, and Payment
Forum Session
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July 19, 2013
Hospital Community Health Needs Assessment: An Analytic Approach to Community Benefits
Forum Session
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June 28, 2013
EMS "Hot Spotting": San Diego's Experience Creating a System of Care for Frequent Users of Emergency Medical Services
Forum Session
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June 14, 2013
Can I Get a Break? Hospital Financial Assistance, Billing, and Debt Collection
Forum Session
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April 26, 2013
Projecting Health Care Workforce Needs in an Era of Practice and Technological Change
Forum Session
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April 19, 2013
Rethinking Medicare's Cost Sharing and Supplemental Coverage: Options and Implications
Forum Session
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April 12, 2013
Annual Report 2012
Annual Report
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April 1, 2013
Understanding New Exchange Marketplaces for Health Insurance
Forum Session
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March 1, 2013
Health Policy Essentials: Private Health Insurance
Fundamentals Briefing
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March 1, 2013
The "Coopetition" Model: Caring for San Diego's Low-Income Population
Site Visit
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February 19–20, 2013
Health Policy Essentials: Medicare and Health Care Spending
Fundamentals Briefing
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February 8, 2013
Changes in Latitudes, Changes in Attitudes: FQHCs and Community Clinics in a Reformed Health Care Market
Issue Brief
No. 848
—
December 18, 2012
Spending Trends in Private Insurance and Medicare: Variations on a Theme
Forum Session
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September 28, 2012
Is Health Care Eating Our Lunch? The Impact of Cost Trends on Workers and Retirees
Forum Session
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July 20, 2012
We've Seen the Future: Insights About the Real Dynamics of Marketplace Competition
Small-Group Session
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July 13, 2012
Examining the Condition of the Health Care Safety Net: Time to Re-Cast?
Forum Session
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May 18, 2012
Bundled Payment in Medicare: Promise, Peril, and Practice
Forum Session
—
April 20, 2012
Caesar's Ghost: The Effect of the Rising Rate of C-Sections on Health Care Costs and Quality
Forum Session
—
March 30, 2012
Employers and Today's Health Care Marketplace: Between a Rock and a Hard Place?
Small-Group Session
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March 16, 2012
Beacon Communities: Signaling Success in Health Information Exchange?
Forum Session
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March 2, 2012
Mission Possible II: Reducing Health Care Costs Through Administrative Simplification
Forum Session
—
February 24, 2012
Medicare Supplemental Coverage: Weighing the Consequences and Trade-Offs for Medicare Spending and Beneficiaries
Forum Session
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December 9, 2011
Mission Possible? Saving on Health Care Costs by Reducing Unnecessary Services
Forum Session
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December 2, 2011
Review and Disclosure of Health Insurance Premium Changes: State and Federal Roles After PPACA
Forum Session
—
October 21, 2011
Reengineering Health Care Delivery: What Lies Ahead?
Special Briefing
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October 14, 2011
Individual and Small-Group Market Health Insurance Rate Review and Disclosure: State and Federal Roles After PPACA
Issue Brief
No. 844
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September 28, 2011
Fiscal Pressure and Hospital Financial Position
Forum Session
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July 29, 2011
Tiered Provider Networks: Steps to Cost Containment?
Forum Session
—
June 24, 2011
Rocky Mountain Highs and Lows: Efforts to Improve Health and Reduce Costs in Denver
Site Visit
—
May 31–June 2, 2011
Medicare's Vision of Accountable Care Organizations: Will Providers Have the Same View?
Forum Session
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May 20, 2011
Private Long-Term Care Insurance: Where Is the Market Heading?
