国家小集团市场改革在准入和提高价值计划特征上的比较快照,1999。

Sudha Xirasagar, Carleen H Stoskopf, William R Shrader, Saundra H Glover
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引用次数: 3

摘要

审查了截至1999年48个州和哥伦比亚特区的小型团体健康保险法规。被认为与市场有一定相关性的改革条款被编入目录,共有74项不同的规定。市场相关性的判断是基于在一家领先的健康保险公司的精算经验。这些法规分为以下几类:(1)改善准入;(二)价格和费率改革;(3)提高覆盖稳定性;(4)完善规划的价值特征。讨论了各州以不同组合方式采用的这些法规的细微差别和多样性。改革方案的复杂性表明需要进行考虑到改革整体的影响研究。过去的研究孤立地评价了选定的重大改革的影响,因此不足以就改革的影响得出明确的结论。
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A comparison snapshot of states' small group market reform on access and enhancing valued plan features, 1999.

Small group health insurance statutes of 48 states and the District of Columbia, as of 1999, were reviewed. Reform provisions judged to have some relevance for the market are catalogued and total 74 distinct regulations. Judgment of market relevance was based on actuarial experience at a leading health insurance company. The regulations are categorized under: (1) Access improvement; (2) Pricing and Rating Reforms; (3) Improving stability of coverage; and (4) Improving valued features of plans. The nuances and variety of these regulations, adopted in various combinations by the states, are discussed. The complexity of the reform scenario suggests the need for impact studies that take into account the totality of reform. Past studies have evaluated the impact of selected major reforms in isolation, and, thus, have been inadequate to provide definitive conclusions on the reforms' impact.

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