Abstract
The state-based and federally facilitated health insurance Marketplaces, or exchanges, enrolled more than eight million people during the first open enrollment period, which ended March 31, 2014. There is significant variation in how states have designed and implemented their Marketplaces. We examined how premiums varied with states' involvement in the Marketplaces through governance, plan management authority, and strategy during the first year that the exchanges have been open. State-based Marketplaces using "clearinghouse" plan management models had significantly lower adjusted average premiums for all plans within each metal level compared to state-based Marketplaces using "active purchaser" models and the federally facilitated and partnership Marketplaces. Clearinghouse management models are those in which all health plans that meet published criteria are accepted. Active purchaser models are those in which states negotiate premiums, provider networks, number of plans, and benefits. Our baseline estimates provide valuable benchmarks for evaluating future performance of states' involvement in governance, plan management, and regulatory authority of the insurance Marketplaces.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 161-169 |
| Number of pages | 9 |
| Journal | Health Affairs |
| Volume | 34 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2015 |
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State-based marketplaces using 'clearinghouse' plan management models are associated with lower premiums. / Krinn, Kelly; Karaca-Mandic, Pinar; Blewett, Lynn A.
In: Health Affairs, Vol. 34, No. 1, 01.01.2015, p. 161-169.Research output: Contribution to journal › Article
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TY - JOUR
T1 - State-based marketplaces using 'clearinghouse' plan management models are associated with lower premiums
AU - Krinn, Kelly
AU - Karaca-Mandic, Pinar
AU - Blewett, Lynn A.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - The state-based and federally facilitated health insurance Marketplaces, or exchanges, enrolled more than eight million people during the first open enrollment period, which ended March 31, 2014. There is significant variation in how states have designed and implemented their Marketplaces. We examined how premiums varied with states' involvement in the Marketplaces through governance, plan management authority, and strategy during the first year that the exchanges have been open. State-based Marketplaces using "clearinghouse" plan management models had significantly lower adjusted average premiums for all plans within each metal level compared to state-based Marketplaces using "active purchaser" models and the federally facilitated and partnership Marketplaces. Clearinghouse management models are those in which all health plans that meet published criteria are accepted. Active purchaser models are those in which states negotiate premiums, provider networks, number of plans, and benefits. Our baseline estimates provide valuable benchmarks for evaluating future performance of states' involvement in governance, plan management, and regulatory authority of the insurance Marketplaces.
AB - The state-based and federally facilitated health insurance Marketplaces, or exchanges, enrolled more than eight million people during the first open enrollment period, which ended March 31, 2014. There is significant variation in how states have designed and implemented their Marketplaces. We examined how premiums varied with states' involvement in the Marketplaces through governance, plan management authority, and strategy during the first year that the exchanges have been open. State-based Marketplaces using "clearinghouse" plan management models had significantly lower adjusted average premiums for all plans within each metal level compared to state-based Marketplaces using "active purchaser" models and the federally facilitated and partnership Marketplaces. Clearinghouse management models are those in which all health plans that meet published criteria are accepted. Active purchaser models are those in which states negotiate premiums, provider networks, number of plans, and benefits. Our baseline estimates provide valuable benchmarks for evaluating future performance of states' involvement in governance, plan management, and regulatory authority of the insurance Marketplaces.
UR - http://www.scopus.com/inward/record.url?scp=84920879726&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84920879726&partnerID=8YFLogxK
U2 - 10.1377/hlthaff.2014.0627
DO - 10.1377/hlthaff.2014.0627
M3 - Article
C2 - 25520299
AN - SCOPUS:84920879726
VL - 34
SP - 161
EP - 169
JO - Health Affairs
JF - Health Affairs
SN - 0278-2715
IS - 1
ER -