Forum Session
—
April 15, 2011
Been There, Done That, Bought the Practice? Why Hospital Employment of Physicians Is Rising Again
Forum Session
—
March 25, 2011
Health Policy Essentials: The Fundamentals of Private Health Insurance
Fundamentals Briefing
—
February 25, 2011
Health Policy Essentials: The Fundamentals of Health Care Spending, Growth, and Managing Costs
Fundamentals Briefing
—
February 18, 2011
Oral Health Update: Ten Years After the Surgeon General’s Report
Forum Session
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January 21, 2011
Self-Insurance and the Potential Effects of Health Reform on the Small-Group Market
Issue Brief
No. 840
—
December 21, 2010
Insurer-Provider Payment Negotiations: Implications for Health Spending
Forum Session
—
December 10, 2010
Transforming Primary Care: Implications for Practice Design and Workforce
Forum Session
—
October 15, 2010
Premium Assistance: An Update
Background Paper
No. 80
—
October 12, 2010
The Cost of Hospital Care
Forum Session
—
October 8, 2010
Focus on Reform: Employer-Sponsored Insurance
Forum Session
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September 17, 2010
Focus on Reform: How a Law Becomes a Reg - Regulatory Processes to Implement Legislation
Forum Session
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July 22, 2010
Tapping the Potential of the Health Care Workforce: Scope-of-Practice and Payment Policies for Advanced Practice Nurses and Physician Assistants
Background Paper
No. 76
—
July 6, 2010
Keeping Health Insurance After a Job Loss: COBRA Continuation Coverage and Subsidies
Issue Brief
No. 837
—
June 24, 2010
Health Care Cost Drivers in Massachusetts: Lessons for Federal Policymakers
Forum Session
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June 21, 2010
Heath Care Spending: Why Is Miami an Outlier?
Site Visit
—
June 2–4, 2010
Focus on Reform: Private Health Insurance Provisions
Forum Session
—
May 14, 2010
Focus on Reform: Medicaid Coverage Expansions
Forum Session
—
May 7, 2010
Recession and Budgets: Where Do States Stand for 2011 and Beyond?
Forum Session
—
April 30, 2010
Transforming Health Care Delivery: Insights from the New Orleans Safety Net
Forum Session
—
April 16, 2010
Not Your Father's Drug Approval Process: FDAAA and the Evolving Pharmaceutical Marketplace
Forum Session
—
March 12, 2010
Assessing and Ensuring Health Plan Provider Network Adequacy
Forum Session
—
February 26, 2010
Health Information Exchange: Building the Infrastructure for Better Care
Forum Session
—
January 14, 2010
Health Care Provider Consolidation and Reform
Forum Session
—
November 13, 2009
Fit for the Job: What Can Workplace Wellness Programs Deliver?
Forum Session
—
November 6, 2009
Prevention and Early Detection of Health Care Fraud, Abuse, and Waste
Forum Session
—
October 30, 2009
Encouraging Cost-Reducing Innovations in Health Care: New Technology Apps, New Business Models
Small-Group Session
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July 17, 2009
Proposals to Reform the Individual Health Insurance Market
Forum Session
—
June 26, 2009
A Health Insurance Exchange: Prototypes and Design Issues
Issue Brief
No. 832
—
June 5, 2009
Underwriting in the Non-Group Health Insurance Market: The Fundamentals
Background Paper
No. 69
—
June 4, 2009
Issues in Health Insurance Reform: Federal/State Regulatory Roles, Subsidy Administration
Small-Group Session
—
May 8, 2009
Show Me the Money: The Implications of Schedule H
Issue Brief
No. 831
—
April 21, 2009
Schedule H: New Community Benefit Reporting Requirements for Hospitals
Background Paper
No. 67
—
April 21, 2009
Issues in Health Insurance Reform: More on Insurance Exchanges
Small-Group Session
—
April 15, 2009
Issues in Health Insurance Reform: Actuarial Equivalence
Small-Group Session
—
April 7, 2009
Issues in Health Insurance Reform: Rating in the Small-Group Market, Merging the Individual and Small-Group Markets, and Risk Adjustment
Small-Group Session
—
March 20, 2009
Issues in Health Insurance Reform: Health Insurance Exchanges
Small-Group Session
—
March 6, 2009
Issues in Health Insurance Reform: The Nuts and Bolts of Rating Rules in the Individual Insurance Market
Small-Group Session
—
February 19, 2009
Medicaid, Employers, and Medigap: Wrapping Around Medicare
Fundamentals Briefing
—
February 6, 2009
The World of Prescription Drugs: Approvals, Pricing, and Purchasing
Fundamentals Briefing
—
January 30, 2009
Glossary of Health Insurance Terms
Tools
—
December 12, 2008
Issues in Health Insurance Reform: Underwriting, Rating, and Regulation in the Individual Market
Small-Group Session
—
December 3, 2008
Preview of RAND Health's COMPARE (Comprehensive Assessment of Reform Efforts) Initiative
Small-Group Session
—
November 21, 2008
A Tale of Three Cities: Local Health Care Markets and Health Care Reform
Forum Session
—
November 14, 2008
Medical Imaging Services: Utilization, Spending, and Appropriateness
Forum Session
—
November 13, 2008
Physician Income and Medical Practice Differences Across Specialties: Should Medicare Care?
