In anticipation of the upcoming publication of Susan Channick’s “The ACA, Provider Mergers and Hospital Pricing: Experimenting With Smart, Lower-Cost Health Insurance Options” in the Review, the journal editors recently hosted a panel to discuss the implications of the paper, and cost containment after the Affordable Care Act.
Guests at the panel were Claire Winiarek of Anthem and Professor Jennifer Mellor, director of the Schroedinger Center of Health Policy at William and Mary.
Ms. Winiarek discussed the growth of dual-eligibles, that are those eligible for both Medicare and Medicaid and Anthem’s movement into provider collaboration. This movement is away from fee-for-service methods of payment and towards managed care. Anthem’s also providing administrative and logistic support to assist with collaborative care.
Professor Mellor discussed cost containment efforts in the ACA. Acknowledging that cost containment is a long growing problem due to a knowledge gap amongst technical analysts. She then discussed the influence that prices and incentives have on cost; prices explain up to 40% of cost overruns.
Complete audio from the panel is attached below