Small-Group Session
—
May 2, 2008
Employer Use of Medicare Private Fee-for-Service Plans as a Retiree Health Benefit
Forum Session
—
April 11, 2008
Competition and Collaboration, Chicago-Style
Site Visit
—
March 16–18, 2008
Insurance 101: The Fundamentals of Private Health Insurance
Fundamentals Briefing
—
February 21–22, 2008
Pharmacogenomics: A Primer for Policymakers
Background Paper
—
January 28, 2008
Running Up the Health Care Tab: Will We Have Buyer's Remorse?
Forum Session
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January 17, 2008
Shampoo, Sunscreen, and Strep Tests: The Retail Approach to Primary Care
Forum Session
—
November 9, 2007
Physician Profiling: Can Medicare Paint an Accurate Picture?
Issue Brief
No. 825
—
September 10, 2007
Behavioral Health in the Workplace: How are Employers Managing Mental Health and Disability?
Forum Session
—
July 20, 2007
What Can Physician Profiling Do for Medicare?
Forum Session
—
July 13, 2007
The Fundamentals of Health Savings Accounts and High-Deductible Health Plans
Background Paper
—
April 23, 2007
What Have You Done for Me Lately? Assessing Hospital Community Benefit
Issue Brief
No. 821
—
April 19, 2007
Competition and Collaboration: The Spirit of St. Louis
Site Visit
—
April 3–5, 2007
Health Care Price Transparency and Price Competition
Background Paper
—
March 28, 2007
Specialty-Service Lines: Healthy Competition or Arms Race?
Forum Session
—
September 22, 2006
Canary in the Coal Mine or Crying Wolf? Examining Crowding in America's Emergency Departments
Forum Session
—
July 27, 2006
Don't Bring Me Your Tired, Your Poor: The Crowded State of America's Emergency Departments
Issue Brief
No. 811
—
July 7, 2006
Health Care for All in Massachusetts: Implications for a Changing Safety Net
Forum Session
—
June 20, 2006
“Mental Health: Progress and Pitfalls,” the Health Affairs Special Issue—A Discussion of Trends in Mental Health Services
Forum Session
—
June 14, 2006
Physician Spending Growth: Do We Get What We Pay For?
Forum Session
—
March 17, 2006
Financing Health Care in Retirement: A Day Late and a Dollar Short?
Forum Session
—
February 24, 2006
Health Benefits in Retirement: Set for Extinction?
Background Paper
—
February 8, 2006
Redesigning Practice to Improve Care Delivery (Boston)
Site Visit
—
December 4–6, 2005
The Bean, the Cod and the Medical Establishment: A Boston Market Overview
Special Briefing
—
November 30, 2005
Location, Location, Location: Market Characteristics and Private Payer Health Care Spending
Forum Session
—
September 23, 2005
Containing Health Care Costs for Active Employees: What's New in Health Plan Design?
Forum Session
—
July 28, 2005
Specialty Hospitals: Can General Hospitals Compete?
Issue Brief
No. 804
—
July 13, 2005
Parity Is in the Eye of the Beholder: Evaluation of Mental Health Parity Under the FEHB Program
Forum Session
—
July 8, 2005
Insurance 101: The Fundamentals of Private Health Insurance
Fundamentals Briefing
—
April 22 and May 6, 2005
Health Insurance Coverage for Small Employers
Background Paper
—
April 19, 2005
Fundamentals of Underwriting in the Nongroup Health Insurance Market: Access to Coverage and Options for Reform
Background Paper
—
April 13, 2005
Health Savings Accounts: The Fundamentals
Background Paper
—
April 11, 2005
Cost, Quality, Access: Balancing the Health Policy Triumvirate
Forum Session
—
March 4, 2005
Financing Long-Term Care: Will Insurance Make the Difference?
Forum Session
—
October 22, 2004
Fundamentals of the Prescription Drug Market
Background Paper
—
August 24, 2004
The Promise and the Reality of Long-Term Care Insurance
Background Paper
—
July 31, 2004
The Economics of Prescription Drug Importation
Forum Session
—
June 9, 2004
Consumer Cost Sharing in Private Health Insurance: On the Threshold of Change
Issue Brief
No. 798
—
May 14, 2004
Implementing the Health Coverage Tax Credit Program: Model for the Future?
Forum Session
—
May 7, 2004
Toward Safer, Better, More Accountable Health Care: A Conversation with George Halvorson
Forum Session
—
January 27, 2004
Rural Health Care in the Electronic Age (Danville, PA)
Site Visit
—
November 6–7, 2003
The Medicare Prescription Drug Proposals and Health Insurance Risk
Forum Session
—
September 25, 2003
The Medicare Prescription Drug Proposals and Health Insurance Risk
Issue Brief
No. 793
—
September 4, 2003
The Geography of Medicare: Explaining Differences in Payment and Costs
Forum Session
—
July 30, 2003
Preferred Provider Organizations: Bringing the Mainstream to Medicare?
Forum Session
—
July 9, 2003
The Geography of Medicare: Explaining Differences in Payment and Costs
Issue Brief
No. 792
—
July 3, 2003
Depression in Primary Care: Making Good Care Good Business
Forum Session
—
June 6, 2003
Depression: A Decade of Progress, More to Do
Issue Brief
No. 786
—
November 22, 2002
U.S. Childhood Vaccine Availability: Legal, Regulatory, and Economic Complexities
Issue Brief
No. 785
—
November 15, 2002
Waiting for the Next Vision: Purchasing Health Care in Uncertain Times
Small-Group Session
—
October 11, 2002
Medigap: Prevalence, Premiums, and Opportunities for Reform
Forum Session
—
October 2, 2002
Medigap: Prevalence, Premiums, and Opportunities for Reform
Issue Brief
No. 782
—
September 9, 2002
Expanding Health Coverage for the Uninsured: Fundamentals of the Tax Credit Option
Background Paper
—
August 28, 2002
Managing Advanced Illness: A Quality and Cost Challenge to Medicare, Medicaid, and Private Insurers
Forum Session
—
July 18, 2002
Hatch-Waxman, Generics, and Patents: Balancing Prescription Drug Innovation, Competition, and Affordability
Background Paper
—
June 21, 2002
Managing Advanced Illness: A Quality and Cost Challenge to Medicare, Medicaid, and Private Insurers
Issue Brief
No. 779
—
June 20, 2002
Pharmacy Benefits: New Concepts in Plan Design
Forum Session
—
April 26, 2002
Food and Drug Administration: Center for Biologics Evaluation and Research (Bethesda, Maryland)
Site Visit
—
April 19, 2002
Pharmacy Benefits: New Concepts in Plan Design
Issue Brief
No. 772
—
March 8, 2002
From Diagnosis to Payment: The Dynamics of Coding Systems for Hospital, Physician, and Other Health Services
Background Paper
—
January 25, 2002
Managed Care: As Good As It Gets? (Los Angeles)
Site Visit
—
January 8–11, 2002
Meeting Employees' Information Needs in an Evolving Health Care Marketplace
Background Paper
—
November 2001
Terrorism and Mental Health: Private-Sector Responses and Issues for Policymakers
Forum Session
—
October 23, 2001
Food and Drug Administration, Center for Drug Evaluation and Research
Site Visit
—
October 12, 2001
Pharmacy Benefit Managers: A Model for Medicare?
Issue Brief
No. 765
—
July 9, 2001
Pharmacy Benefit Managers: A Model for Medicare?
Forum Session
—
July 9, 2001
Using Arbitration to Resolve Disputes between Individuals and Health Plans: Issues for Federal Policymakers
Forum Session
—
December 1, 2000
Emerging Issues in the Use of Binding Arbitration to Resolve Disputes between Individuals and Health Plans
Background Paper
—
November 2000
ASPE's Conference on Pharmaceutical Pricing Practices, Utilization, and Costs: A Recap and Some Further Thoughts
Forum Session
—
September 15, 2000
Medicare+Choice: Where to from Here?
Issue Brief
No. 758
—
September 8, 2000
Medicare+Choice: Where to from Here?
Forum Session
—
September 8, 2000
Pharmaceutical Marketplace Dynamics
Issue Brief
No. 755
—
May 31, 2000
Pharmaceutical Marketplace Dynamics
Forum Session
—
May 31, 2000
Hospital-Based Health Care Systems: The Post-BBA Era
Workshop
—
April 27–28, 2000
Site Visit to Seattle — University of Washington Academic Medical Center
Site Visit
—
April 10–11, 2000
Site Visit to Detroit — Henry Ford Health System
Site Visit
—
March 20, 2000
Site Visit to Richmond and Hampton Roads — Bon Secours Health System, Inc.
Site Visit
—
March 16–17, 2000
Beyond Survey Data: Prescription Drugs, Medicare, and Managed Care
Forum Session
—
March 10, 2000
ERISA Health Plan Liability: Examining Models for Reform
Forum Session
—
February 18, 2000
Reshaping AHCs' Role in Biomedical Research
Issue Brief
No. 751
—
January 7, 2000
Reshaping AHCs' Role in Biomedical Research
Forum Session
—
January 7, 2000
ERISA Health Plan Liability: Issues and Options for Reform
Background Paper
—
January 2000
The Public Stake in Biomedical Research: A Policy Perspective
Background Paper
—
November 1999
The ABCs of PBMs
Issue Brief
No. 749
—
October 27, 1999
The ABCs of PBMs
Forum Session
—
October 27, 1999
A Chicken (Nugget?) in Every Pot: What's at Stake in the Budget Debate
Issue Brief
No. 747
—
September 17, 1999
A Chicken (Nugget?) in Every Pot: What's at Stake in the Budget Debate
Forum Session
—
September 17, 1999
Mental Health Coverage Parity: Separating Wheat from Chaff
Issue Brief
No. 745
—
July 20, 1999
Mental Health Coverage Parity: Separating Wheat from Chaff
Forum Session
—
July 20, 1999
HIPAA as a Regulatory Model — Part II: Views from Capitol Hill
Forum Session
—
May 3, 1999
HIPAA as a Regulatory Model: Early Experiences and Future Prospects
Issue Brief
No. 735
—
April 5, 1999
HIPAA as a Regulatory Model: Early Experiences and Future Prospects
Forum Session
—
April 5, 1999
Margins As Measures: Gauging Hospitals' Financial Health
Issue Brief
No. 734
—
March 30, 1999
Margins As Measures: Gauging Hospitals' Financial Health
Forum Session
—
March 30, 1999
Examining the Links between Retirement and Health Insurance: Implications for Medicare Eligibility
Issue Brief
No. 733
—
March 24, 1999
Medicare HMO Pullouts: What Do They Portend for the Future of Medicare+Choice?
Issue Brief
No. 730
—
February 5, 1999
Medicare HMO Pullouts: What Do They Portend for the Future of Medicare+Choice?
Forum Session
—
February 5, 1999
Site Visit to Southern California — Plans and Providers: Risk, Accountability, and Staying Power
Site Visit
—
November 17–20, 1998
Retooling Tax Subsidies for Health Coverage: Old Ideas, New Politics
Issue Brief
No. 728
—
November 12, 1998
Retooling Tax Subsidies for Health Coverage: Old Ideas, New Politics
Forum Session
—
November 12, 1998
Physician Organizations Assuming Risk: Market and Policy Implications
Issue Brief
No. 727
—
November 9, 1998
Physician Organizations Assuming Risk: Market and Policy Implications
Forum Session
—
November 9, 1998
Site Visit to Utah and Nevada — Essential Community Health Services on the Frontier
Site Visit
—
October 27–30, 1998
Protecting the Confidentiality of Health Information
Issue Brief
No. 724
—
September 18, 1998
Protecting the Confidentiality of Health Information
Forum Session
—
September 18, 1998
Protecting the Confidentiality of Health Information
Background Paper
—
July 1998
ERISA Health Plan Denials: Exploring Models for External Review
Issue Brief
No. 720
—
June 19, 1998
ERISA Health Plan Denials: Exploring Models for External Review
Forum Session
—
June 19, 1998
The Federal Employees Health Benefits Program: What Lessons Can It Offer Policymakers?
Issue Brief
No. 715
—
March 12, 1998
The Federal Employees Health Benefits Program: What Lessons Can It Offer Policymakers?
Forum Session
—
March 12, 1998
Site Visit to Northern California — Risk, Accountability, and Staying Power in Next-Generation Managed Care
Site Visit
—
February 18–20, 1998
Preempting State Authority to Regulate Association Plans: Where Might It Take Us?
Forum Session
—
October 15, 1997
Small Group Market Health Insurance Purchasing Cooperatives Revisited
Issue Brief
No. 653
—
July 28, 1994
